Marking Strategies for Upper Blepharoplasty

Abstract

Pinching skin to leave lids closed without redundancy of upper lid skin is the safest way to approach upper blepharoplasty. There may be a need for revision (especially temporally) on probably 20% of patients—especially in the cosmetic population, whose expectations are high (not so much in older patients in which insurance covers surgery and whose expectations are different). Leaving lash eversion and even up to 2 mm of incomplete closure is typically safe if orbicularis strength is good (check by forced eyelid closure and attempt to pry lids open) and other corneal protective mechanisms are intact (Bell’s phenomenon, tear production, and corneal sensation).