Upper blepharoplasty with lateral segmental orbicularis excision.

In an effort to avoid symptoms of persistent lateral eyelid excess, exaggerated segmental resection of lateral preseptal orbicularis oculi muscle is performed. This involves an elliptical excision of the lateral orbicularis oculi muscle larger than that traditionally described using the blepharoplasty incision. This results in a relative advantage to the frontalis muscle, limiting the descent of the lateral brow soft tissues. The procedure was performed on 59 patients over a period of 1 year. None of these patients reported persistent lateral excess after surgery.