- Upper eyelids
- Lower eyelids
- Lower eyelids II
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Eyelid surgery tutorial >> Upper eyelids >> page 3
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Now let's take a look
at the operative procedure. The excess skin to
be removed is marked with a skin marker (which is what surgeons call a
felt-tipped pen).
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The lower edge of the incision (yellow line) is placed approximately where we
want to see the upper eyelid crease. That upper eyelid crease
naturally sits a little farther from the eyelashes in the central portion of the
upper eyelid
than it does in the lateral portions of the lid, so the central red line on the
diagram is longer than the other
two red lines. This lower incision (still in yellow) is marked a bit closer to the
eyelashes than the position where we want the crease to be after healing is
complete: the eyelid skin will stretch because of the tension on it after
surgery, and the distance along those red lines will increase by a millimeter or
two.
Out to the side, we blend the incision parallel to the crow's feet, so it will hide well (light blue line). |
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The location of the
upper limb of the incision (purple line) is determined by the amount of excess skin
that is planned for removal. With the patient upright and her face in
repose, I gently tease and pull on the skin with a forceps, and determine
how much skin can safely be removed. I don't want to remove so much skin that
the patient can't close her eyes after surgery, but I want to make as much
improvement as I can.
Also, we don't want to approach the eyebrows too closely with our skin excision: we don't want the green line in the diagram, the distance from the upper limb of the incision to the eyebrow, to be too small. Look at the picture below. After healing is complete, that green line length will be the distance from the upper eyelid crease to the bottom of the eyebrow. Young-appearing eyes have a substantial distance between the crease and the eyebrow, so we must respect that distance. |
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The horizontal black lines
highlight the large distance between the upper eyelid crease and the bottom of
the eyebrow in young eyes.
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Clear all red checks in the Eyelid Surgery Tutorial |
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