Treatment for Cosmetic Complications of Upper Blepharoplasty

Cosmetic complications in upper blepharoplasty are so-called as “Patient dissatisfaction” with the result. They can be categorized as the true impairment in eyelid and vision. The patient disappointment may be the result of:


- Unrealistic expectations
- Poor procedure used by an inexperienced blepharoplasty surgeon
- Asymmetric or Excess creases
- Under correction


Once blepharoplasty has been performed, the Unrealistic expectations by the patient are difficult problem to undue. The actual effective "treatment" for this is an honest and caution discussion between patient and his blepharoplasty surgeon. This discussion is about what can and cannot be attained by blepharoplasty.


Poor choice of procedure and execution by an inexperienced blepharoplasty surgeon can cause uneven results and excessive scarring. The approach to a more experienced blepharoplasty surgeon can retrace most of the steps of the surgery and can undertake correction as needed.


The upper two eyelids may be unmatched in height and shape after blepharoplasty due to Asymmetric or high creases in upper. This outcome is not rare. The same problem may not be related to blepharoplasty and can exist before the surgery. This can be caused by some separate problem (may be unrecognized) like brow drop and ptosis. To correct these deficiencies a patient has to elect a proper surgical method or he can simply ignore the imbalance between the two eyelids if it is soft. There is a fact that mild eyelid asymmetries are natural rather than any exception and this does not depend upon whether a person undergone blepharoplasty or not. The procedure to lower a crease is slightly complex. The crease may lower by the slight removal of additional skin usually accompanied by deep fixation.


There is a common reason why patient is dissatisfied, which is the overly conservative removal of upper eyelid skin. It is important for a blepharoplasty surgeon to accentuate that the prime goal of blepharoplasty is to enhance the looks without creating a bleak "surgical" look. Thus healthy conservatism will leave a patient slightly undercorrected. Fortunately, this problem can be easily corrected by the further excision of excess tissue and commonly, the skin needs to be removed and healing is rapid.


The blepharoplasty may results as hollowness and/or high eyelid crease when excessive fat removed from the upper eyelid. The procedure to repair this problem is quite difficult. To correct this fat grafts received from the patient's body can be implanted into a space formed between the closing muscle (orbicularis muscle) and opening muscle tendon (levator aponeurosis). This implant creates fullness and gives a tissue buffer to lower the crease. Such procedure is not entirely precise because of its limitation of scarring and survival of fat implanted. More than one technique may require achieving the best possible shape.