Blepharoplasty is one of the most common aesthetic procedures performed in the United States. Significant improvements in facial aesthetics can be made with a relatively short operation that can be performed under intravenous sedation or entirely with local anesthesia. Upper blepharoplasty focuses primarily on removal of excess skin and aesthetic placement of the supratarsal crease, along with filling and contouring of a deep upper orbital sulcus with injections when necessary. Lower blepharoplasty addresses the orbitomalar sulcus (lid-cheek junction and tear-trough abnormalities) and pseudoherniation of periorbital fat, and is based on selective removal and repositioning of fat. Upper blepharoplasty generally does not require fat removal. In addition, lower blepharoplasty involves releasing deep structures, whereas upper blepharoplasty is generally more superficial. In general, the upper lid should be approached transcutaneously, whereas lower blepharoplasty can be safely performed through a transconjunctival or a transcutaneous incision. Complications of upper blepharoplasty are uncommon with more current techniques, but lower lid blepharoplasty has potentially disastrous complications. Blepharoplasty can significantly enhance periorbital and midface aesthetics by improving the tired appearance of even young patients, and is an important tool for facial rejuvenation.
Learning Objectives
After viewing this course, the participant should be able to:
- Identify the essential preoperative considerations for patients undergoing blepharoplasty.
- Describe upper and lower eyelid anatomy and the relevance to blepharoplasty techniques.
- Discuss a standard approach to upper and lower lid blepharoplasty, beginning with preoperative assessment, planning, and marking.
- Describe the major considerations in periorbital rejuvenation and the critical steps taken during blepharoplasty to create aesthetic improvements.
Faculty
Brian C. Drolet, MD; Patrick K. Sullivan, MD
Plastic and Reconstruction Surgery® Editors:
Editor-in-Chief: Rod J. Rohrich, MD
Co-Editor: James M. Stuzin, MD
Section Editor: Donald H. Lalonde, MD
Accreditation Information
Patient Safety Credit: 0.5
Media: Journal Article, Video
Publish Date: 5/1/2014
Estimated time to complete this course: 1.0 hour
Directly provided by the American Society of Plastic Surgeons® (ASPS®)
Accreditation Statement
The American Society of Plastic Surgeons (ASPS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
Designation Statement
The ASPS designates this enduring material for a maximum of 1.0 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Intended Audience
This educational activity is intended for plastic surgery practitioners, residents, and other healthcare professionals interested in translating expanded knowledge into practice for the improvement of patient outcomes in plastic and reconstructive surgery.
Disclosures
Dr. Rohrich, MD is the Principal/Co-Principal Investigator of research grants awarded to the University of Texas Southwestern Medical Center, Dallas, from Medicis, Mentor, and Contura Pharmaceutical. All research funds are provided directly to UT Southwestern. Dr. Stuzin has no relevant financial relationships or affiliations to disclose. Dr. Lalonde is a consultant for ASSI Instruments. None of the authors have any relevant financial relationships or affiliations to disclose. All ASPS staff members managing this activity have no relevant financial relationships or affiliations to disclose. All identified conflicts of interest have been resolved and the educational content thoroughly vetted by ASPS for fair balance, scientific objectivity, and appropriateness of patient care recommendations. The ASPS also requires faculty/authors to disclose when off-label/unapproved uses of a product are discussed in a CME activity or included in related materials.