Often, in Italy, blepharocalasis is associated with dermatocalase or drooping eyelid. In reality, these are different pathologies, with different symptoms and appearance.

Blepharocalase is an episodic inflammation of the eyelids that very frequently tends to affect especially the upper eyelids; much rarer cases in which the lower eyelids are involved.

People with blepharocalase complain of episodic swelling of the eyelids. In most cases this condition does not cause pain although sometimes a rash may appear in the affected area.

The causes of blepharocalase often stem from the analysis of known cases. We can, say that almost always blepharocalase is a manifestation of an angioneurotic edema.

This is why we tend to think that hormonal changes and puberty may be the basis for the onset of this pathology and this also explains why the average age of activation is around 11 years old.

The problem can affect both men and women, but from known cases it has been found that so far the latter are the most affected.

The skin of the eyelids affected by blepharocalase is usually thinner and more wrinkled than usual, with an appearance similar to that of a “cigarette paper”. Often blepharocalase also determines: 1. eyelid ptosis; 2. rounding of the outer corner of the eye; 3. loss of support of the lower eyelid;

Riccardo presented a particularly important case of blepharocalase, on which drug therapies have not had any improving effect.

Only thanks to the combined surgical approach of ptosis, malar lifting and cantoplasty, it was possible to correct the important abnormalities of the eyelid tissues caused by blepharocalase.

Results may vary from patient to patient
Riccardo is an actual patient of Dr. Graziani
The photos are used with the consent of the patient and copyrighted. Please do not reproduce.

It is not uncommon for a patient to arrive in my office with a precise idea of the surgery he wants to do, after having been informed through various sources, including authoritative ones.

However, as I often repeat, each case is unique, which is why it is important to trust and rely on the professional you choose to contact. Even if this means “upsetting” one’s expectations and preparing for a different protocol than what was thought.

Often, it is in fact necessary to intervene with more interventions and treatments, as in the case of this week. Contrary to what one might think, a more complex protocol can lead to more natural and long-lasting results.

It’s becoming increasingly clear that blepharoplasty surgery alone isn’t enough to give a fresher look to the whole face.

In Giovanna’s case, we can observe a loss of tonicity of the upper and lower eyelid tissues which gives her a tired and dull look.

An integrated approach of traditional blepharoplasty plus ptosis correction combined with a malar facelift, has made it possible to restore tone and volume to the area below the lower eyelid and to open the patient’s gaze.

Results may vary from patient to patient
Giovanna is an actual patient of Dr. Graziani
The photos are used with the consent of the patient and copyrighted. Please do not reproduce.

Patients turn to the oculoplastic surgeon to correct and rejuvenate the main imperfections of the periocular region.

In the figure, however, we can observe all the areas on which a professional can intervene, often with treatments or interventions in combination that guarantee a homogeneous and natural result to harmonize full face.

An oculoplastic surgeon treats all areas of the face, each having different needs and approaches depending on the case studies: in the figure, it is possible to observe how they are divided in the study of the optimal protocol.

For me it’s important to have a full face overview, identifying customized protocols to make the result of an aesthetic treatment or surgery as effective as possible.

To treat malar edema, small injections are made underneath it, using an innovative technique that involves the use of a micro-cannula.

This technique allows to minimize the risk of bruising, resulting painless and does not leave scars.

For those who are not an optimal candidate, it is important to remember that the surgical treatment of malar edema remains an option that is always valid and not to be underestimated.

Facial aging often results in a loss of volume and sagging skin.

In Laura’s case, we can also observe a marked malar bursa in the lateral area of ​​the lower eyelid.

Thanks to the use of a filler based on deep hyaluronic acid, we have greatly improved the imperfection by restoring the right volumes of her face to Laura.

Results may vary from patient to patient
Laura is an actual patient of Dr. Graziani
The photos are used with the consent of the patient and copyrighted. Please do not reproduce.

The correction of eyelid ptosis is undoubtedly one of the most advanced practices.

Those who decide to resort to eyelid ptosis surgery often do so not only to solve a problem that could compromise vision but also for an aesthetic issue.

More and more attention is paid to the eyes and what they are able to convey and this pushes many women, but also many men, to want to improve the appearance of the gaze region.

Rebecca had a major fall of her upper eyelids from birth. This forced her to adopt an incorrect posture to compensate for her reduced vision.

Thanks to a front suspension surgery, it was possible to restore the normal position of the upper eyelids, giving Rebecca the entire field of vision, as well as giving her a lively and brilliant look again.

Results may vary from patient to patient
                                                                                                          Rebecca is an actual patient of Dr. Graziani                                                                                                       
     The photos are used with the consent of the patient and copyrighted. Please do not reproduce.

In cases where the levator muscle of the eyelid is so deficient that it cannot be strengthened, I will be able to elevate the eyelid using the replacing action of the frontal muscle.

The suspension can take place with autologous (ie taken from the patient) or heterologous (ie synthetic) material.

The intervention has a variable duration depending on the complexity of the case; it tends to last from 45 minutes per hour and is performed under local anesthesia without pain.

Here is a detail of the complication from upper and lower eyelid fillers (following repeated treatments with hyaluronic acid performed elsewhere) solved thanks to a personalized protocol with hyaluronidase.

The upper eyelid of the right eye was so swollen that the eye was more closed (eyelid ptosis) and the lower eyelids were both excessively swollen causing the normal harmony of the gaze and face to be lost.

Precisely for these reasons, every aesthetic treatment must be preceded by an in-depth specialist visit, which determines the patient’s suitability to undergo a hyaluronic acid-based filler.

Hyaluronidase is a safe remedy for filer complications, but it must be injected by expert hands, by a specialist who knows and treats the area on which to operate every day.

Often the treatment is divided into several sessions in order to be able to resolve in the most selective way the anti-aesthetic edema caused by lymphatic stasis.

The management of complications from hyaluronic acid-based fillers is represented by Hyaluronidase, antidote to hyaluronic acid.

Anna had marked swelling in the upper eyelid, caused by repeated hyaluronic acid fillers over a short period of time.

Thanks to the personalized treatment with hyaluronidase, it was possible to reopen and rebalance the eyes by removing that unnatural and tired aspect, while respecting Anna’s natural features.

Results may vary from patient to patient
Anna is an actual patient of Dr. Graziani
                                                                                                                  The photos are used with the consent of the patient and copyrighted. Please do not reproduce.

When I visit a child, my attention is both on the correct planning of the intervention and on putting my little patient at ease as much as possible, establishing a peaceful and fun environment.

In this way, even the parents of my little patients face the path with extra security.

By eyelid ptosis we mean a condition in which one or both of the upper eyelids are lower than their normal level

The correction of pediatric ptosis must take place within the first 5 years of life, in order to allow a correct visual development of the patient, reducing the risk of amblyopia.

The child is followed by a highly specialized team for interventions on pediatric patients, which ensures maximum sensitivity and attention from the pre-operative phase to discharge.

Congenital eyelid ptosis can have serious consequences for those affected: from visual defects, up to headaches and stiff necks caused by involuntary incorrect posture to social discomfort caused by insecurity.

Carlotta’s parents took her to my office to carefully evaluate her case, and together we studied the best protocol for her.

Today, Carlotta has solved her problem thanks to an intervention to strengthen the levator muscle of the upper eyelid.

Results may vary from patient to patient
Carlotta is an actual patient of Dr. Graziani
The photos are used with the consent of the patient and copyrighted. Please do not reproduce.

Since practicing hyaluronidase I have learned to perform a personalized, non-invasive treatment, so as not to cause important emptying of the face.

For those patients who wish to undergo hyaluronic acid treatment again it is possible, and I usually do it at least 2 weeks after hyaluronidase.

It is therefore a safe remedy for the complications of filler, but it must be injected by expert hands, by a specialist who knows and treats the area on which to operate every day.

I strongly believe that every filler treatment of the gaze region must be preceded by a specialist visit, during which the oculoplastic surgeon will be able to verify the feasibility of the treatment.

Rebecca came to me with an important filler complication, caused by repeated injections over the years carried out elsewhere.

Thanks to the personalized treatment with hyaluronidase, it was possible to reopen and rebalance the eyes, removing that unnatural and tired look.

Results may vary from patient to patient
Rebecca is an actual patient of Dr. Graziani
The photos are used with the consent of the patient and copyrighted. Please do not reproduce.

Currently the fastest solution, and within everyone’s reach, in countering the first signs of aging of the face bags under the eyes, dark circles, sunken eye is represented by hyaluronic acid-based fillers.

Fillers are so successful because painlessly, quickly and without limiting one’s work or social activities, they allow us to significantly improve our appearance.

The gaze region, given its delicacy, can present complications following injections with hyaluronic acid. Hyaluronidase is an important ally in resolving any complications.

To improve the eyelid bags, small injections are made under them but also in the middle face. In this way it is possible to obtain an important aesthetic improvement in the transition area between the lower eyelid and the face.

The technique involves the use of a micro-cannula, in order to minimize the risk of hematomas, making it painless.

The final effect is an overall rejuvenation of the eyelids and face, which does not distort the general features.

Paola had significant bags under her eyes, which gave her a tired and heavy look

Paola, being the right candidate for a filler treatment, was able to improve her imperfection without surgery

Results may vary from patient to patient
Paola is an actual patient of Dr. Graziani
The photos are used with the consent of the patient and copyrighted. Please do not reproduce.

When it comes to weighted eyes, we are probably dealing with bags under the eyes.

The orbital septum and orbicularis muscle hold the subcutaneous endorbital fat, but the loss of firmness of these structures causes herniation and the appearance of the adipose bag.

A camouflage treatment based on hyaluronic acid injected into the middle face and lower orbit can significantly improve the bags.