How Do Standard and Revision Blepharoplasty Surgery Differ?

Blepharoplasty, commonly referred to as eyelid surgery performed to make the eyes look more youthful or bigger. The first performed eyelid surgery is the standard blepharoplasty. If its results don’t show up as hoped or there are complications, a revision of blepharoplasty is undertaken. In this article, you can learn what both standard and revision blepharoplasty surgeries entail, why they are performed, and which one is more complex and challenging to perform. Keep reading and make a well-informed decision before going for blepharoplasty surgery in Bangalore.

Standard Vs Revision Blepharoplasty: The Key Differences

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• The Meaning and Purpose

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A standard blepharoplasty is a primary, cosmetic eyelid surgery to get rid of extra eyelid skin and fat and rejuvenate the eyes for the first time. It is done to eliminate the under-eye bags, bulging fat pads, and drooping upper eyelid, and even strengthen the eyelid muscles. As it fixes sagging upper eyelids, it can also help clear the peripheral vision field.

A revision blepharoplasty is a secondary, cosmetic or functional eyelid surgery to correct problems raised by a previous blepharoplasty. It includes fixing of unappealing/ non-satisfactory results; functional problems like ptosis that impairs peripheral vision; prominent scarring; over- or under correction of eyelid appearance; and inward (entropion)/outward (ectropion) turning of lower eyelid- in short, everything caused or failed to be corrected by previous eyelid surgery! It aims to make patients satisfied with their surgery outcomes.

• The Techniques/Types

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A standard blepharoplasty is of the following types:

1. 1. Upper blepharoplasty- It involves the removal of the surplus skin and fat, sometimes muscle, from the upper eyelids through an 8-10 mm incision created within the upper eyelid crease and then using suture to close the incision.

2. 2. Lower blepharoplasty- A traditional approach is the subciliary incision (cut made below the eyelash line) for removal of extra skin, fat, and sometimes muscle from the lower eyelid. It helps address hanging or uneven lower eyelids. For correction of only puffy under-eye bags, the procedure involves creation of a transconjunctival incision (a cut made inside the lower eyelid) and elimination and redistribution of excess fat. The incision is sutured closed.

3. 3. Double blepharoplasty- For cases where there is an absence of natural crease in the eyelid, this approach is beneficial in making eyes look open, youthful, and appealing. The procedure involves making an incision in the upper eyelid for the removal of extra skin and fat, followed by the creation or repositioning of the existing eyelid fold and incision closure with stitches.

4. 4. A revision blepharoplasty is of the following types:

   Corrective blepharoplasty- It involves the removal and even repositioning of extra eyelid skin and fat, as well as the muscles of the eyelids, to address cosmetic concerns or complications that have resulted from a standard blepharoplasty.

   Scar revision- It involves reducing the prominence of the scars left behind by the previous eyelid surgery by removal or re-orientation of scar tissue. It focuses on the restoration of a more natural eyelid contour.

****  Lower blepharoplasty repair- This is carried out when the previous lower eyelid surgery has caused retraction or displacement of the lower eyelid. The malposition or dropping of the lower eyelids is fixed by adjusting the eyelid muscles. For restoring eyelid volume and contour, autologous fat transfer/grafting is done. However, fillers can work in some cases. Lastly, to address eyelid displacement, support is provided by a skin graft.

Ptosis repair- Ptosis is the impact on vision caused by sagging upper eyelids. In a revision eyelid surgery, the upper eyelid muscles are tightened or repositioned to control the upper eyelid movement and lift the upper eyelid. It’s done when ptosis fails to be addressed by standard upper blepharoplasty.

• The Complexity

A standard blepharoplasty is the first-time correction of eyelids and so easier to perform. However, a revision of blepharoplasty is more complex. As the standard blepharoplasty alters the natural anatomy of eyelids, the desired results are harder to achieve. With a highly skilled and experienced plastic surgeon, the complex eyelid surgery can be successful.

• The Challenges

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A standard blepharoplasty process goes smoothly when executed by an experienced, expert surgeon on a suitable candidate. But a revision of blepharoplasty has some challenges to face, like scarring, less blood supply to the delicate tissues of the eyelid, and misshapen anatomical structures resulting from standard blepharoplasty. 

To Sum Up

Fixing the existing state of upper and/or lower eyelids is possible with either standard or revision blepharoplasty. The approach chosen depends on whether it’s one’s first-time investment or not in eyelid surgery and the current concerns with the eyelid.

To get your eyelid repaired quickly and correctly without straining your budget, schedule a consultation with Dr. Sandhya Bala, the best plastic surgeon in Bangalore and start your journey with this procedure.