Eyelid Surgery in Malaysia

This is my website for eyelid surgery. The site contains the clinic and hospital addresses where I operate. It also has a new message board where you may post any questions without having to register.

 

 

Evolution of the Lower Lid Surgery VI

The picture above shows a patient with eyebags and prominent tear troughs.  

If only the fat is removed, the tear troughs can become accentuated

and give the eyes a hollow look. The patient below had had

transconjunctival (behind the eyelids) fat removal

and has a hollow look and prominent tear troughs.

 

 

The previous post mentioned the use of fillers to treat eyebags and tear troughs. However, the procedure is not permanent and would not be suitable for all patients. Some patients are unhappy after the injection because the lower eyelids will appear more swollen than before even though the unevenness is smoothed out.

 

For patients with eyebags and tear troughs who wish to have more lasting results, fat repositioning over the tear trough can achieve good results. In this procedure, the fat is only minimally removed and the remaining is sutured over the tear troughs.

 

Diagrams showing how the fat is being repositioned.

A patient undergoing fat respositioning (A). The area over the tear trough

is exposed and the fat is sutured to the area to obliterate

 the tear trough (B and C).

Appearance at one day (D) and at two weeks (E). 

 

Fat repositioning

Before (picture above )and 4 weeks after the operation (picture below).

 

Fat repositioning.  

Before (picture above )and 6 weeks after the operation (picture below).

Fat repositioning and double eyelid surgery.

Before (picture above )and 3 weeks after the operation (picture below).

 

Fat repositioning and upper blepharoplasty.

Before (picture above )and 2 weeks after the operation (picture below).

 

Fat repositioning and removal of excess upper eyelid skin.

Before (picture above )and 3 weeks after the operation (picture below).

 

 

 

 

 

 

Evolution of the Lower Lid Surgery V

There are two main ways of addressing the tear troughs. The non-surgical and surgical ways. The non-surgical ways involve the injection of substances (fillers) into the groove to pump up the depression. The substances used may be fat or hyaluronic acid (such as restylane). It is important to seek qualified doctors for such injections as some unscrupulous personnel are known to inject silicone in beauty centres resulting in disfigurement for the patients.

 

Patient undergoing hyaluronic injection for the tear troughs.

The picture below show the immediate effect of the injection.

This patient complains of swollen lower eyelids one year after silicone injection.

Unlike fat or hyaluronic acid, silicone is not absorbed by the body and

very often causes tissue swelling and hardness due to inflammation.

The inflammation occurs slowly but relentlessly.

Click here for more blotched tear trough treatments.

Injection of fillers can reduce or smooth out the tear troughs and make the face appear youthful. Unfortunately, the results are not lasting as the body will absorb the fillers and further injections will be needed usually after one year.

Public Talk in Sibu RH Hotel at 7pm on the 13th of July, 2013

Oral Scientific Presentation in the British OculoPlastic Surgery Society - BOPSS in Bristol June 2013

 

 

 

Talk on Eyelid Surgery in Penang this Weekend (29th June 2013) in Mandarin

Evolution of the Lower Lid Surgery IV

In some patients, the age-related changes include a deepening of the fold running along the orbital rim. This is known as the nasojugal fold or commonly called the tear trough (from the observation that tears will track along this groove). This structure creates a tired look. In addition, the shadow produced by this structure gives the appearance of dark circle.

 

Nasojugal folds or tear troughs (arrowed).

 

Anatomically, the tear trough corresponds to the attachment between the orbicularis muscle (the muscle that closes the eyes) and the underlying orbital rim and the midface.

 

Side view of tear trough and the corresponding structure.

Front view of tear trough and the corresponding structure.

 

Surgically, the tear trough is difficult to treat using the traditional method of lower blepharoplasty in which only fat is removed. Furthermore, excessive fat removal can make the tear trough more prominent.

 

Patient without prominent tear trough, traditional

lower blepharoplasty gives good aesthetic result.

 

Patient with obvious tear trough, traditional lower blepharoplasty

does not remove the lines which resemble dark circle.