eyelid surgery

BB Eyes Series

“BB eyes” stands for Bigger and Brighter eyes. This is a series of customized cosmetic eyelid surgeries created by oculoplastic surgeon Dr Alice Goh. As she believes that no two eyes are the same, each eyelid design is customized to cater for the needs of different individuals.

1. BB Double Eyelid (Suture Method)

This is a safe and lasting double eyelid procedure invented by Dr Alice Goh to create a natural eyelid crease. This method is safe and uses high quality suture material to create the double eyelid. It is performed under strict hygienic clean procedure room and sterilized instruments. The double eyelid procedure alone takes approximately 30 mins. However, additional time required if more procedures are done at the same time.

The conventional double eyelid formation rely almost solely on the suture to create the eyelid crease. Over time, the tensile strength of the suture reduces and therefore the force of keeping the eyelid crease is also compromised. She believes that BB Double Eyelid technique will last longer because of an additional step which create tissue adhesion to reinforce the lid crease formation. Therefore, as time passes when the tensile strength of the suture reduces, the tissue adhesion will continue to hold the lid crease formation.

The 10 advantages of BB Double Eyelid Suture Technique:

1. Safe

2. Scarless

3. Natural

4. Lasting

5. Quick procedure

6. Quick recovery

7. No suture removal

8. Fat removal can be done together

9. Droopy eyelid can be corrected together

10. Lengthening eyelid procedure such magic epicanthoplasty and lateral canthotomy can be done together

2. BB Double Eyelid (Incision Method)

The incision technique is reserved for patients with extremely puffy eyelids or with excess skin. This can be achieved by either a small incision or full incision of the eyelid. The advantages of this technique is that the double eyelid creation is permanent. However, the downtime is longer and the recovery of the scar will depend on individuals. Most patients heal well that leaves on a very faint scar which may not be noticeable over time.

Small incision technique

A central small incision measuring about 1-1.5 cm is created in the upper eyelid. This technique is suitable for patients with minimal or no excess skin to remove puffiness. The wound is closed with few stitches. The recovery time is quicker than conventional full incisional technique.

Incisional technique

This is the conventional way of creating double eyelids. A full incision is created from inner to outer corner of the upper eyelids. Usually excess skin is removed along with fat tissues that cause puffiness. Skin is closed with sutures which is removed a week after.

3. Inner Corner Surgery (Magic Epicanthoplasty)

The epicanthal fold is a skin fold covering the inner corner of the eyes (medial canthus). This fold is more common among East Asians. Epicanthoplasty, sometimes called medial canthoplasty, is an operation designed to remove or minimize the epicanthal fold to create a much larger and attractive eye. This procedure is commonly performed together with double eyelid surgery. A fine stitch will be used to close the skin and removed after 5-7 days.

Dr Goh feels that in individuals with epicanthal fold, double eyelid with magic epicanthoplasty gives more superior results than double eyelid procedure alone. With the epicanthal fold removed, the entire length of the eyelid will be exposed. This

4.Outer Eye Corner Surgery (Lateral Canthotomy)

To widen the eyelids for cosmetic purpose, the lateral canthus can be modified surgically.

Cosmetic lateral canthotomy is a simple procedure whereby the lateral canthus is split to widen the horizontal aperture of the eyelid. In this procedure, it is imperative that the lateral canthal tendon is not disrupted so as to maintain the anatomic relationship of the lateral canthus to the bony structure. Therefore, an additional of only 2-4 mm can be achieved with this procedure.

This can be performed along with double eyelid procedure (whether suture or incision technique) and magic epicanthoplasty to achieve longer and wider eye that makes the eye appear larger, wider and more attractive.

eyelid surgery, double eyelid surgery, eyebags, epicanthoplasty

eyebags, eyebags surgery, non surgical eyebag correction, double eyelid surgery, epicanthoplasty

4. Eyelid Lift (Upper Blepharoplasty)

Blepharoplasty or upper eyelid lift surgery is an eyelid surgery whereby the excess skin and in some cases fat, are removed. This will give a rejuvenated appearance to the surrounding area of your eyes, making you look more rested and alert.

Upper Blepharoplasty

The amount of excess skin to be removed is determined and removed under local anaesthesia. In some instances, fatty tissues are also removed to reduce puffiness. Double eyelid can be created during this surgery.The wound is then sutured and stitches are removed 1 week later.

Infrabrow blepharoplasty

In some patients who have existing double eyelid or lid crease, infrabrow blepharoplasty can be done to retain the natural eyelid crease. In this technique the excess skin is removed right below the eyebrow and sutured. Stitches are also removed 1 week after. The eyebrow hair is tattooed 6 weeks later to camouflage the scar.

5. Eyebag Correction (Lower Blepharoplasty)

The surgical technique for eyebag correction has evolved over the eyears.

In eyebag surgery, the prolapsed fat pads (which appears as the bulge and puffy on the skin) are excised whether through an incision on the eyelid skin or from the inside the eyelid (transconjunctiva).

We now learn that it's not such a good idea to dispose the fat. Removing too much will render one hollow or 'skeletonized'. Dr Goh's approach to eyebag correction emphasizes on a conservative approach with the aim to preserve and redistribute the eyelid tissue (fat and muscles) to restore volume and achieve natural results.

In younger individual, fat pads may be removed from inside the eyelid so no scar will be seen on the skin surface. Depending on the severity of the eyebags, the fat pads may be conservatively removed or in more severe cases, fat pads will be transposed to the cheek to augment the tear trough (groove seen under the bags).

In older individuals, the approach is usually through the lower eyelid skin just below the eye lashes. The fat pads are isolated and transposed to the cheek to augment the tear trough. The subcutaneous complex consists of muscles and fat will be lifted and anchored to bone next to the eye corner. This procedure will lift and support the midface. A conservative amount of excess eyelid skin will be trimmed. Therefore, this is a 3-steps surgery ::

1. Fat transposition / redistribution

2. Midface lift

3. Skin removal

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