Esthetic blepharoplasty.

Esthetic blepharoplasty is the operation designed to correct excess skin and/or pseudoherniation of fat in the eyelids. These eyelid changes give the pateint a tired look and make him or her look (prematurely) old. The indications and contraindications for the procedure are reviewed. The possibilites and the limitations of the operation must be thoroughly discussed with the patient preoperatively. A psychological evaluation of the patient must be carried out by the surgeon in order to discard unsuitable candidates for the operation. The esthetic blepharoplasty is performed under local anesthesia, completed by intravenous sedation. The operative technique is outlined and consists of judicious skin excisions and resection of fat from the differenct orbital compartments. Atraumatic technique is of utmost importance. Complications are rare in experienced hands but are almost unavoidable in inexperienced hands. Ectropion of the lower eyelid is the most common complication. The cause, prevention and treatment of possible complications are discussed. If carried out properly in a well selected patient by a competent plastic surgeon, the esthetic blepharoplasty gives very satisfying results.