Upper lid blepharoplasty, eyebrow ptosis, and lateral hooding.

BACKGROUND Upper blepharoplasty is a common aesthetic surgical procedure. Different surgical techniques and markings have been described, some of which may incorporate browpexy or browlifting. Considering the upper periorbital area as an aesthetic unit, various techniques of browpexy and browlifting have been taken into consideration. OBJECTIVES The authors describe their technique for upper blepharoplasty, which includes an extended cutaneous excision that permits good correction of lateral hooding, reducing the need for browpexy or browlifting. Indications and surgical outcomes are also presented. METHODS The authors retrospectively reviewed the records of 552 consecutive patients who underwent upper blepharoplasty according to the authors' technique between January and December 2008. The patients received local anesthesia. Cutaneous excision extended beyond the eyelid to include the lower lateral portion of the eyebrow area. RESULTS Optimal functional correction was achieved in all cases, and the majority of patients were pleased with their aesthetic result. No significant complications occurred; 4 minor complications were noted and are described fully in the text. CONCLUSIONS The authors' modification of the usual technique of blepharoplasty results in excellent correction, both functional and aesthetic, of the periocular area, particularly the lateral portion. The technique is safe, and patient satisfaction is high. LEVEL OF EVIDENCE 4.