Under-eye circles treatment by malar lift

Under-eye circles are cavities situated under the lower eyelid near the orbital edge. They can extend inside towards the root of the nose and outside towards the cheekbone.
Their appearance varies from person to person. Circles give a tired look and are the first sign of aging in a social context. There are two types of under-eye circles:

• deep circles: they may be associated with under-eye puffiness and are one of the most visible signs of aging. They may also be associated with a volume loss in the cheeks.

• dark circles: often old because genetically based, the only treatment existing is based on aesthetic medicine.

Treatment will vary according to the appearance of the under-eye circles.

Under-eye circles treatment by malar lift

Malar lift is a very effective under-eye circles surgery which extends its action to the cheekbone. The under-eye circle is filled and the volume of the cheekbone is reshaped at the same time.

This procedure applies to patients with a cheekbone sagging.

• Malar lifting is discussed when the patient, in front of a mirror, corrects some signs of aging with a vertical lift towards the top of the cheekbones.
• This surgery is not adapted to every patient and the surgeon will recommend or advise against the procedure.

Before the procedure

A usual preoperative check-up is made following your surgeon’s recommendations. An anaesthesiologist will see you in consultation at the latest 48 hours before the operation. No aspirin-based medication should be taken during the 10 days preceding the operation. You must wash your hair the day before the operation and make-up must be thoroughly removed the day of the surgery. You need to fast (neither eat or drink) 6 hours before the operation.

The procedure

Two incisions are generally necessary. The first one is situated in the lower eyelid, under the eyelashes and extends in the crow's feet to remain discreet. The second one is concealed in the hair of the temple. The surgeon proceeds to these two incisions on each side to detach the deep sub periosteal plan (in contact with the bone).

The surgeon can proceed to the vertical suspension of the cheekbones with strands or with more sophisticated dissolvable anchoring systems. The excess of lower eyelids is resected at the end of the surgery. The procedure lasts between one and two hours. An absorbent dressing is placed for the hours after the operation. There is a different strategy which does not require a temporal incision. Only one incision is done in the lower eyelid, under the eyelashes and extends in the crow's feet to remain discreet. The detachment of the cheekbone is realised in depth, in contact with the bone. The repositioning of the skin, strictly vertical, does not extend towards the side of the cheekbone, which makes temporal lifting not necessary.

After the procedure

You can return home in the evening or the day after the operation, usually without any bandage. Moisturizing eye drops may be prescribed, as well as anti-inflammatory and analgesic drugs. During the first few days rest is advised, with no physical strain. On the first days after the operation, you should not be surprised by, or worried by, the following:

• hypercorrection
• swelling of the face which can grow rapidly (can be worse on the second day than the first) and can be asymmetrical
• bruises in the eyelids area
• painless irritation of the eyes (redness)

tension in the periorbital bone structure. Swelling and bruising usually disappear between 2 and 3 weeks after surgery. Some areas heal more slowly.