eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Cosmetic Surgery

Blepharoplasty, Upper Eyelid: Follow-up

Author: Vikram D Durairaj, MD, Associate Professor of Ophthalmology, Associate Professor of Otolaryngology-Head and Neck Surgery, Residency Program Director, Department of Ophthalmology, University of Colorado; Medical Director, Rocky Mountain Lions Eye Institute
Coauthor(s): Eric M Hink, MD, Instructor and Fellow, Oculofacial Plastic and Orbital Surgery, University of Colorado Health Sciences Center; Steven Gabel, MD, Fellow, Department of Surgery, Division of Otolaryngology, University of Missouri; Jill A Foster, MD, Associate Clinical Professor, Department of Ophthalmology, The Ohio State University
Contributor Information and Disclosures

Updated: Jan 26, 2009

Outcome and Prognosis

Upper lid blepharoplasty results in improvement of the natural aging changes. The main indication for functional upper lid blepharoplasty is correction of the excess skin of the upper eyelid, thereby resulting in visual field improvement. The indication for cosmetic upper lid blepharoplasty is to improve appearance (see Image 3).

No reports describe long-term follow-up of patients after upper lid blepharoplasty. The prognosis in this surgery depends on many factors: sex and age of the patient at the moment of the surgery, race, underlying medical conditions, brow structure, type of skin, and previous skin damage by the sun.

Dissatisfaction after upper lid blepharoplasty may be related to unrealistic surgical expectations by the patient. The patient's motivations and expectations are important points to discuss in depth during the preoperative consultation. Patients who expect positive alterations in their personal lives after surgery are poor candidates for cosmetic blepharoplasty. Aging changes such as redundant skin around the eyes and fat herniation may be improved with surgery; however, dynamic wrinkles around the eyes (particularly crow's feet) are not corrected with blepharoplasty. Patient goals should be established before the surgery is performed.

Future and Controversies

New technology alters and refines the techniques but not the indications for upper eyelid blepharoplasty. Laser resurfacing of the eyelids, as well as incisional laser surgery, is becoming increasingly popular. Botulinum toxin type A may be used as an adjuvant to blepharoplasty to treat the lateral canthal wrinkles or to modify brow position. Prevention is less expensive than treatment, and increased consciousness of health issues may contribute to cessation of smoking and protection from ultraviolet light.

 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author Everardo Castro, MD, to the development and writing of this article.



More on Blepharoplasty, Upper Eyelid

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Follow-up: Blepharoplasty, Upper Eyelid
Multimedia: Blepharoplasty, Upper Eyelid
References
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References

  1. Biesman BS. Laser assisted upper lid blepharoplasty. Operative techniques in Oculoplastic, Orbital and Reconstructive Surgery. 1998;1:11-18.

  2. Pottier F, El-Shazly NZ, El-Shazly AE. Aging of orbicularis oculi: anatomophysiologic consideration in upper blepharoplasty. Arch Facial Plast Surg. Sep-Oct 2008;10(5):346-9. [Medline].

  3. Anwar M, Smith DE, Kaye AD. Anesthesia for cutaneous surgery. Int J Aesth Restorative Surg. 1997;5:108-115.

  4. Baylis HI, Goldberg RA, Kerivan KM, Jacobs JL. Blepharoplasty and periorbital surgery. Dermatol Clin. Oct 1997;15(4):635-47. [Medline].

  5. Black J. Complications following blepharoplasty. Plast Surg Nurs. Summer 1998;18(2):78-83. [Medline].

  6. Camirand A. The surgical correction of aging eyelids. Plast Reconstr Surg. Apr 1999;103(4):1325-6. [Medline].

  7. D'Assumpcao EA. Blepharoplasty: a personal tactical approach. Aesthetic Plast Surg. Jan-Feb 1999;23(1):28-31. [Medline].

  8. Flowers RS, DuValc C. Blepharoplastic and periorbital aesthetic surgery. Plastic Surgery. 1997;5th.

  9. Foster JA, Barnhorst D, Papay F, Oh PM, Wulc AE. The use of botulinum A toxin to ameliorate facial kinetic frown lines. Ophthalmology. Apr 1996;103(4):618-22. [Medline].

  10. Foster JA, Wulc AE, Castro E. The Botox Brow Lift. American Society of Ophthalmic Plastic and Reconstructive Surgery. 1999;Fall International Symposium.

  11. Januszkiewicz JS, Nahai F. Transconjunctival upper blepharoplasty. Plast Reconstr Surg. Mar 1999;103(3):1015-8; discussion 1019. [Medline].

  12. Konovitch J. Intravenous sedation for aesthetic surgery. Plastic Surgery. 1997;1(8):67-74.

  13. Krupin T, Kolker AE. Eyelid Surgery. Complications in Ophthalmic Surgery. 1999;2nd:240-245.

  14. Meyer DR. Functional eyelid surgery. Ophthal Plast Reconstr Surg. Jun 1997;13(2):77-80. [Medline].

  15. Morax S, Touitou V. Complications of blepharoplasty. Orbit. Dec 2006;25(4):303-18. [Medline].

  16. Putterman AM. The History of Cosmetic Oculoplastic Surgery, Evaluation of the Cosmetic Oculoplastic Surgery Patient, Treatment of Upper Eyelid Dermatochalasis and Orbital Fat: Skin Flap Approach. Cosmetic Oculoplastic Surgery. 1999;II:3-10, 11-22, 77-89.

  17. Roberts E, Holck DE. Prospective clinical evaluation of wound healing after carbon dioxide laser upper lid blepharoplasty closed with polypropylene suture or octylcyanoacrylate tissue adhesive. Abstract Book-ARVO. 1999;152-b112.

  18. Teng CC, Reddy S, Wong JJ, Lisman RD. Retrobulbar hemorrhage nine days after cosmetic blepharoplasty resulting in permanent visual loss. Ophthal Plast Reconstr Surg. Sep-Oct 2006;22(5):388-9. [Medline].

  19. Zarem HA, Resnick JI, Carr RM, Wootton DG. Browpexy: lateral orbicularis muscle fixation as an adjunct to upper blepharoplasty. Plast Reconstr Surg. Oct 1997;100(5):1258-61. [Medline].

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Further Reading

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Keywords

blepharoplasty, upper eyelid blepharoplasty, dermatochalasis, steatoblepharon, eyelid skin, pseudoherniation of orbital fat, pseudoptosis, blepharoplasty, blepharoplasty surgery, cosmetic eyelid surgery, blepharochalasis

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Contributor Information and Disclosures

Author

Vikram D Durairaj, MD, Associate Professor of Ophthalmology, Associate Professor of Otolaryngology-Head and Neck Surgery, Residency Program Director, Department of Ophthalmology, University of Colorado; Medical Director, Rocky Mountain Lions Eye Institute
Vikram D Durairaj, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Society of Ophthalmic Plastic and Reconstructive Surgery, Colorado Medical Society, and Pan-American Association of Ophthalmology
Disclosure: Alcon Labs Honoraria Speaking and teaching; Porex Surgical Honoraria Speaking and teaching

Coauthor(s)

Eric M Hink, MD, Instructor and Fellow, Oculofacial Plastic and Orbital Surgery, University of Colorado Health Sciences Center
Eric M Hink, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, and American Medical Association
Disclosure: Nothing to disclose.

Steven Gabel, MD, Fellow, Department of Surgery, Division of Otolaryngology, University of Missouri
Steven Gabel, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, and American Academy of Otolaryngology-Head and Neck Surgery
Disclosure: Nothing to disclose.

Jill A Foster, MD, Associate Clinical Professor, Department of Ophthalmology, The Ohio State University
Jill A Foster, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and American Medical Association
Disclosure: Allergan Consulting fee Consulting

Medical Editor

Jaime R Garza, MD, DDS, FACS, Consulting Staff, Private Practice
Jaime R Garza, MD, DDS, FACS is a member of the following medical societies: Alpha Omega Alpha, American Academy of Otolaryngology-Head and Neck Surgery, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Medical Association, American Society for Aesthetic Plastic Surgery, American Society of Maxillofacial Surgeons, Texas Medical Association, and Texas Society of Plastic Surgeons
Disclosure: Allergan Honoraria Consulting

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Keith A LaFerriere, MD, Clinical Professor, Fellowship Director, Department Otolaryngology-Head and Neck Surgery, University of Missouri at Columbia
Keith A LaFerriere, MD is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, and Missouri State Medical Association
Disclosure: Nothing to disclose.

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders
Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA, Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine
Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society
Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation unstricted gift unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo  Consulting; Medvoy Ownership interest Management position

 
 
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