The Diagnosis and Management of Blepharoplasty Complications

Abstract

Blepharoplasty is the third most common cosmetic procedure performed by cosmetic surgeons according to the 2003 statistics of the American Society for Aesthetic Plastic Surgery. The number is growing each year, having increased by 17% from 2002 [1]. The procedure may involve removal of eyelid skin and orbital fat excision or repositioning. Occasionally needed complementary procedures are brow elevation, lateral canthal position adjustment, correction of lower eyelid laxity, and eyelid skin rejuvenation. Upper and lower lid blepharoplasty may be performed for cosmetic reasons. Upper lid blepharoplasty may also be performed for the functional correction of blepharochalasis and dermatochalasis. Facial and especially eyelid appearance is scrutinized extensively by female and male patients. Increased acceptance of plastic surgery and easier access to medical information with the advent of the Internet and television have resulted in well-informed and demanding patients. Minute postoperative imperfections may be the source of unsatisfied patients and thus suggest an unsuccessful outcome. Management of blepharoplasty complications should start before surgery. Building a strong and trusting relationship with the patient is as important as setting goals based on realistic expectations. Because eyelids are not all anatomically the same, the surgical plan should be individualized for each candidate. The possibility of real and perhaps debilitating complications should be clarified. Profound knowledge of eyelid and periocular anatomy and the performance of state-of-the-art surgery taking all standard precautions for proper healing is the physician’s responsibility. Study of old photographs and photographic documentation at the preoperative and postoperative stages is necessary. They may prove useful in patient