Eyes are the mirror to the world.
Indeed and eyes speak so much about the face of a person.
They give out the inner emotions of the person, even when the person is trying to be someone else.
And unfortunately they convey the age of a person, even if that person does not feel that old.
Very early age related changes are easily visible in both the upper as well as the lower eyelid.
An aging lower eyelid with its hanging fat bags gives the feeling that the person is actually older than he is.
in addition the tear trough deformity that is often present (the hollow crease present below the eyes), further aggravates the situation.
It is possible surgically to correct this to a large extent, in a process known as blepharoplasty or eyelid rejuvenation surgery.
Causation of the "aging eyelids" The skin of the lids tends to sag as a result of aging.
Further the fat bags which are present over the eyeballs tend to come out of their natural position, and get more visible.
In some persons, the eyebrow also tends to sag down, and it is important to hitch the eyebrows as well as correct the eyelid problem.
Treatment The surgery can be done under local anesthesia in most patients.
This involves an injection containing local anesthesia in the skin of the eyelids.
The skin incision is just under the eyelashes, and the scar is easily hidden in the lines of the lids, and no evidence remains of the surgery.
There is also the approach where the incision is done through the conjunctiva, known as trans-conjunctival blepharoplasty.
Then the excess skin over the eyelid and protruding fat bags are removed, to leave behind a younger looking eyelid, and the "sad" look is not present anymore.
The fat bags can also be used to cover the tear trough, and reduce the hollowness that is present under the eyes.
This procedure has been popularised by Dr Ruth Graf in Brazil, under whom the author has trained.
Possible problems The skin over the eyelids is very thin, hence there is easily some swelling that comes there.
This can take between 3-6 weeks to disappear.
Thus the patient must know, that he/ she will need to wear glasses if they have to go back to work in this period.
Some conjunctival inflammation can be there, particularly with the trans-conjunctival approach.
If the patient is hypertensive, it is mandatory that this is controlled well before surgery.
If there is the use of aspirin or similar drugs, they need to be stopped at least 7 days before surgery, otherwise there is a greater chance of bleeding.