Evidence-Based Medicine: Blepharoplasty | Journal CME Article-Journal CME Article: Evidence-Based Medicine: Blepharoplasty

Journal CME Article: Evidence-Based Medicine: Blepharoplasty - article

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Blepharoplasty, a top aesthetic procedure in the U.S., witnessed over 150,000 cases in 2012, with significant popularity among individuals aged 51 to 64. Predominantly performed on women, it's also common among men. Despite its frequency, blepharoplasty, especially of the lower lid, remains a challenging procedure for surgeons due to the varied techniques and the lack of a standardized method, coupled with potential aesthetic and functional complications.<br /><br />The objective of blepharoplasty is not just the alteration of eyelids, but the rejuvenation of periorbital regions, important for a youthful facial appearance. Upper blepharoplasty primarily addresses excess skin and the supratarsal crease, with limited fat handling. Lower blepharoplasty, more complex, deals with orbitomalar sulcus deformities, focusing on selective removal and repositioning of fat rather than extensive excision to avoid a hollow appearance. The upper lid generally requires a transcutaneous approach, while the lower lid can be safely managed with either a transconjunctival or transcutaneous incision.<br /><br />Preoperative assessments are crucial, involving thorough medical history checks and detailed ophthalmologic evaluations, especially for candidates with conditions like dry eyes or previous eye surgeries. Detailed examination of eyelid anatomy, asymmetries, and desired outcomes is crucial, with comprehensive documentation to set realistic expectations.<br /><br />The discussion suggests that various techniques exist for both upper and lower blepharoplasty, with debate particularly around lower lid procedures. While recent advances advocate for fat preservation and repositioning for a natural appearance, the choice between transconjunctival and transcutaneous approaches remains at the surgeon's discretion. Knowledge of anatomy, procedural innovations, and careful surgical assessments are highlighted as essential for successful outcomes and minimizing the risk of complications like vision loss due to retrobulbar hematoma, which, although rare, is critical to manage promptly.

Keywords

Blepharoplasty

Aesthetic procedure

Upper blepharoplasty

Lower blepharoplasty

Periorbital rejuvenation

Transconjunctival incision

Transcutaneous approach

Fat repositioning

Preoperative assessment

Retrobulbar hematoma