«It is imperative to see a specialist about anything related to the eyelid»

Dr José Nieto, an ophthalmologist specialised in ocular plastic surgery at the Institut de la Màcula, explains the importance of addressing problems in the eye area.

Ocular Plastic Surgery has made a great improvement to the diagnosis and treatment of diseases that affect the periocular area and one of the most requested procedures is blepharoplasty. What is it and when should it be carried out?
Blepharoplasty is a surgical procedure with the aim of rejuvenating the eyelids by reshaping the periocular tissues (eyelids, the area around the eyes and tear ducts). This operation is mainly carried out for aesthetic reasons, but in some cases, it is carried out for visual reasons (functional blepharoplasty), given that sagging of the upper eyelid skin can cause a reduction of the visual field.

What improvements have been made in this type of surgery?
Improvements in surgical technology in this type of surgery allow us to work in great detail on the eyelid skin. The skin is thinner on the eyes than the rest of the face and it is the first area that shows the effects of ageing. These operations require the greatest level of precision and the results are very good.

Many people come to you to hide signs of ageing. When is this advisable? How can they get the best diagnosis?
Excess skin on the upper eyelids can appear from 35 years of age, although in some cases there are patients who have a “full” eyelid much younger. The same thing happens with bags on the lower eyelids. A medical diagnosis and the recommendation of having surgery results from multiple factors that the specialists evaluate and discuss with the patient so that they have the best information available.

More and more, men and women are seeking this type of surgery. Are there differences between requests according to sex or age?
This type of operation does not affect men more than women. It is a pathology that, from a certain age and due to some genetic characteristics, affects a wide range of people in our society. There are many people who opt for blepharoplasty for aesthetic reasons or visual health. In all cases, we aim for a quick recovery with minimally invasive surgery, and which gives the patient the solution they are looking for when they come to the Institut de la Màcula.

Is there a high percentage of patients who ask for corrections of treatments carried out in non-specialised beauty treatment centres?  
Sadly, it is common for us to treat patients who need correction of previous blepharoplasty surgeries. Often conditions relating to the eyelids are not carefully considered and all too often, surgery performed by surgeons who are not experts in the field change the natural appearance of the eye and/or cause damage to the eyelids with significant visual side effects (inability to close the eyes, dry eyes, blurred vision, etc.). It is imperative to see a specialist about anything linked to the eyelid.

Eyelid surgery often creates insecurity about the possibility of having to spend days with covered eyes, the inability to read…
Patients should have no problem reading from the day after the operation. They may experience dryness in their eyes during the first few days, which can be treated with eye drops. The operation is quick and the eyes are never covered after the surgery, given that it is important that the patient can apply a cold pack from the first few hours.  Patients return to normal life the day after surgery.

Is there any way to prevent the conditions treated by ocular plastic surgery?br/>There are measures to treat conditions such as blepharitis (inflammation of the edge of the eyelid), but to determine the appropriate treatment is essential to visit an ophthalmologist so that they can effectively diagnose this condition. Keeping the edges of the eyelids clean and removing the small crusts that form hinders the growth of bacteria and helps to improve the functioning of the eyelids’ sebaceous glands.

Are there any common symptoms?
Yes, the symptoms of blepharitis are common to all patients, although it depends on how severely they develop. Sometimes it is just slight discomfort creating a slight irritation, whereas in other cases it is a more serious illness that may even affect their vision. The symptoms can vary: inflammation and redness of the eyelids, crusts on the base of the eyelashes, watering eyes, burning or discomfort, eye strain, sensitivity to light, blurred vision, ...

What are the most request treatments/procedures?
All treatments relating to the eyelid. Upper and lower blepharoplasty, correction of a previous blepharoplasty procedure, correction of the sagging eyelids...