Eyelid surgery knowledge map

Upper eyelid

• Upper blepharoplasty

  Upper blepharoplasty (upper eyelid surgery, eyelid lift) removes excess skin from the upper eyelids, with or without a strip of orbicularis muscle and some fat. It is for adults with redundant upper lid skin, which can restrict the upper field of vision and cause lid heaviness, headache and tearing.

  Illustrated Upper blepharoplasty

  Research Upper blepharoplasty

• Functional blepharoplasty and visual fields

  Functional blepharoplasty and ptosis repair are eyelid operations paid for by insurance when redundant skin or a low eyelid margin measurably blocks the upper visual field, as distinct from surgery performed only to change appearance. Medicare contractors and most US commercial insurers require a visual field test with the eyelid untaped and then taped or elevated, a measured eyelid position (MRD1), and photographs before they will pay for the surgery (CMS LCD L34028).

  Test Visual field test · Wikidata Q1801370 · Wikipedia · MeSH D058609

  Research Functional blepharoplasty and visual field

• Non-surgical eyelid tightening

  Non-surgical eyelid tightening uses energy devices, most often radiofrequency, microneedling radiofrequency, or plasma (fibroblast) devices, to shrink lax eyelid skin without an incision. It is offered to patients with mild to moderate dermatochalasis who want improvement without surgical blepharoplasty, though surgery remains the first choice for permanent, more pronounced results.

• Male blepharoplasty

  Male blepharoplasty removes or repositions excess upper or lower eyelid tissue in men, using the same core techniques as blepharoplasty in women but aimed at preserving a flat, low-set brow and full eyelid rather than an arched, elevated one. It is for men with dermatochalasis, fat prolapse or brow ptosis who want correction without a feminized result.

  Research Male blepharoplasty

• Blepharoplasty by age · Topic

  Eyelid surgery is done from the 30s into the 80s. What the surgery treats, the technique chosen and the risks all change by decade, from fat bulging without extra skin in healthy adults in their 30s to severe droop with weak lifting muscle in patients in their 80s. Blepharoplasty is projected to rank among the three most requested cosmetic procedures in the United States by 2030 as the patient population ages.

• Eyelid and periorbital skin resurfacing

  Periorbital skin resurfacing treats wrinkles, crepey texture, and photodamage around the eyes with ablative CO2 laser, erbium:YAG laser, or a trichloroacetic acid (TCA) or phenol chemical peel, applied to skin that blepharoplasty's excision of skin and fat does not smooth. It is for patients whose main complaint is skin quality rather than excess lid skin, and it is used both as an alternative to surgery and as an add-on performed at the same time as blepharoplasty.

  Research Laser and resurfacing

Research Orbital fat

Lower eyelid and eye bags

• Lower blepharoplasty

  Lower blepharoplasty (lower eyelid surgery, eye bag surgery) treats bags under the eyes by removing or repositioning the orbital fat that bulges below the eye, and by removing excess skin when present. It is done mainly for appearance, for adults who see bags or circles under the eyes, a tired look or a flattened face.

  Illustrated Lower blepharoplasty approaches

  Research Lower blepharoplasty

• Transconjunctival blepharoplasty

  Transconjunctival blepharoplasty removes or repositions lower eyelid fat through an incision on the inside of the lid, leaving no visible skin scar. It suits patients whose main problem is bulging fat rather than excess skin, since the incision itself removes no skin.

  Research Transconjunctival blepharoplasty

• Fat repositioning in lower blepharoplasty

  Fat repositioning moves lower eyelid fat over the orbital rim instead of removing it, to fill the tear trough and blend the lid-cheek junction. Loeb first described sliding the fat pad over the rim and grafting fat to level lid depressions in 1981.

  Illustrated Fat repositioning

  Research Fat repositioning

• Tear trough and lid-cheek junction surgery

  Tear trough surgery smooths the groove between the lower eyelid and the cheek by releasing the ligament that tethers it and filling it with the patient's own fat, either moved on its blood supply from the eye bag or grafted. It is used mainly for moderate to severe grooves; filler suits mild grooves with good skin, little lid laxity and little fat bulging.

  Research Tear trough

• Tear trough filler versus lower blepharoplasty

  Tear trough filler injects hyaluronic acid (HA) gel to fill the groove between the lower lid and cheek; it is a same-day, non-surgical option for volume loss without significant skin excess. Lower blepharoplasty with fat repositioning moves or grafts fat over the orbital rim surgically, giving a longer-lasting correction at the cost of surgical downtime and risk.

  Research Fillers

Droopy eyelids and ptosis

• Ptosis surgery (blepharoptosis repair)

  Ptosis surgery (blepharoptosis repair) raises an upper eyelid whose margin sits too low, either by reattaching and advancing the levator tendon through a skin incision or by shortening Müller's muscle from inside the lid. Acquired ptosis is often missed because the forehead muscle lifts the lids; more than half of patients seen for facial rejuvenation had it.

  Illustrated Ptosis repair

  Research Ptosis repair · Muller muscle resection · Frontalis sling

• Upper blepharoplasty with ptosis repair

  Upper blepharoplasty removes excess eyelid skin while ptosis repair raises a lid margin that sits too low; the two are done in one operation when a patient has both dermatochalasis and ptosis in the same eyelid. Ptosis is often missed on a routine blepharoplasty exam, since the forehead muscle can mask it, which is why surgeons are advised to check for it before every upper-lid case.

• Upneeq eye drops and nonsurgical ptosis treatment

  Oxymetazoline hydrochloride ophthalmic solution 0.1%, sold as Upneeq, is an eyedrop that raises a drooping upper eyelid for hours at a time by contracting Müller's muscle, and is the only drug the FDA has approved for acquired blepharoptosis in adults (FDA label, DailyMed). Across randomized trials the lift is real but modest, roughly 1 mm of eyelid margin, so it suits mild to moderate droop rather than severe ptosis.

  Drug Upneeq (oxymetazoline hydrochloride ophthalmic solution 0.1%)

  Research Nonsurgical ptosis treatment

Double eyelid

• Double eyelid surgery

  Double eyelid surgery (Asian blepharoplasty) creates a supratarsal fold in an upper eyelid that has none, using a buried-suture technique, a partial incision, or a full incision. It is for Asian adults seeking a defined upper lid crease; surgery to form the fold is reported as the most common upper-eyelid procedure among Asians, with some patients undergoing it 2 to 3 times in a lifetime.

  Wikidata Q5327743 · Wikipedia

  Illustrated Double eyelid surgery

  Research Double eyelid surgery

• Epicanthoplasty

  Epicanthoplasty removes or repositions the epicanthal fold, a skin fold over the inner corner of the eye formed by a connection between the upper and lower preseptal orbicularis oculi muscle. It is for patients seeking a longer horizontal eye opening and is usually performed together with double eyelid surgery in the same operation.

  Wikidata Q5382486 · Wikipedia

  Research Epicanthoplasty

• Double eyelid revision surgery

  Double eyelid revision surgery corrects a crease that sits too high, a lid with more than one crease, a crease that has faded or disappeared, or an upper lid that looks hollow after a prior double eyelid operation. About 1 in 5 revisions in one surgeon's series was a revision of an already-failed revision, most often for ptosis, asymmetric creases, supratarsal depression, or a high or short crease.

Brow lift

A low brow pushes skin down onto the upper lid. A brow lift raises it through small scalp incisions, the temple, the hairline, the lid crease or an incision above the brow, often with upper blepharoplasty.

Wikidata Q141333520

Research Brow lift

• Endoscopic brow lift

  An endoscopic brow lift raises low eyebrows through a few short scalp incisions and a camera, without the ear-to-ear coronal incision, and weakens the frown muscles between the brows. It is used for brow droop and frown lines, and it was the most frequent brow lift technique in American Society of Plastic Surgeons member surveys in 2000 and 2020.

  Illustrated Brow lift incisions

• Temporal and lateral brow lift

  A temporal (lateral) brow lift raises the tail of the eyebrow and the hooded skin at the outer corner of the eye through a short incision in the temple, usually behind the hairline. It is for people whose outer brow has dropped, which usually happens before the inner brow drops, and it is often done together with a blepharoplasty or a facelift.

• Browpexy and direct brow lift

  A browpexy holds up the outer eyebrow with stitches placed through the upper eyelid incision during a blepharoplasty, so the brow does not drop below the bony rim. A direct brow lift removes a strip of skin just above the eyebrow to raise it, and it is used for any degree of brow droop, most often in men, older women and people with facial nerve weakness.

  Research Browpexy

• Blepharoplasty with facelift and brow lift

  Blepharoplasty is often done together with a brow lift, a facelift, or both, because the brow, the eyelids and the lower face age together and share surgical planes. In the largest eyelid-specific review, adding a brow lift to blepharoplasty did not raise the major complication rate.

Eye shape and lid position

• Canthoplasty and canthopexy

  Canthopexy and canthoplasty anchor the outer corner of the eyelids (the lateral canthus) to the orbital rim so the lower lid stays against the eye and keeps its shape. Surgeons add them to lower eyelid and midface operations that can pull the lid down or turn it out, and to blepharoplasty when the lower lid is lax.

  Illustrated Canthopexy and canthoplasty

  Research Canthoplasty and canthopexy

• Fox eye and canthal tilt surgery

  Canthal tilt is the angle of the line connecting the inner and outer corners of the eye. Raising the outer corner produces the upswept look patients call "fox eye," "cat eye," or "almond eye," achieved with lateral canthoplasty, lateral canthopexy, or thread lifts. An upward lateral canthal tilt is endorsed almost unanimously as more feminine-appearing in a large survey, which is why the tilt is also a target in facial feminization surgery.

• Eyelid surgery in thyroid eye disease

  Thyroid eye disease is an autoimmune orbital disease, usually tied to Graves' hyperthyroidism, that swells the eyelids, retracts them, and pushes the eyes forward. Surgery (orbital decompression, eyelid retraction repair, and blepharoplasty) treats the residual, inactive-phase changes once the drug for active inflammation, teprotumumab, has run its course or was never an option.

  Condition Thyroid eye disease · Wikidata Q1340722 · Wikipedia · MeSH D049970

  Research Thyroid eye disease

Research Lagophthalmos

Safety, recovery and revision

• Blepharoplasty complications · Topic

  Blepharoplasty complications range from temporary dry eye to permanent vision loss, and most are minor and resolve on their own. Orbital hemorrhage (bleeding behind the eye) occurs in about 1 in 2,000 cosmetic eyelid surgeries, and permanent visual loss in about 1 in 22,000.

  Research Complications

• Blepharoplasty scars · Topic

  Blepharoplasty scars sit in the upper eyelid crease, below the lower lashes, or inside the lid itself (no visible scar). In most patients they heal to a thin, pale line, because incision placement and the patient's own skin biology matter more than the technique and tools used. Hypertrophic (raised, red) scarring after cosmetic eyelid surgery is uncommon, about 1%, and keloid scarring is rare, with none reported in a systematic review.

• Eyelid surgery anesthesia · Topic

  Eyelid surgery is done under local anesthesia alone, local anesthesia with oral or intravenous sedation, or general anesthesia, depending on the procedure, the patient and the setting. Most upper and lower blepharoplasty and ptosis repair can be done with local anesthesia in an office, but combined procedures, anxious patients or children more often need sedation or general anesthesia in an accredited facility.

  Research Anesthesia

• Revision blepharoplasty

  Revision blepharoplasty corrects a problem that persists or appears after an earlier eyelid operation, most often lower lid retraction, upper lid hollowing, crease asymmetry, or a misplaced crease. Correction is difficult and unpredictable, so surgery for a revision patient differs from a first-time blepharoplasty in both planning and materials.

  Research Revision

Research Recovery