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Review
. 2017 Feb;31(1):51-57.
doi: 10.1055/s-0037-1598628.

Upper Eyelid Blepharoplasty: Evaluation, Treatment, and Complication Minimization

Patrick Yang  1 , Audrey C Ko  1 , Don O Kikkawa  2 , Bobby S Korn  2
Affiliations
Review

Upper Eyelid Blepharoplasty: Evaluation, Treatment, and Complication Minimization

Patrick Yang et al. Semin Plast Surg. 2017 Feb.

Abstract

Upper eyelid blepharoplasty is one of the most common procedures performed worldwide for both functional and cosmetic indications. There is a high rate of patient satisfaction; however, in this era of social media, patient expectations are higher than ever. Today's digitally savvy patients expect perfect outcomes with no complications and rapid recovery. To achieve optimal results, a careful preoperative evaluation and sound surgical technique is essential for minimizing complications. Here the authors review their approach to the management of the blepharoplasty patient.

Keywords: blepharoplasty; complications; cosmetic surgery; dry eye; eyelid ptosis; functional surgery; upper eyelid.

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Figures

Fig. 1
Fig. 1
Cross-sectional anatomy of the upper eyelid.
Fig. 2
Fig. 2
Exposure of the upper eyelid fat pads and lacrimal gland. The nasal fat pad has a paler color compared with the orange-colored central preaponeurotic fat pad. Care is taken to avoid damage to the lacrimal gland during blepharoplasty.
Fig. 3
Fig. 3
Concurrent upper eyelid dermatochalasis (yellow arrow) and blepharoptosis (red arrow).
Fig. 4
Fig. 4
Configuration of the male (A) versus female brow (B). The male brow has a flatter shape compared with the more curved, arching brow in females. Brow ptosis can be concurrently treated during upper eyelid blepharoplasty.
Fig. 5
Fig. 5
(A) The pinch technique is used to identify excess upper eyelid dermatochalasis. (B) A typical upper eyelid blepharoplasty showing extension of the mark beyond the lateral canthus to address hooding.
Fig. 6
Fig. 6
Before (A) and after (B) upper eyelid blepharoplasty with nasal fat removal and orbicularis oculi preservation at 3 months postoperatively.
Fig. 7
Fig. 7
(A) Anterior lamellar deficiency and lagophthalmos resulting from the excessive removal of upper eyelid skin and orbicularis muscle. (B) Placement of a full-thickness skin graft from the retroauricular area with improvement in eyelid closure.
Fig. 8
Fig. 8
Postoperative retrobulbar hemorrhage treated by evacuation through the upper eyelid blepharoplasty incision. If necessary, a lateral canthotomy and cantholysis may be performed to further relieve an orbital compartment syndrome.
Fig. 9
Fig. 9
Dehiscence of the medial aspect of the blepharoplasty incision.
Fig. 10
Fig. 10
Delayed, hyperemic nodule along the blepharoplasty incision caused by an atypical mycobacterial infection.
See this image and copyright information in PMC

References

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