Lower Lid Blepharoplasty
As individuals age, the skin of the body begins to lose its elasticity and can therefore begin to sag. This occurs in many areas such as the arms, the breasts, and the face. One of the common areas in which patients desire to have cosmetic surgery to correct the sagging of skin is the lids of the eye. This can occur on both the upper and lower lid with the upper eye lid accumulating loose folds of skin and the lower lid forming creases and bags. The bags under the eyes are caused by the loosening of the muscles in this area which leads to fat protruding outwards. Although this occurs to everyone with age, some people are genetically prone to this condition.
Sagging of the Eyelids
The problem is always more apparent in the early morning particularly when an individual has been subjected to large amounts of stress and sleep deprivation. This results because the natural fluids in the body, which are normally distributed evenly when in an upright position, tend to accumulate in areas of loose skin when an individual is supine. Although the sagging of the lids is typically only a cosmetic problem which poses no actual physical issues, occasionally the lids will become so loose that a patient’s vision may become obstructed.
A lower lid blepharoplasty involves a reduction of the eyelid by removing the excess skin and fat from around the lid. Depending on the particular patient, it may only be necessary to remove the skin or remove the fat. However, in some cases, the removal of both is required in order to achieve the desired effect. If fat is the only tissue that needs to be removed from the lower lid, this might be performed by a procedure called transconjunctival blepharoplasty, which involves the removal of the fat from inside of the eyelid as opposed to externally.
The Lower Lid Blepharoplasty Procedure
Lower lid blepharoplasty can typically be performed under local anaesthesia although general anaesthesia in a hospital may also be used. During the procedure, the surgeon will make an incision under the lid of the eye which expands into the area where crow’s feet form. In order to avoid the appearance of conspicuous scars, the surgeon will typically make the incision along the natural creases in the lids. It is through this incision that the skin and the surrounding muscle can be pulled upward allowing the surgeon to access the fat in the area. The fat can then be tightened, removed, or redistributed.
Patients should be made aware that the only area where wrinkles will be removed will be within the margins of the eye socket. The area extending from the eyes to the cheeks will most likely remain the same after the surgery. In order to be able to open and close the eyelids freely, the skin of the eyelid, although taught, must have enough free skin to be able to perform these functions. In order to remove wrinkles in the face, a chemical peel or laser resurfacing may be performed.
Following the lower lid blepharoplasty procedure, the surgeon will recommend applying cold compresses to the area of incision as well as maintaining the head at an elevated level in order to minimize swelling. The eyes should be washed regularly with water after the surgery and eye drops may be prescribed in order to avoid infection. The sutures are typically removed between three and five days after the surgery although suture strips might still be recommended for a week following the procedure.
After Surgery
After the surgery, the patient will experience some difference in sensation when closing their eyes due to both the removal of the skin as well as the swelling, which will make the eyelids seem tighter. The patient may need to use ointment at night if the eyes are not able to close completely. This, however, is temporary as the swelling will soon subside. After the procedure, the eyes will also appear watery due to the swelling of the tear ducts which causes the eyes to not drain as they would normally. The leakage of the eyes is also temporary and should last for no more than a few weeks.
In addition, the area will appear bruised usually for a period of a couple weeks. This can typically be covered with makeup which can be worn as soon as the sutures are removed. Bleeding and infection may also occur, although these are incredibly uncommon. If pooling of blood or hematoma occurs, it typically resolves itself on its own within two to three weeks although it is sometimes necessary for the area to be drained. The resulting scars from the procedure are very faint and will eventually become almost invisible after a few months. It is common that one eyelid may heal faster than another which can most likely be attributed to which side of the face an individual sleeps on. It is also possible for the area where the stitches are placed to develop small white cysts. This does not pose a serious problem and will resolve itself by pricking them with a needle.
In order to avoid complications, it is necessary that the patient inform the surgeon of any health issues or disorders that they might have such as thyroid disease, diabetes, high blood pressure, detached retina, or glaucoma.
The majority of patients are pleased with the results of the procedure. However, it is possible that an additional operation may be necessary. This can occur if too much skin is removed and a downward pull results on the eye. Therefore it is better to leave some excess skin as opposed to risking the removal of too much. Lines around the eyes will remain after a lower lid blepharoplasty but can be treated with a Botulinum toxin injection which would involve an additional cost. It is also necessary to avoid removing too much fat as this can lead to the sunken appearance of eyes in the future.
Our Practices
Mr Fourie practices at Nuffield Health Hospital, Leeds, conveniently situated in the city centre near Leeds General Infirmary and at Barnsley Medical Consulting Rooms in central Barnsley.
Cosmetic Surgery Procedures
Mr LeRoux Fourie offers a wide range of cosmetic surgery and non surgical treatments and below is a brief outline of each
Inverted Nipple Correction
Many women find their nipples to be a great cause of embarrassment as they do not project past the breast and remain inverted. Mr Fourie is able to correct this problem using a quick and reliable treatment that can be done in as little as thirty minutes
Prominent Ear Correction
Although having prominent ears typically causes no physical discomfort as such they can sometimes lead to a lack of self-confidence and be on the receiving end of cruel jokes. Sometimes just one ear is the problem but usually both will be pinned back. It is also possible to perform other types of ear surgery to the lobes depending on the complexity of the case.
Male Breast Reduction
Gynecomastia is the medical term for male breasts and can be a very humiliating condition for men and can make them very self-conscious. Because of this, some individuals decide to undergo a male breast reduction procedure in order to remove the excess tissue and, occasionally, even skin from the area of the breasts.
Liposuction / Liposculpture / Body-Jet Lipo
You can now experience the latest advancements in cosmetic surgery with the revolutionary Body-Jet Water-jet assisted liposuction procedure. The gentle water jet washes away the fat without damaging the underlying structures such as the blood vessels and nerves which means less recovery time and bruising.
Non Surgical Treatments
Antiwrinkle Injections
It is inevitable that as we age lines and wrinkles will become visible and to some this is of concern. Lines around our eyes can develop as can lines on the forehead. The prescription injection treatment we all know as BOTOX® is now formally approved for cosmetic use and is called a new name which is VISTABEL®. VISTABEL® is a treatment that is used to relax the frown lines that can trouble our forehead as well as crows feet which can develop around the eyes.
Excessive Sweating
Our body uses sweating to help control body temperature and is normal human function however some people suffer from excessive sweating which can lead to severe embarrassment and anxiety. Following a consultation if your suitable we can provide a treatment that will prevent your excessive sweating that involves BOTOX® being injection into your arm pit.
DermaRoller
Genuine Dermaroller™ Therapy™ can offer a significant improvement in appearance for those who suffer from acne scars, sun damaged skin, fine lines and wrinkles and stretch marks. The DermaRoller procedure stimulates your skin to help with the regeneration and repair of itself and is a natural and safe way to create smoother, brighter and healthy skin.
Fillers
Dermal fillers can be used for many different non surgical enhancements and anti ageing treatments. They can be used for lip enhancement to create subtly increase the volume of the lips, smoothing lines around the lips, nose and cheeks as well as many other areas of the face and body to improve the appearance of the skin.
Mole Removal
It is very common for moles, lesions or cysts and can appear in many different places on the face and body. Sometimes they can be in a prominent position which can cause frustration or self awareness. Mr Fourie is able to assist in many different types of these problems and would be happy to perform many of these in the minor theatre or treatment room if he is able.
Mr Fourie
About Mr Le Roux Fourie
Mr Le Roux Fourie is a Cosmetic and Reconstructive Plastic Surgeon based in West Yorkshire. Mr Fourie was born and raised in South Africa and underwent his medical and post graduate training in South Africa, obtaining his basic Medical Degree in 1979. Thereafter he served as a Medical Officer in the South African Defence Force Medical Corp, before starting training as a registrar in Plastic Surgery at the University of Stellenbosch in CapeTown. He qualified as a Plastic Surgeon in 1987 and was appointed a Consultant Plastic Surgeon at Number One Military Hospital in Pretoria, where he served as full-time Consultant for three years reaching the rank of a Lieutenant Colonel.
In 1991 and 1992 he was in full-time Cosmetic Surgery Practice in Pretoria.
In 1993 Mr Fourie joined the Department of Plastic Surgery and Burns at Pinderfields General Hospital as the second consultant to be appointed after the tragic murder of the two previous Plastic Surgeons. He helped establish the current Department of Plastic Surgery from two members to the current seven consultants. During his time in Pinderfields General Hospital he established a Breast Reconstructive Surgery Service, which works mostly with the Breast Surgeons in dealing with primary breast reconstructions and delayed breast reconstructions after breast cancer.
Mr Fourie has been in part-time Private Cosmetic Surgery Practice in Methley Park Hospital, Nr Leeds since 1993.
Since April 2008 Mr Fourie has been in full-time Private Cosmetic Surgery Practice in Methley Park Hospital.
Special Interests
Mr Fourie is an experienced Breast Surgeon dealing with congenital breast problems, acquired breast problems such as breast reconstructions after cancer surgery (both immediate and delayed) and cosmetic breast surgery.
He has published articles regarding nipple areola reconstruction and has developed a tattooing technique which is now used by Cosmetic Tattooists in the UK.
He has been involved with the Allergan Implant Corporation in a ten year follow-up study of the long term effects of silicone breast implants which was published in the International Journal of Plastic and Reconstructive Surgery.
Mr Fourie further specialises in Facial Aesthetic Surgery and is one of the first surgeons to use the MACS (Minimum Access Cranial Suspension) face lift technique in the UK in October 2002. His long term results using the MACS face lift were presented at the Summer Meeting of the British Association of Plastic Surgeons in Dublin in 2005.
Publications and Presentations
Mr Fourie was awarded the BAPRAS prize for the best clinical paper read at the British Association of Plastic and Reconstructive Anaesthetic Surgeons Summer Meeting in Windsor in 2005.
He was awarded the BAAPS prize for the best paper read at the 2007 Conference in London. The Hackett Prize for the best paper at the BAAPS Conference 2007 was awarded to Mr Fourie.
Mr Fourie has lectured on nipple areola reconstruction and tattooing techniques, the treatment of pressure sores, wound infections and wound problems, facial aesthetic surgery and body contour surgery.
Mr Fourie has appeared in the Discovery Channels series on cosmetic surgery. He also featured on BBC's Inside Out in October 2007.
Mr Fourie has published papers in International Peer Review Journals on topics such as Breast Reconstruction, Breast Implants, Cosmetic Breast Surgery, Nipple Reconstruction and Facial Plastic Surgery
Charity Work
Mr Fourie does voluntary charity work in Africa as part of the Facing Africa Team involved in the treatment of noma (www.facingafrica.org). This is based at Yakatit 12 Hospital in Addis Abbaba, Ethiopia where reconstructions are done on patients suffering from Noma
Qualifications
MBCHB.
FCS (SA) PLAST
FRCS
BAPRAS (British Association of Plastic, Reconstructive and Aesthetic Surgeons)
BAAPS (British Association of Aesthetic Plastic Surgeons)
BAHNO (British Association of Head and Neck Oncologists)
GMC Specialist Register - Registered as a Specialist Plastic Surgeon on GMC full registration. The GMC registration is 3633562.
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