Blepharoplasty: indications, outcomes, and patient counseling.

A tell-tale sign of the aging face is upper eyelid skin redundancy and lower eyelid bags. These changes can contribute to a "tired" appearance. Upper and lower blepharoplasty procedures can correct these processes. By removing skin and muscle, an upper eyelid blepharoplasty can give the eye a larger appearance. A lower blepharoplasty can remove pseudo-herniated fat, or transpose it to provide a smooth infraorbital contour. It appears that a transconjunctival approach for the lower blepharoplasty will lead to a lower incidence of eyelid malposition. An adjunctive procedure such as laser resurfacing may be appropriate. Patients should be counseled on all potential complications, including visual loss from muscle injury or hematoma, as well as the extent of postoperative recuperation.