Bump thermoplasty as a simple treatment for lateral incision closure artifacts after upper eyelid blepharoplasty.

U pper eyelid blepharoplasty is the most commonly performed facial rejuvenation surgery with a high rate of success. It is also one of the most gratifying procedures because functional and cosmetic improvements are readily appreciated by the patient. Precision is required when creating a blepharoplasty incision. The inferior portion of the incision is routinely made in the patient’s existing eyelid crease or placed at the desired height for skin crease reformation centrally. Laterally, the inferior edge of the incision should continue 5 mm above the lateral canthus with a gentle upturn to end before the lateral orbital rim. The shape of the upper portion of the incision relative to the lower portion is dictated by the patient’s anatomy, the degree of dermatochalasis, lateral hooding, and the surgeon’s preference. Incisions that extend beyond the lateral orbital rim leave a noticeable scar and should be avoided. In addition, if the underlying orbicularis is not removed from the lateral extent of the incision, it is likely to heal in a raised, full fashion that is aesthetically unacceptable. Given the cosmetic and functional nature of the procedure, avoidance of a noticeable scar and closure artifacts is vital. Nevertheless, artifacts of skin closure can occur despite taking the precautions mentioned. A small elevation of tissue appearing as a bump can be noted in the lateral aspect of the incision in a small proportion of patients after blepharoplasty. The raised tissue usually improves and settles with time; however, in some patients it persists. Few descriptions regarding these bump artifacts and their treatment are present in the literature. Anecdotally, they have been treated in a number of ways, including massage, steroid injection, and/or surgical excision. Herein, we describe the incidence of these closure artifacts after upper eyelid blepharoplasty. We provide a new, quick, and simple method of their correction: bump thermoplasty.