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Blepharoplasty Grand Rounds Presentation by Gregory Young, M.D. Karen Calhoun, M.D.

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Presentation on theme: "Blepharoplasty Grand Rounds Presentation by Gregory Young, M.D. Karen Calhoun, M.D."— Presentation transcript:

1 Blepharoplasty Grand Rounds Presentation by Gregory Young, M.D. Karen Calhoun, M.D.

2 Anatomy s Skin s Orbicularis Oculi s Septum s Levator and Lower Lid Aponeurosis s Mullers/Horners Muscle s Tarsal Plate s Orbital Fat

3 Indications s Functional –Impaired vision –Asthenopia s Cosmetic –Blepharochalasis –Dermachalasis –Excess fat or orbicularis muscle

4 Precautions s Ocular anatomy- Proptosis, Dry eyes s Systemic- Coagulopathy, Shingles, MI s Meds- NSAIDS, Anticoagulants s Social- Tobacco

5 Preoperative Evaluation s Complete H & P s Systematic Evaluation of fat, skin, muscle, eyelid position, puncta s Ophthalmologic Exam- visual acuity, visual field, shirmer test, EOMs, ocular pressures, scleral show

6 Preoperative Evaluation s Concomitant Cosmetic Deformities –Eyelid or Brow Ptosis s Generalized Skin Conditions –Acne or Keloids s Photographs s Realistic Expectations

7 Operative Techniques s Upper Lid Blepharoplasty

8 Operative Techniques s Lower Lid Blepharoplasty –Transconjunctival Approach

9 Operative Techniques s Lower Lid Blepharoplasty –Transcutaneous Approach

10 Postoperative Considerations s Ice, elevate HOB, ointment s Watch for hematoma s Postoperative diplopia, lower lid dysfunction s Remove sutures in 3-4 days

11 Complications s Dissatisfied Patient s Corneal Injury s Subcutaneous/Submuscular Hematoma s Retrobulbar Hematoma s Blindness s Lagophthalmos

12 Complications s Ptosis s Epiphora s Entropion s Ectropion s Dry eye syndrome s Enophthalmos

13 Complications s EOM Muscle Imbalance s Conjunctival Granuloma s Prolonged Chemosis s Conjunctival Inclusion Cysts s Lower Lid Retraction


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