Blepharoplasty, or cosmetic eye surgery, was described nearly seventy years ago and then practiced with only minor refinements. Twenty years ago, a major innovation initiated rapid evolution in eyelid surgery technique while also introducing its own set of shortcomings that have only recently begun to be addressed.
Things have changed. Today's procedures are based upon a better understanding of eyelid aging and the perils of disturbing orbital fat and natural eyelid support.
Even so, many cosmetic surgeons still employ "textbook" upper and lower blepharoplasty based upon classic concepts from the 1950s. While such surgery may yield a noticeable change, it often leaves the face and lids looking harsh, hollowed, or windswept and may lead to later undesirable signs and symptoms.
By trading one deformity for another, it may even accelerate the very changes for which eyelid lift surgery was first sought.
