| The upper eyelid of this middle-aged lady shows thin skin folding over itself and obscuring the platform of typically taut skin between lashes and crease. The brow is in good position, and there is no indication of excessive upper fat.
Upper blepharoplasty excising skin alone is sufficient in such cases. The underlying orbicularis muscle may be left alone or, as was done in this case, it may be incised to expose the deeper tarsal plate and allow for "deep fixation," a technique creating a temporary attachment of the skin edges to the deeper anatomy. This helps to deepen the final crease and tighten the skin over the exposed platform for smoother application of makeup.
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