Armando Boccieri - Gobba Nasale

Blepharoplasty is a surgical operation designed to give a younger appearance through the removal of surplus skin, fat, and muscle from one or both eyelids.

A cutaneous surplus builds up over time due to the great mobility required of the skin in this area and normal aging. Gravity also plays an important part, of course, in determining this type of blemish. Weakening of the orbicular muscle of the eyelids and septum is instead responsible for the protrusion of periocular fat and the appearance of bags under the eyes.

The patient’s situation is analyzed on the basis of photographs taken in particular poses and conditions of light. For example, upward rotation of the ocular globe makes it possible to display the adipose bags of the lower eyelids very clearly.

The upper scar is completely hidden, as it runs along the palpebral fold, and the lower is practically invisible, as it is situated along the palpebral margin a few millimetres away from the ciliar border. In blepharoplasty too, it is important not to overdo the removal of tissue in order to avoid complications and obtain a safe and natural result.

The operation is generally performed under local anaesthetic with vasoconstrictor. The presence of an anaesthetist is useful, however, in order to make sure that the patient is suitably sedated and feels no discomfort from the injection into the eyelid or other causes.

Upper-eyelid blepharoplasty can easily be combined with rhinoplasty so as to take advantage of one general anaesthetic with no particular added discomfort for the patient.

As regards the postoperative period, a certain degree of palpebral swelling is present for the first 2–3 days but then moves down towards the cheek before disappearing. The bruising caused by the operation is highly variable in degree, being indeed completely absent in some cases, but in any case generally lasts no longer than 10–15 days.

It proves useful to place packs of ice cubes wrapped in cellophane on the eyelids, covered with gauze or cotton, immediately after the operation in order to reduce swelling and bruising. Their use can be continued for as long as a few hours with intervals of ten minutes every hour. It is also advisable to sleep with the head upright in the period after the operation so as to facilitate the gradual downward movement of oedemas. The patient should be informed that the occasional drop of blood and serum is normal for the first 12–24 hours and that the eyelids may not close completely due to their swelling and the paresis of some muscles as a result of the anaesthetic. The stitches are removed after 3–4 days and it is advisable to wear sunglasses in this period.


This 40-year-old patient complained of always looking tired and prematurely old due to an excess of skin on the upper eyelids.




Upper-eyelid blepharoplasty succeeded to revealing the beauty of the patient’s eyes once again and giving her a younger and more intense expression.


Patient aged 45 suffering from dermatochalasis (baggy skin) of the upper eyelids with bags of adipose tissue on the lower eyelidste.






Blepharoplasty on the upper and lower eyelids made it possible to restore the upper palpebral fold and eliminate the bags below. In overall terms, the operation gave the patient an altogether younger appearance and livelier expression.

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