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The article describes the indications and techniques for blepharoplasty of the upper and lower eyelids as well as combinations with other eyelid correction techniques. Upper eyelid blepharoplasty may include skin excision with orbital fat modulation as well as ptosis correction and definition of the superior sulcus palpebralis. The main goal of lower lid blepharoplasty is modulation of intraseptal fat and also often the treatment of a lower lid laxity by canthopexy. It is recommended to avoid excessive skin resection in the lower lid. Furthermore techniques to address an ectropium are reviewed and possible complications of blepharoplasty are presented. [ABSTRACT FROM AUTHOR]

Blepharoplasty is one of the most popular and common procedures in facial plastic surgery. Initially performed in 1818 for eyelid reconstruction, blepharoplasty has evolved to become a cosmetic or functional operation. Although the surgical approaches are relatively straightforward, achieving natural and predictable results require precision and judgment. After performing more than 3500 blepharoplasties, the senior author has learned that the "art of blepharoplasty" has less to do with how much skin or fat is removed and is more about understanding the anatomic changes associated with aging, developing an individualized surgical plan, and anticipating postoperative outcomes or complications. [ABSTRACT FROM AUTHOR]

The purpose of this study was to analyze prospectively 50 patients submitted to lower blepharoplasty allocated to two surgical groups at Federal University of São Paulo, between April 2005 and May 2007. Fifty patients were assigned for interventions into two surgical groups by using random allocation. The SG1 (control group) was composed of 25 patients who were submitted to conservatively standard fat-resection lower blepharoplasty, and routine lateral canthal support. The SG2 (experimental group) was represented by 25 patients submitted to lower blepharoplasty with periorbital fat mobilization and arcus marginalis redrape, and routine lateral canthal support. Preoperative demographic and morphological data from patient charts and standardized photographs obtained before and after surgery were evaluated by an independent observer. Surgical techniques and management of complications were determined from operative reports and clinical notes. The median follow-up was 395 days (range 364 to 547 days). The mean age was 48.8 years; the population’s gender was predominantly female (96%). Analysis of preoperative and postoperative photographs showed that all patients achieved significant improvement. Lateral canthal support was performed in all patients with statistically significant results. The authors concluded that both procedures are safe and effective, with low complication rates. [ABSTRACT FROM AUTHOR]

Background: Ectropion of the lower eyelid can occur after blepharoplasty as well as reconstructive procedures. Even mild ectropion can cause irritation or epiphora. Patients with preexisting lid laxity are at higher risk for post procedure ectropion. Aims: To describe a method for canthopexy and discuss its indications, benefits and limitations. Methods: We describe a technique that has been used on dozens of patients by both the authors. Results: This suspension suture canthopexy corrects mild to moderate ectropion. Discussion: Suspension suture canthopexy is effective in patients with the appropriate indications. It can be performed under local anesthesia with minimal complications. Unlike other forms of lid tightening, it does not change the shape of the eye. Conclusion: Suspension suture canthopexy which is an ancillary procedure for eyelid rejuvenation is valuable procedure to master by the dermatologic surgeon. [ABSTRACT FROM AUTHOR]