Abstract
While many of the basic tenants of upper lid blepharoplasty remain constant regardless
of skin type, the thick-skinned eyelid patient requires special consideration. The
brow may be naturally lower in the thick-skinned patient. These patients are more
prone to having the brow pulled downward while attempting to remove redundant skin.
There may also be more fat in the medial and central compartments. There may be fat
in a lateral compartment overlying the lacrimal gland. Patient's expectations for
a deep lid sulcus and complete excision of redundant skin may not be possible. They
are more prone to an observable scar, a small dog ear at the lateral wound edge, and
prolonged postoperative lid edema. Patients with lifelong upper lid fullness must
get some input from significant others because their upper face aesthetic will change.
In these patients, the eyelid surgery is not a rejuvenation, but a creation.
Keywords
blepharoplasty - thick skin - upper lid
