Blépharoplastie

Qu'est-ce que la blépharoplastie ?

La blépharoplastie, également appelée lifting des paupières, est une chirurgie esthétique du visage qui vise à améliorer l'apparence des paupières en retirant l'excès de peau et de graisse des paupières. La blépharoplastie consiste pour le chirurgien à inciser les plis des paupières afin de couper la peau relâchée et d'enlever l'excès de graisse.

 

Pourquoi procède-t-on à une blépharoplastie ?

 

Outre le vieillissement, un relâchement important de la peau autour des yeux peut réduire la vision périphérique, en particulier les parties supérieures et extérieures du champ visuel. La blépharoplastie peut réduire ou éliminer les problèmes de vision causés par l'excès de peau. En outre, la blépharoplastie donne aux paupières une apparence esthétiquement agréable qui peut faire paraître le patient plus jeune et plus alerte.

 

Quelles sont les conditions pour une blépharoplastie ?

 

La blépharoplastie est recommandée aux patients suivants :

 

  • Excès de peau masquant le pli naturel des paupières supérieures.
  • Une peau des paupières supérieures relâchée qui gêne la vision.
  • Des paupières supérieures bouffies qui donnent aux yeux un air fatigué et triste.
  • Des poches et des cernes sous les yeux.

 

Le patient doit également être en mesure de subir une anesthésie générale en toute sécurité et ne doit pas avoir de problèmes de santé susceptibles d'entraver la cicatrisation ou d'augmenter les risques de l'opération.

 

Quels sont les différents types de blépharoplastie ?

 

Il existe deux types de blépharoplastie, qui peuvent être pratiqués séparément ou en même temps.

 

  • La blépharoplastie supérieure consiste à retirer l'excès de graisse, de muscle et de peau de la paupière supérieure, ce qui atténue l'aspect tombant, lourd et encapuchonné des yeux.
  • La blépharoplastie inférieure consiste à éliminer les dépôts de graisse, les muscles et la peau excédentaires de la paupière inférieure, ce qui atténue les rides, les cernes, les bouffissures et les poches sous les yeux. Elle permet également de repositionner et de resserrer la paupière afin de créer une transition bien dessinée entre la paupière inférieure et le milieu du visage.
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Quels sont les éléments à prendre en compte avant une blépharoplastie ?

 

Avant la blépharoplastie :

 

  • Les patients doivent éviter les médicaments contenant de l'aspirine ou de l'ibuprofène (Advil, Motrin IB, autres) pendant les deux semaines précédant l'opération. Ces médicaments peuvent augmenter le risque d'hémorragie interne. Les patients doivent confirmer chaque médicament et complément qu'ils souhaitent prendre avec leur coordinateur de patients.
  • Les patients doivent arrêter de prendre des multivitamines 7 jours avant l'opération, et si elles contiennent de la vitamine K, elles ne doivent pas être utilisées pendant les 30 jours suivant l'opération.
  • Les patients doivent arrêter de prendre des contraceptifs oraux 30 jours avant l'intervention chirurgicale.
  • S'abstenir de fumer deux semaines avant l'intervention chirurgicale. Car la nicotine et la fumée de tabac retardent la cicatrisation et peuvent entraîner des cicatrices.
  • Les patients doivent éviter les coups de soleil pendant les deux semaines précédant l'opération. Portez un indice de protection 50 tous les jours si possible.
  • Les patients ne doivent rien manger ni boire, y compris de l'eau, après minuit la veille de l'intervention.

Comment la blépharoplastie est-elle pratiquée ?

 

La blépharoplastie peut être pratiquée sur les paupières supérieures, les paupières inférieures ou les deux. Sur la base d'une évaluation préopératoire de nombreux facteurs, tels que la structure musculaire faciale sous-jacente du patient, la structure osseuse et la symétrie des sourcils, le chirurgien plasticien décidera de la quantité de peau, de muscle et de graisse à retirer. Le chirurgien plasticien éliminera les poches sous les paupières inférieures et les cernes sur les paupières supérieures, ce qui permettra au patient de paraître plus jeune et en meilleure santé.

 

  • Blépharoplastie supérieure : Au cours de l'intervention, une incision est pratiquée dans le pli de la paupière supérieure. Également connue sous le nom de lifting des paupières supérieures, la blépharoplastie supérieure aide les patients à paraître plus reposés, plus alertes et plus jeunes.
  • Blépharoplastie inférieure : Une blépharoplastie inférieure nécessite une petite incision le long des paupières inférieures, soit à l'extérieur de la ligne des cils, soit à l'intérieur de chaque paupière, afin d'accéder à la zone située sous chaque œil. L'excès de tissu et les dépôts de graisse sont ensuite retirés ou repositionnés pour rajeunir et rafraîchir l'apparence des yeux.

 

Les cicatrices éventuelles de la blépharoplastie seront cachées dans les plis naturels des paupières, ce qui les rendra presque invisibles.

 

Quels sont les éléments à prendre en compte après une blépharoplastie ?

 

Après l'opération, il est recommandé aux patients de suivre les recommandations suivantes :

  • Éviter les efforts, le port de charges lourdes, la natation et les activités intenses, telles que l'aérobic et le jogging, pendant dix à quatorze jours. Plus précisément, le patient doit éviter les activités dans lesquelles il doit bouger la tête brusquement ou qui augmentent la pression sanguine dans la tête. Cette restriction inclut, sans s'y limiter, le fait de se pencher, ce qui a pour effet de placer la tête plus bas que le cœur, et de soulever des objets suffisamment lourds pour provoquer un effort. Cette restriction peut s'appliquer pendant trois à quatre semaines.
  • Faire des siestes fréquentes et éviter les activités susceptibles d'assécher les yeux, notamment lire, regarder la télévision, porter des lentilles et utiliser un ordinateur.

 

Le patient peut ressentir un larmoiement excessif, une sensibilité à la lumière et une vision double juste après l'opération. Les incisions seront rouges et visibles au début, et les paupières peuvent être gonflées et engourdies pendant plusieurs jours. Le gonflement et les ecchymoses, semblables à des "yeux noirs", dureront probablement une semaine ou plus.

 

Le chirurgien plasticien retirera les points de suture entre deux et sept jours après l'opération des paupières. Le patient se sentira suffisamment bien pour reprendre ses activités normales vers le dixième jour de convalescence.

 

Quels sont les risques de la blépharoplastie ?

  • Une vision temporairement floue ou double
  • Yeux asymétriques
  • Hématome
  • Cicatrice visible
  • Saignement excessif
  • Développement d'un caillot de sang dans une veine
  • Infection
  • Une réaction allergique à l'anesthésique

Dans de rares cas, la blépharoplastie peut entraîner des problèmes graves.

 

  • Blessures des muscles de l'œil
  • La paupière inférieure s'affaisse loin de l'œil et se tourne vers l'extérieur.
  • Rétraction de la paupière
  • Déficience visuelle

 

La déficience visuelle est extrêmement rare et la vision s'améliore généralement à long terme.

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