The skin around the eyes is the thinnest in the body, and since there are few sebaceous glands that secrete sebum, it tends to dry out, due to the weakening of the orbicularis oculi muscle (ganrinkin) that opens and closes the eyelids. , Wrinkles, bears, and sagging of the lower eyelids become more noticeable. Lower eyelid formation is a cosmetic treatment that mainly improves wrinkles, bears, and sagging of the lower eyelids that appear with age .
There are various types of lower eyelid formation, such as surgical methods that involve incision of the skin of the lower eyelid, partial excision of fat and muscle under the skin, and injection that does not require an incision, such as wrinkles and sagging. The appropriate surgical procedure depends on the symptoms and causes of the disease .
Therefore, when undergoing lower eyelid formation, it is important to know in advance the characteristics of each surgical procedure and the symptoms and downtime risk of the lower eyelid that can be expected to improve, and to consider the treatment method that suits you. .. By understanding the characteristics of lower eyelid formation, which has various surgical procedures, you can deepen your understanding of the counseling content received at medical institutions .
Table of contents
Lower eyelid formation is a procedure that improves the problems such as bears, wrinkles, and sagging that appear on the lower eyelids, which means the lower eyelids .
There are various types of treatment, such as surgical treatment in which the skin of the lower eyelid is incised to remove excess skin and fat, and treatment without incision, and the lower eyelid is reduced by reducing the substances that maintain the firmness and elasticity of the skin. Treatments that correspond to each problem, such as fine wrinkles and bears due to pigmentation, are selected.
In order to know exactly what kind of lower eyelid formation is suitable for your own lower eyelid trouble , you need to actually get a doctor's diagnosis at a medical institution . There are multiple problems with the lower eyelid that can be expected to improve by lower eyelid formation other than fine wrinkles and bears, but in order to understand the cause of each symptom, we will first briefly explain the structure of the eyelid and the parts related to the treatment.
The eyeball is contained in the hollow of the skull called the orbit (cancer), and the eyelid (cancer), which means the eyelid, has the role of protecting the eyeball from external stimuli and dryness. Eyelid and eyelid upper, generally referred to as upper eyelid consists lower eyelid called lower eyelid, by moving the upper and lower eyelids by orbicularis oculi (Ganrinkin) is a muscle that exist around the eyeball, blinking Can be done.
The lower eyelid does not move up and down much more than the upper eyelid, and there is little movement when blinking. Under the skin of the lower eyelid, the orbicularis oculi muscle, the fat orbital fat (cancer tarsal) that protects the eyeball from external impact, the orbital septum that wraps the orbital fat (cancer tarsal) , and the eyelid There is a tarsal plate (kenban) with a tissue like a plate in which collagen fibers existing at the edge are densely packed .
Basically, the lower eyelid does not move much up and down, so it is said that there are few symptoms caused by daily overuse of tissues such as muscles under the skin of the lower eyelid.
In addition, the skin of the lower eyelid is extremely thin, about 0.6 mm, and it is characterized by having almost no sebaceous glands (sebaceous glands) that secrete sebum or sweat glands (kansen) that secrete sweat .
Fine wrinkles that appear on the eyes and mouth with few sebaceous glands, such as the shallow layer of the skin and the lower eyelids, are called "small wrinkles" or "crepe wrinkles." The skin, including the lower eyelid, has a three-layer structure of epidermis, dermis, and subcutaneous tissue from the outside, and fine wrinkles and crepe wrinkles basically occur in the dermis layer .
In the dermis layer, the fibrous protein "collagen" is bundled with an elastic protein called "elastin", and the jelly-like substance "hyaluronic acid" fills the space between them while holding water. It supports the firmness, elasticity and moisturization of the skin.
However, when the dermis is damaged mainly by aging, ultraviolet rays, and disturbance of skin metabolism called turnover, collagen and elastin, which maintain the firmness and elasticity of the skin, and hyaluronic acid, which has a role of storing water, deteriorate and decrease. As a result, it may cause skin problems such as fine wrinkles and sagging .
The main treatments that can be expected to improve fine wrinkles and sagging on the lower eyelids are surgery to remove the skin by making an incision in the skin just below the hairline of the lower eyelashes, and hyaluronic acid, which has the effect of supplementing the volume of the skin. Examples include injection and baby collagen injection, which has the effect of promoting the activation of skin cells.
When the skin is intermittently exposed to external stimuli such as UV rays and friction, it produces melanin in the lower layers of the epidermis to protect the skin cells from the stimuli. The melanin produced is normally excreted from the body together with old keratin by turnover, which is the metabolism of the skin, but when the amount of melanin produced exceeds the excreted amount due to intermittent external stimuli, it stays in the skin. Causes pigmentation that looks dull brown .
The condition in which the skin of the lower eyelids causes pigmentation and becomes dull brown to dark brown is called a bear, and it may be seen on a tired face or give the impression of being older than the actual age.
Pigmented bears can be improved by topical retinoic acid, which regulates turnover, which is the metabolism of the skin, and promotes melanin excretion, and light or laser machine irradiation treatment, which aims to remove melanin by destroying it with heat or shock waves. Can be expected.
When the bones contract or the muscles and ligaments that support the eyeball weaken due to aging, the eyeball gradually sinks, and the orbital fat that covers the eyeball is pushed forward (on the surface side of the skin), and the lower eyelid. Bulging or sagging may occur just below . The swelling and sagging caused by the protrusion of orbital fat is called the eye bag ( mebukuro ) or eye bag .
In addition to aging, eye bags may be noticeable regardless of age due to their natural skeleton and high orbital fat. In addition, the state in which the eyelids due to the protruding orbital fat , which is not caused by pigmentation , becomes a step between the lower eyelid and the cheek and a shadow is formed, is called a "shadow bear" .
Shadow bears, also known as baggy eyelids, can look older or look tired than they really are. Orbital fat-induced eye bags and shadow bears can be improved by removing the orbital fat under the lower eyelid or moving it to the depression between the lower eyelid and the cheek.
The main cause of wrinkles that enter diagonally from the inner corner of the eye to the cheek, which is generally called the Golgo line, is that the boundary of the facial muscle becomes conspicuous due to the weakening of the orbicularis oculi muscle and the decrease in subcutaneous fat due to aging. Will be done. The origin of the Golgo line is a popular name because it resembles the characteristic line on the face of the main character of a famous comic, and it is correctly called Mid Cheek Groove.
The main treatments that can be expected to improve Golgoline are hyaluronic acid injection, which has the effect of compensating for dents such as wrinkles on the skin, and calcium hydroxyapatite, which is composed of calcium and phosphate ions that originally exist in the body. There is a ready essence injection using a dermal filler.
The symptom that the eyelashes that should originally grow outwards grow inward (on the eyeball side) is called varus, and is generally called upside down eyelashes. When varus occurs, the cornea and conjunctiva of the eyeball may be stimulated by the eyelashes, causing irritation and a foreign body sensation in the eyeball.
Entropion is "congenital varus" due to a natural defect or abnormality in the tissue that supports the tarsal plate at the edge of the eyelid, and the aponeurosis that supports the lower eyelid mainly due to aging. It is said that there is "senile entropion of the eyelids" due to loosening and sagging of the aponeurosis. In addition, contrary to varus, the symptom that the edge of the eyelid is inverted to the outside (the surface side of the skin) is called valgus, and varus and valgus are lower. It is a symptom that can occur not only on the eyelids but also on the upper eyelids .
Vaginal palsy is a condition in which the lower eyelids are turned outward and the red conjunctiva on the back is visible. The main cause is the deterioration of the skin, muscles, and fascia around the eyes due to aging, but the face. It can also be caused by paralysis. Since the eyelids cannot be opened and closed normally, there is a risk of dry eye and damage to the cornea.
Even if varus or valgus occurs, self-treatment such as tweezers may cause eye damage or infection, and simple plucking may cause symptoms to recur, so please refrain from doing so. .. Treatment methods include removing excess skin from the eyelids to change the direction of the eyelashes and destroying the roots of the eyelashes that are facing inward or outward, and some medical institutions apply health insurance. In some cases.
Suitable lower eyelid formation differs depending on the wrinkles, bears, and sagging problems that occur in the lower eyelids. In order to know your lower eyelid problems and the treatment that suits the cause, you need to see a doctor at a medical institution.
|Transconjunctival defatting (Keiketsu Makuda Shijutsu)||An incision is made in the conjunctiva inside the lower eyelid to remove excess orbital fat||・ Eye bag ・ Shadow bear|
|Lower eyelid incision (Kaganken Sekaijutsu)||An incision is made in the skin just below the hairline of the lower lashes to remove excess skin and loose orbicularis oculi muscles.||・ Mild lower eyelid sagging ・ Small wrinkles on the lower eyelid|
|Lower eyelid wrinkle removal (Kagankenjosujutsu)||An incision is made in the skin just below the hairline of the lower lashes to remove excess orbital fat and then the loose lower eyelid skin is excised.||・ Sagging lower eyelids ・ Deep wrinkles ・ Eye bags|
|Hamra method (percutaneous orbital fat transfer: Keihiki cancer Kashiboidojutsu)||An incision is made in the skin just below the lower eyelashes to move the protruding orbital fat to the depression between the lower eyelid and the cheek, while removing excess skin.||・ Lower eyelid sagging ・ Deep wrinkles ・ Eye bags ・ Shadow bear|
|Back Hamra method (transconjunctival orbital fat transfer: Keiketsu Maku Cancer Kashiboidojutsu)||An incision is made in the conjunctiva on the back of the eyelid to move the protruding orbital fat to the depression between the lower eyelid and the cheek.||・ Lower eyelid sagging ・ Deep wrinkles ・ Eye bag * Tendency to be selected mainly when there is not enough excess skin to be excised|
Transconjunctival defatting (transconjunctival degreasing) is a method of incising the conjunctiva inside the lower eyelid and removing part of the orbital fat in the back, which is also called "lower eyelid defatting" depending on the medical institution. It is said. By removing the orbital fat that protrudes forward due to bone atrophy and muscle weakness from the conjunctival side, the step created between the lower eyelid and the cheek is eliminated, and improvement of the eyelid and shadow bear is expected. You can .
Since the conjunctiva inside the lower eyelid is incised with a scalpel, there is no risk of scarring on the skin surface of the lower eyelid, so downtime after surgery tends to be shorter than other lower eyelid formations . When removing orbital fat, the skin surface of the lower eyelid is removed in a well-balanced manner from the inside, center, and outside according to the amount of different facial skeleton and orbital fat so that the skin surface of the lower eyelid does not become uneven after surgery.
In addition, since transconjunctival defatting does not remove the skin, it is mainly used by young people who do not have sagging skin due to a decrease in collagen and elastin that maintain the firmness and elasticity of the skin due to aging. It is often selected when the protrusion is noticeable.
As for downtime after surgery, symptoms such as swelling, swelling, and redness tend to continue for about 2 to 7 days , and makeup including eye makeup is possible from the day after surgery. The main risks and side effects include dents in the lower eyelids due to excessive fat removal, laterality, and rarely infections from the surgical site .
The time required for surgery is about 30 to 40 minutes per eye, and the method of suturing the incised conjunctiva differs depending on the medical institution, and suturing with a type of thread that is naturally absorbed in the body that does not require surgical removal. There are treatments with electric scalpels and lasers.
| (1) Doctor counseling and medical examination|
(2) Use local anesthesia and intravenous anesthesia
(3) After inverting the lower eyelid, make a few mm incision in the conjunctiva inside the lower eyelid.
(4) Remove the orbital fat in the back
(5) Suture of the incision site with an absorbent thread or an electric knife or laser
|Approximately 250,000-400,000 yen per eye|