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PubMed1993

Upper blepharoplasty by eyelid invagination. Anchor blepharoplasty.

Anchor or lid invagination blepharoplasty is an operation giving neat, crisp, and youthful lids of a permanency unobtainable by traditional techniques. It allows the surgeon to preserve precious lid skin and give optimal results. Although there is more postoperative edema, long-term results verify the efficacy of the technique. This article represents the author's 25 years' experience with thousands of patients, both Caucasians and Orientals, undergoing invagination-technique lid blepharoplasty procedures.

Anthropometry↗
PubMed2004

Recent trends in upper eyelid blepharoplasties in medicare patients in the United States from 1995 to 1999.

PURPOSE: To present data regarding the rate of upper eyelid blepharoplasty in the Medicare population at both the national and the regional levels from 1995 to 1999 and to analyze these data for any correlation with reimbursement, surgical criteria differences, or the number of ophthalmologists per capita. METHODS: This was a retrospective cohort study. The subjects consisted of a 5% random sample of the Medicare population who had blepharoplasty from 1995 to 1999. Number, rate, and reimbursements of blepharoplasty of the 10 Health Care Financing Administration (HCFA) regions were compared for the 5-year period. Number of ophthalmologists per capita and differences in the regional criteria for Medicare-approved upper eyelid blepharoplasty were compared among the 10 HCFA regions. RESULTS: Across the nation, there was a 13% annual increase in the rate of blepharoplasty from 1995 to 1999 in the Medicare-population after adjusting for age, race, sex, and HCFA regions. During the same period, the average reimbursement per surgery decreased by $26.50 annually. There was a statistically significant inverse correlation between reimbursement and rate of blepharoplasty at the national level (r= - 0.74, P< 0.001). On the regional level, this relation was less profound (r= -0.29, P= 0.039). There was no correlation between the rate of blepharoplasty and the number of ophthalmologists per capita or the differences in surgical criteria. CONCLUSIONS: The inverse relation between rate of Medicare-approved blepharoplasty and reimbursement between 1995 and 1999 was evident at both the national and regional levels. No relation between regional differences in the rates of blepharoplasty and regional differences in surgical criteria or the number of ophthalmologists per capita were identified. Though our study suggests no causal link between annual rate of blepharoplasty and Medicare reimbursement, such inverse correlation is interesting and may have been affected by other factors such as changing clinical indications for this procedure.

Aged↗
PubMed2000

Our experience with transconjunctival, laser-assisted lower blepharoplasty.

INTRODUCTION: Transconjunctival lower blepharoplasty has become more popular in the last decade with the introduction of the CO2 laser as a cutting and resurfacing tool. The authors have 4 years experience with this procedure. METHOD: Patient selection, preoperative evaluation and the surgical technique are described in detail. The operation itself is divided into two parts: 1. Laser-assisted transconjunctival exposure and resection of prolapsed fat pads, 2. Laser resurfacing of the lower eyelid skin. RESULTS: 36 patients underwent transconjunctival, laser-assisted lower blepharoplasty in the author's department in the period 1997-2000. Transitional hyperpigmentations were treated in 4 patients (11.1%). No severe complications were noted. All patients except one were satisfied or very satisfied. DISCUSSION: Transconjunctival and transcutaneous lower blepharoplasties are compared: 1. Transcutaneous blepharoplasty is simpler to perform, some skin resection is possible and no laser device is needed. 2. The danger of ectropion is relatively high in transcutaneous blepharoplasty, and the scar may not be fully acceptable for the patient. 3. Aged and sun-damaged skin is not influenced with the transcutaneous approach except for some improvement of rhytides. 4. Transconjunctival lower blepharoplasty is a relatively safe procedure with very good cosmetic results avoiding an incision and scar of the lower eyelid. 5. There is much less risk of ectropion and other complications in transconjunctival blepharoplasty than in the transcutaneous one. 6. An unpleasant side effect in transconjunctival blepharoplasty is erythema of the lower eyelids persisting for about 2-3 months. CONCLUSION: Laser-assisted transconjunctival lower blepharoplasty requires a shorter operating time and causes less bleeding and less patient discomfort. This is full-value alternative to the conventional transcutaneous lower blepharoplasty.

Adipose Tissue↗
PubMed2000

Laser blepharoplasty with transconjunctival orbicularis muscle/septum tightening and periocular skin resurfacing: a safe and advantageous technique.

Carbon dioxide (CO2) laser blepharoplasty with orbicularis oculi muscle tightening and periorbital skin resurfacing is a safe procedure that produces excellent aesthetic results and diminishes the occurrence of complications associated with skin and muscle resection in the lower lid, particularly permanent scleral show and ectropion. The authors present a review of 196 cases of carbon dioxide laser blepharoplasty and periocular laser skin resurfacing performed at their center from April of 1994 to September of 1998. Of these cases, 113 patients underwent four-lid blepharoplasty, 59 underwent upper lid blepharoplasty only, and 24 underwent lower lid blepharoplasty only. Prophylactic lateral canthopexy was performed in 24 patients. Concomitant procedures (brow lift/rhytidectomy/rhinoplasty) were performed in 92 patients. The carbon dioxide laser blepharoplasty procedure resulted in no injuries to the globe, cornea, or eyelashes. Combined with laser tightening of the orbicularis oculi muscle and septum and periocular skin resurfacing, the transconjunctival approach to lower blepharoplasty preserves lower lid skin and muscle. Elimination of the traditional scalpel skin/muscle flap procedure results in a dramatically lower complication rate, particularly with regard to permanent ectropion and scleral show. Laser shrinkage of the orbicularis muscle and septum through the transconjunctival incision enables the correction of muscle aging changes such as orbicularis hypertrophy and malar festoons. The addition of periocular resurfacing enables the correction of skin aging changes of the eyelid that are not addressed by traditional scalpel blepharoplasty. In addition, lateral canthopexy constitutes an important adjunct to the laser blepharoplasty procedure for the correction of lower lid canthal laxity.

Blepharoplasty↗
PubMed2006

Upper lid blepharoplasty in patients with LASIK.

PURPOSE: To investigate the changes in tear secretion and tear film stability after upper lid blepharoplasty in patients that had previously undergone excimer laser in situ keratomileusis (LASIK). METHODS: We performed carbon dioxide (CO2) laser upper lid blepharoplasty to 18 eyes of 9 patients that had undergone bilateral LASIK at least 18 months before the surgery. Six women and 3 men aged 35 to 52 were included in this group. An additional control group of 18 eyes of similar age patients with no history of LASIK, contact lens usage or dry eye symptoms were studied. We studied the Schirmer tear test values without anesthesia at 5 minutes in both groups before and after the upper lid blepharoplasty procedure. Tear break-up time values were also measured before and 4 weeks after (CO2) laser upper lid blepharoplasty. The Schirmer tear test and tear break-up time values were analyzed statistically using the independent t-test. RESULTS: The mean Schirmer tear test value was 19.07 +/- 4.03 mm in both eyes of the patients who had undergone LASIK and upper lid blepharoplasty, and it was 21.07 +/- 7.03 mm in the eyes of the control group that only had (CO2) laser upper lid blepharoplasty. The mean tear break-up time value was 21.0 +/- 3.55 seconds in the eyes that had LASIK treatment, and it was 21.27 +/- 6.79 seconds in the eyes of the control group. There was no statistical difference between the two groups. CONCLUSION: Because LASIK and blepharoplasty both may cause dry eye symptoms, the possible cumulative effect of these surgeries is a serious consideration. However, dry eye symptoms after LASIK is usually temporary, and we may perform upper lid blepharoplasty to these patients after a certain time interval by closely monitoring their preoperative and postoperative tear function.

Adult↗
PubMed2003

Lower eyelid blepharoplasty: analysis of indications and the treatment of 100 patients.

Traditionally, lower lid blepharoplasty has been confined to a choice of skin or skin-muscle flap transcutaneous blepharoplasty. In the past decade, in particular, various new techniques and technologies have emerged, altering our ability to treat the lower eyelids. These techniques include transconjunctival blepharoplasty, a variety of canthopexy procedures, fat-conserving or fat-replacing methods, wedge excision, and laser resurfacing techniques, and they allow a more individualized approach based on variations in anatomical features and patient goals. A retrospective review of data for 100 consecutive patients (ranging in age from 30 to 80 years) who underwent lower eyelid procedures during a 12-month period is presented. Procedures were categorized as follows: lower lid blepharoplasty, 35 cases; lower lid transconjunctival blepharoplasty, 27 cases; lower lid transconjunctival blepharoplasty with laser resurfacing, 17 cases; lower lid laser resurfacing, 16 cases; tarsorrhaphy with lower lid operation, three cases; tarsorrhaphy with laser resurfacing, two cases. Two complications of retained fat pads (one medial and one lateral) were encountered and were addressed with a secondary operation using a transconjunctival blepharoplasty approach. The results indicate that laser treatment has become the predominant form of lower eyelid resurfacing and that transconjunctival blepharoplasty is now the most common surgical procedure for the lower eyelid. All of our tarsorrhaphy procedures were performed for patients who had previously undergone surgical treatment of the lower eyelids. An algorithm based on physical findings and these techniques has been developed, for appropriate tailoring of the procedure to each patient's specific concerns. With the availability of a variety of techniques, an individualized approach based on variations in anatomical features is feasible.

Adult↗
PubMed2003

Acquired strabismus following cosmetic blepharoplasty.

The purpose of this study was to report on 12 patients with acquired strabismus following cosmetic blepharoplasty and to identify patterns of strabismus related to the surgical procedure. Clinical ophthalmologic examinations were performed to specifically clarify the type of strabismus. Operative reports of the blepharoplasty procedures were reviewed. Patients were followed for a minimum of 3 months after the blepharoplasty procedure before surgical intervention was considered. Operative findings at corrective strabismus surgery were noted and an attempt was made to correlate these findings with the clinical ophthalmologic examination and the blepharoplasty surgical procedure. Twelve cases of persistent vertical strabismus occurred following blepharoplasty procedures. Five patients had clinical findings consistent with the diagnosis of acquired superior oblique palsy; one of these five patients also showed signs of an acquired Brown syndrome. Seven patients developed an incomitant vertical deviation consistent with an inferior rectus paresis. Strabismus occurred after conventional lower lid, upper lid, and four-lid blepharoplasty with or without laser blepharoplasty. Acquired strabismus accompanied by persistent diplopia may occur as a complication of cosmetic blepharoplasty. Extraocular muscle damage resulting in either superior oblique muscle palsy or inferior rectus paresis was noted in these patients. In some cases, patients with inferior rectus paresis also showed mechanical restriction to upward rotation of the globe.

Blepharoplasty↗
PubMed1996

Transconjunctival blepharoplasty.

Cosmetic blepharoplasty is directed at the surgical correction of undesirable changes of the eyelids that are usually of an acquired nature and caused by aging. The goals are to improve the appearance and, many times, the function of the eyelids. Just as important as attaining these goals is avoiding any complications or undesirable sequelae of a blepharoplasty procedure. In this article, the technique and application of transconjunctival blepharoplasty are reviewed. The differences in the preseptal and retroseptal approaches are discussed and illustrated. The transconjunctival technique can be expanded through the use of various other techniques in order to apply it to a wider variety of patients. These expanded techniques of transconjunctival blepharoplasty allow the surgeon to manage excess skin and rhytids more effectively. Transconjunctival blepharoplasty, therefore, represents a technique in the armamatarium of surgeons performing cosmetic blepharoplasty that has gained new popularity. The technique can be effectively applied to a wide variety of patients. Transconjunctival blepharoplasty allows the surgeon to accomplish many of the esthetic goals of blepharoplasty while reducing the incidence of many of the associated problems, i.e., lid malposition and a visible cutaneous scar.

Aged↗
PubMed1999

Eyelid kinematics following blepharoplasty.

PURPOSE: This study characterizes the effects of blepharoplasty on blink dynamics in subjects with dermatochalasis. The authors evaluate the hypothesis that orbicularis oculi removal and the consequent alterations in blink are potentially harmful consequences of blepharoplasty. METHODS: Sixteen patients were studied, before and after laser blepharoplasty, by a modified scleral search coil technique. Changes in lid position during blinks were recorded before surgery as well as 2 months, and 1 year postoperatively. Off-line analyses assessed blink down-phase amplitude, peak velocity, duration, and main sequence (peak velocity versus amplitude) relationships. RESULTS: Despite muscle resection, there was no significant compromise of mean blink down-phase amplitude, peak velocity, or main sequence following blepharoplasty. Mean blink duration was likewise unchanged at either follow-up session from the preoperative state. Our data show that upper lid blepharoplasty does not cause any lasting decrement in lid function in blinking. CONCLUSIONS: Blepharoplasty includes resection of a portion of the orbicularis oculi. It appears unlikely that the purposeful resection of preseptal portion of the orbicularis oculi that accompanies blepharoplasty is responsible for any functional complications such as dry eye.

Adult↗
PubMed2003

Cautery of the orbital septum during blepharoplasty.

PURPOSE: Application of a grid of electrocautery to the orbital septum to treat anteriorly prolapsed eyelid fat pads during blepharoplasty has been previously described. A review of patients who underwent this technique was performed to determine if this technique led to a higher incidence of postoperative eyelid retraction. METHODS: A retrospective case series of patients who underwent application of a grid of electrocautery to the orbital septum during blepharoplasty from 1979 to 1999 was reviewed. RESULTS: There were 1492 patients (3018 eyelids) who underwent an application of a grid of electrocautery to the orbital septum during this period. Five hundred twenty-nine patients (1036 eyelids) underwent upper blepharoplasty, 91 patients (174 eyelids) underwent lower blepharoplasty, 149 patients (596 eyelids) underwent combined upper and lower blepharoplasty, and 723 patients (1212 eyelids) underwent a combined upper blepharoplasty and ptosis repair. All patients were followed for at least 3 months. Follow-up ranged from 3 months to 20 years. No patient had postoperative eyelid retraction. CONCLUSIONS: The application of a grid of electrocautery to the orbital septum during blepharoplasty to treat anteriorly prolapsed eyelid fat pads is effective, safe, and does not lead to late postoperative eyelid retraction.

Adipose Tissue↗
PubMed1997

The effect of blepharoplasty on eyebrow position.

OBJECTIVE: To determine if upper eyelid blepharoplasty causes eyebrow position to drop in a cosmetic surgery population. DESIGN: Retrospective, observational study. A treatment group that underwent upper eyelid blepharoplasty was compared with a matched control group that did not undergo the surgery. SETTING: Private facial plastic surgery practice. All surgery was performed at an ambulatory surgical facility on an outpatient basis. PATIENTS: A total of 82 patients (164 eyes) were included in this study: 54 (8 men and 46 women; average age, 46.8 years) in the treatment group and 28 (6 men and 22 women; average age, 43.8 years) in the control group. The treatment group was chosen in a retrospective fashion to include only those patients (1) for whom preoperative and postoperative photographs were available and (2) who had undergone upper eyelid blepharoplasty by the senior author (F.M.K). These patients underwent no other procedures, either before or during the time span between the photographs, that could affect eyebrow position. The control group consisted of patients who had an available set of matching photographs taken over time. These patients did not undergo blepharoplasty or any other procedure that could alter eyebrow position between their initial and final photographs. INTERVENTION: Upper eyelid blepharoplasty performed by the senior surgeon (F.M.K.). The surgical technique was identical in all cases. OUTCOME MEASURE: The change in eyebrow height reflected as a percentage of the pretreatment height. Results are based on measurements taken from standardized photographs. RESULTS: Original treatment and control groups of 108 and 56 eyes, respectively, were restricted to a smaller number to create similar populations for comparison. Therefore, 40 eyes in the treatment group were matched with 28 eyes in the control group to control for the duration between measurements. A t test found no significant difference (P = .94) in eyebrow height between patients who had a blepharoplasty and those who had not. CONCLUSION: In a cosmetic surgery population, upper eyelid blepharoplasty does not cause a lowering of the eyebrow.

Eyebrows↗
PubMed1995

Current trends in laser blepharoplasty. Results of a survey.

BACKGROUND: The use of lasers in cosmetic surgery has been expanded fairly recently to include blepharoplasties. Controversy exists as to the efficacy of this procedure. This survey is designed to gain an understanding of the efficacy of blepharoplasty performed by laser versus conventional scalpel techniques. METHODS: A group of surgeons who perform the procedure were questioned. Over 4,000 cases of upper and lower lid laser blepharoplasty were reported by the responding physicians. RESULTS: The results of this survey indicate that carbon dioxide is by far the most common laser used in laser blepharoplasty (96%). A laser is used as a sole cutting tool by 70% of the responders and as a sole hemostasis tool by 88% of surgeons. Overall, both the intraoperative time and postoperative recovery period were reported as significantly reduced when blepharoplasty is performed by laser as compared with scalpel. In general, the incidences of edema, ecchymosis, and postoperative pain were reported as less severe with laser. No serious complications related to the laser were documented by the survey responders. CONCLUSIONS: This study confirms that laser blepharoplasty techniques can be safe and effective in skilled hands and may even have some potential advantages over conventional blepharoplasty.

Eyelids↗
PubMedDate not supplied

Persistent blurred vision after blepharoplasty and ptosis repair.

BACKGROUND: Visual disturbance after upper (eyelid) blepharoplasty is a relatively common postoperative complaint. Recent ophthalmology literature has demonstrated alternations of corneal curvature after procedures that reposition the upper eyelid using corneal topography. Astigmatic changes induced by eyelid repositioning may be a cause of persistent blurred vision after upper eyelid procedures. This observation has not been reported in the facial plastic literature. OBJECTIVE: To determine the incidence of persistent visual disturbance after upper blepharoplasty. METHODS: A retrospective review of upper blepharoplasty by 1 facial plastic surgeon and 2 oculoplastic surgeons during the year 2000. Patient interviews were conducted via telephone. RESULTS: A total of 146 patients were identified, and 106 of them responded to the study request. Six patients (5.7%) had subjective visual acuity changes 1 year after upper blepharoplasty, and 4 of the 6 patients had combined blepharoplasty and ptosis repair. Three patients had worse vision, 2 had improved vision, and 1 was unable to wear rigid contact lenses because of fogging. CONCLUSIONS: Prior studies have shown that most patients have measurable astigmatic changes 3 months after blepharoplasty and ptosis repair. We found that only a small percentage of them have persistent subjective symptoms 1 year postoperatively. It is important for facial plastic surgeons to properly advise patients, especially those with combined procedures, that upper eyelid repositioning procedures may induce long-term vision changes. Patients may need to obtain new prescription spectacles and contact lenses postoperatively.

Astigmatism↗
PubMedDate not supplied

Transcutaneous lower eyelid blepharoplasty with fat excision: a shift-resisting paradigm.

OBJECTIVE: To prove through our experience that the use of transcutaneous lower eyelid blepharoplasty results in negligible incidence of unacceptable scar and eyelid malposition and that the overall lower eyelid contour is acceptable. A detailed overview of the lower eyelid anatomy and a discussion of the "aging" eyelid are further discussed. DESIGN: Retrospective, observational study. The study population comprised 50 patients (100 eyes) seen at the McCollough Plastic Surgery Clinic, Gulf Shores, Ala, between 2002 and 2003 (45 women and 5 men), who had undergone transcutaneous lower eyelid blepharoplasty with fat excision. Lower eyelid blepharoplasty was performed by the senior surgeon (E.G.M.), and the surgical technique was identical in all cases. The patients were followed up for a minimum of 6 months and a maximum of 2 years. Patients were selected on the basis of return visits to record the findings, documented by consecutive digital photos. By comparing standard blepharoplasty digital views, the patients were assessed by 3 independent unbiased plastic surgeons. This study was performed in a private practice setting. The main outcome measure was mean score for the presence of unacceptable scarring, the presence of lower eyelid malposition, and the overall appearance of the eyelid after transcutaneous lower eyelid blepharoplasty, as assessed with the Garcia-McCollough Scale for Lower Eyelid Appearance. RESULTS: The 50 patients were retrospectively reviewed and analyzed by a group of 3 unbiased plastic surgeons, and there was negligible evidence of lower eyelid contour abnormality, lower eyelid malposition, or easily visible scars. CONCLUSIONS: Transcutaneous lower eyelid blepharoplasty with fat excision is a time-tested method of correcting the undesirable sequelae of the aging eye. This technique not only is a safe and effective manner to rejuvenate the lower eyelid but also results in virtually nonexistent ill effects.

Adipose Tissue↗
PubMed2002

Treatment of post-blepharoplasty lower lid retraction by free tarsoconjunctival grafting.

BACKGROUND: Blepharoplasty is probably the most commonly performed facial cosmetic procedure. Despite attempts to prevent its occurrence, post-blepharoplasty lower eyelid malposition with inferior scleral show and corneal exposure can occur, particularly with non-ophthalmologist surgeons. Since a repair must oppose the force of gravity and recurrent scarring, it is often difficult to achieve functional and esthetically pleasing surgical correction. A variety of authors have documented methods to correct post-blepharoplasty lower eyelid malposition. A review of such methods is presented. This is the first paper to analyze results from free tarsoconjunctival grafting specifically in cases of post-blepharoplasty lower lid retraction. METHODS: The present case-series report attempts to examine the efficacy of free tarsoconjuctival grafting in patients with post-blepharoplasty lower lid malposition. Ten patients, ranging in age from 48-75 years (mean = 58.7 years), presented with varied amounts of inferior scleral show and ocular symptoms, including epiphora, dry eye and ocular irritation. Varied amounts of lagophthalmos and superficial punctate keratitis were detected in five eyes and ten eyes, respectively. As described, each patient (20 eyes) underwent bilateral free conjunctival grafting from upper to lower eyelids. RESULTS: After a follow-up interval of 3-32 months (mean = 15 months), all patients experienced a decrease in inferior scleral show and symptomatology. The decrease in inferior scleral show ranged from 0.75 to 3 mm, with an average decrease of 1.61 mm; symptoms of epiphora, dry eye or discomfort persisted in only four eyes. The amount of lagophthalmos and superficial punctate keratitis also decreased postoperatively. Side effects were minimal. INTERPRETATION: We conclude that in the specific case of post-blepharoplasty lower lid retraction, free tarsoconjunctival grafting is both safe and effective.

Aged↗
PubMed2005

Evaluation of conventional subciliary incision used in blepharoplasty: preoperative and postoperative videography and electromyography findings.

BACKGROUND: The purpose of this study was to evaluate the innervation and function of the orbicularis oculi area clinically, with video imaging, and electrically, with electromyography, before and after lower-eyelid blepharoplasty using a conventional subciliary incision. METHODS: Nine patients (18 eyes) were studied before and 4 to 12 weeks after lower-eyelid blepharoplasty. Video imaging documented clinical changes in involuntary (blink) and voluntary (squeeze and squint) eyelid function as well as resting lid position and tone. Electromyography was performed using concentric needle electrodes (25 mm in length, 0.03 mm in diameter) placed in the lateral and medial subciliary orbicularis oculi. A total of 36 sites in nine patients (four sites per patient) were studied. Acute denervation was identified by the presence of fasciculation; fibrillation potentials; insertional activity; sharp waves; and grade based on standard electromyography techniques. All patients underwent lower-eyelid blepharoplasty with a subciliary incision, skin-muscle flap and canthal anchoring with canthopexy or cantholysis, and canthoplasty. RESULTS: Video imaging of the lower eyelid before and after blepharoplasty showed evidence of eyelid malposition or abnormal voluntary or involuntary orbicularis oculi muscle function. There was no evidence of acute denervation in 34 of 36 sites (94 percent). Two patients had abnormal fasciculation in the left lateral position on two of 36 sites (6 percent). Thirty-three weeks postoperatively, one patient was retested and a normal electromyography result was obtained. CONCLUSIONS: This study demonstrated that lower-lid malposition or abnormal function after lower-lid blepharoplasty cannot be explained by denervation of the zygomatic branch of the facial nerve. Any acute or residual denervation seen in the subciliary orbicularis is not clinically significant. The importance of lower-lid support and canthal anchoring cannot be emphasized enough in preventing lower-lid malposition. Blepharoplasty is a challenging procedure that requires careful preoperative planning, intraoperative reassessment, and meticulous surgical technique to optimize facial rejuvenation and patient safety.

Adult↗
PubMed1992

Lower eyelid blepharoplasty.

BACKGROUND: Lower eyelid blepharoplasty is a frequently performed procedure to reverse partially gravitational aging effects on eyelid tissues. Careful planning, proper execution, and appropriate management of potential postoperative complications will generally result in a happy and satisfied patient. However, in any surgical procedure that is primarily aesthetic in nature, the surgeon needs to be constantly aware of factors that may compromise the functional integrity of the eyelid. A patient with altered visual function or ocular discomfort is no longer primarily concerned about the final aesthetic appearance of even the most perfectly executed, technically correct blepharoplasty procedure. OBJECTIVE: To describe the preoperative evaluation, surgical technique, and postoperative complications of lower eyelid blepharoplasty. Specific attention will be given to lower eyelid retraction and ectropion following blepharoplasty. CONCLUSION: Successful lower eyelid blepharoplasty surgery can be a source of both patient and physician satisfaction. As long as patient expectations are consistent with realistic surgical goals, lower eyelid blepharoplasty is an important aspect of overall facial aesthetic surgery.

Eyelid Diseases↗