Upper Blepharoplasty: Management of the Upper Eyelid and Brow Complex via Transblepharoplasty Approach

Abstract

Upper blepharoplasty is one of the more common facial plastic procedures. The upper lid and brow complex are managed together. Whether upper blepharoplasty is performed for medical or cosmetic reasons, the aim is to improve appearance while retaining natural shape and maintaining (or improving) function. For optimal results, it is important to understand relevant eyelid anatomy and the concept of maintaining youthful volume and position of the eyelid brow orbit complex. Management of patient expectations, meticulous planning, and a degree of surgical finesse all contribute to the desired outcome. The article will focus on the assessment, techniques, and complications of upper blepharoplasty, which involve management of the skin, orbicularis oculi, preaponeurotic fat, levator aponeurosis and muscle as related to concomitant ptosis, and lateral brow complex via transblepharoplasty (internal) brow lift and fixation.

Intraoperative Significance of Lower Eyelid Positions in Levator Advancement to Prevent Overcorrection

“…Overcorrection can cause discomfort due to lagophthalmos, worsening of dry eye, and keratitis. [13][14][15] Mild lagophthalmos is usually temporary with complete resolution after a few days to up to 2 weeks of conservative therapy, but permanent lagophthalmos due to excessive skin and orbicularis resection can occur, which can lead to septal scarring and contracture, as well as levator aponeurosis tethering. Further, dry eye symptoms can be more severe with risk of exposure keratopathy, corneal ulceration, and scarring.…”

Comparison of tumescent local anesthesia vs normal anesthesia technology in upper blepharoplasty in Asian women

“…The performance of upper eyelid blepharoplasty in younger patient usually aims to improve esthetic concerns while in middle aged or elderly patients usually for both cosmetic and functional issues 9 . Patients, especially the Asian patients with typical Asian eyelid features, hope to modifying or creating eyelid crease to generate higher and symmetrical creases by the performance of upper eyelid blepharoplasty 10 .…”

“…For the satisfaction with postoperative recovery, the score of NA side was 9.2 (range, 4.3-9.7) and the score of TLA side was 9.3 (range, The performance of upper eyelid blepharoplasty in younger patient usually aims to improve esthetic concerns while in middle aged or elderly patients usually for both cosmetic and functional issues. 9 Patients, especially the Asian patients with typical Asian eyelid features, hope to modifying or creating eyelid crease to generate higher and symmetrical creases by the performance of upper eyelid blepharoplasty. 10 Thus, blepharoplasty has a crucial function in facial rejuvenation.…”

Eyebrow-lift With Frontal Muscle Plication

“…Aiming to also repair drooping eyelids or impaired vision, it is possible to perform blepharoplasty and eyebrow-lift (Figure 1 and Figure 2). Each procedure can be done either separately or through a transblepharoplasty approach …”