Blefaroplastica
Blefaroplastica
La blefaroplastica o plastica palpebrale è uno degli interventi maggiormente richiesti.
E’ altamente gratificante per il paziente in quanto i risultati sono brillanti ed eliminano quell’aspetto triste e stanco che spesso viene determinato da una palpebra cadente.
L’intervento è indicato in tutti quei casi in cui vi è o un rilassamento della cute palpebrale o un protrusione del grasso sottocutaneo: le cosidette “borse palpebrali.
La Blefaroplastica si effettua in anestesia locale e dura circa un ora.
Sulla palpebra inferiore l’incisione può essere eseguita all’interno o all’esterno della palpebra stessa, dove comunque rimane ben nascosta.
Sulla palpebra superiore la cicatrice coincide con una normale piega cutanea.
La chirurgia delle palpebre, tecnicamente definita blefaroplastica, è una procedura chirurgica che rimuove la cute ed il grasso in eccesso lungo le palpebre superiori ed inferiori. La blefaroplastica corregge la palpebra cadente che purtroppo dona un senso di stanchezza e di vecchiaia superiore alla realtà e che può talvolta anche interferire con una corretta visione oculare. Tuttavia la blefaroplastica non riesce a correggere le cosiddette “zampe di gallina” o ad eliminare i cerchi neri intorno agli occhi. Questa metodica chirurgica può essere eseguita da sola o in combinazione con il face-lift o con il minilifting frontale.
I migliori candidati per un intervento di blefaroplastica sono quei pazienti che desiderano migliorare il loro aspetto fisico, con prospettive realistiche. Molti di loro hanno 35 anni o più, ma talvolta possono essere più giovani soprattutto quando hanno una storia familiare di “borse” palpebrali.
Cautela andrebbe utilizzata per quei pazienti che abbiamo problemi di tipo medico riguardanti l’apparato oculare (ipotiroidismo, glaucoma,etc.).
Rischi
Se l’intervento di blefaroplastica è eseguito da un chirurgo plastico esperto, le complicanze sono rare e solitamente minori.
Sono da considerare complicanze minori l’edema temporaneo del canto esterno (angolo dell’occhio), una lieve asimmetria di cicatrice, la comparsa di grani di miglio lungo i punti di sutura (che peraltro vengono rimossi con un ago sottile e con una manovra semplicissima durante una delle visite di controllo).
Complicanze maggiori vanno considerate invece il lagoftalmo (incompleta chiusura della palpebra superiore) e l’ectropion (eccessivo stiramento della palpebra inferiore). Queste due ultime condizioni richiedono un secondo intervento di correzione.
Preparazione all’intervento
E’ buona norma, a cominciare dalla settimana precedente all’intervento, non assumere Ac. Acetilsalicico (aspirina) per evitare problemi di coagulazione, e per i fumatori astenersi per almeno 4 settimane (due prima e due dopo l’operazione)
Generalmente si viene operati in regime di Day-Surgery (dimissione nello stesso giorno) ed è indispensabile quindi che il/la paziente venga accompagnato da una persona che possa prendersene cura nel riaccompagnarla a casa e nelle necessità delle prime 24-48 ore. I portatori di lenti a contatto, dovranno sospenderne l’uso per almeno 2 settimane.
L’intervento chirurgico
L’intervento di blefaroplastica richiede da una a tre ore in relazione al numero di palpebre da operare (soltanto due o tutte e quattro). Le incisioni vengono eseguite lungo le linee naturali e si estendono sino alle “zampe di gallina” subito al di fuori dell’angolo esterno dell’occhio. Viene rimosso quindi il grasso in eccesso, responsabile delle “borse” palpebrali, ed eventualmente la cute se è in eccesso. Talvolta anche il muscolo(orbicolare) viene rifilato. Le incisioni vengono quindi richiuse con suture intradermiche particolarmente delicate.
Nel caso in cui nelle palpebre inferiori, esistessero borse palpebrali, ma non cute in eccesso si può effettuare un approccio trans-congiuntivale e non cutaneo.
L’Anestesia
La blefaroplastica viene generalmente eseguita in Anestesia Locale, al massimo accompagnata da una sedazione (per i pazienti più ansiosi).
Il post-operatorio
Gli occhi sono estremamente delicati e pertanto, al fine di ridurre edemi ed ecchimosi, si impiegano, nelle prime ore del post-operatorio, compresse gelate. Il dolore normalmente è di lievissima entità e viene ben controllato dagli analgesici. Se dovesse invece essere forte è buona norma avvisare immediatamente il chirurgo. Nel caso di blefaroplastica completa, c’è aumento della lacrimazione per alcuni giorni, temporanei problemi di visione (fastidio alla luce, etc.).
I punti di sutura vengono rimossi da 3 a 7 giorni dopo l’intervento. Sarà poi buona norma tenere, nell’immediato post-operatorio e per almeno 2 o 3 giorni, la testa sempre sollevata, anche a riposo, per contenere il gonfiore e le ecchimosi, che sono comunque frutto di una reazione assolutamente individuale. Le ecchimosi tendono a scomparire generalmente entro 2 settimane.
Ripresa dell’attività
Il/la paziente potrà riprendere a guardare la televisione dopo 2 o tre giorni, mentre per la lettura sarà opportuno attendere almeno 6-7 giorni.
Molti pazienti si sentono in grado di riprendere la loro attività e di tornare al lavoro anche dopo 8-10 giorni, magari coprendo con un correttore e del make-up i segni dell’ecchimosi ancora presenti.
E’ buona norma per tutti comunque astenersi per almeno 7 giorni da qualsiasi attività, soprattutto sportiva in quanto esse causa rialzo della pressione sanguigna, così come va evitata l’assunzione di alcolici che determinano ritenzione di liquidi.
Il nuovo aspetto
La guarigione è un processo graduale che si attua nell’arco di mesi. Dopo 2 settimane generalmente il mondo che ci circonda non si rende conto dell’intervento subito (essendo praticamente scomparsi i segni), ma i tempi di guarigione sono molto più lunghi.
La cicatrice ad esempio, prima che diventi una linea bianca,quasi invisibile, impiega non meno di 6 mesi.
Bisogna anche dire che i risultati di ringiovanimento e freschezza dureranno per anni e che addirittura per molti pazienti questo può essere un intervento definitivo.
La blefaroplastica può cambiare l’aspetto e restituire quella self-confidence perduta, ma non necessariamente cambia il proprio look secondo i propri desideri o modifica il modo di fare delle persone che ci circondano.
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