Blepharoplasty With Ptosis Repair

Larning Objectives: The reader is presumed to have a broad understanding of aesthetic surgical procedures. After studying this article, the participant should be able to: Evaluate the patient with eyelid ptosis who presents for cosmetic blepharoplasty. Describe eyelid ptosis repair performed simultaneously with cosmetic upper lid blepharoplasty. Analyze the cosmetic blepharoplasty patient who presents postoperatively with asymmetric eyelid levels. Physicians may earn 1 AMA PRA Category 1 credit by successfully completing the examination based on material covered in this article. The examination begins on page 62. ASAPS members can also complete this CME examination online by logging on to the ASAPS Members-Only Web site (http://www.surgery.org/members) and clicking on “Clinical Education” in the menu bar. A patient seeking blepharoplasty to improve the upper eyelids may require correction of excess hooding of skin, mechanical ptosis, lid ptosis, asymmetry of the eyelid margin, and/or brow ptosis. Correction of ptosis can be performed at the same time as cosmetic or functional blepharoplasty, thereby avoiding the necessity of 2 separate procedures, and is frequently helpful in improving appearance and range of the visual field. A simplified technique under “monitored” conditions will allow good correction in most patients. Monitored technique, with the patient awake and positioned vertically, is essential for viewing eyelid level so that corrections can be made in cases of asymmetry or if lid levels need to be adjusted before completion of the procedure. The author presents a simplified procedure and discusses proper lid level and correction of asymmetric ptosis repair.