The "KISS" in KISS Blepharoplasty has nothing to do with those bite-size pieces of chocolate wrapped in foil, a tender meeting of the lips, or the heavy metal band from the seventies. It's a reference instead to a principle widely revered in science, technology, and business that states that simplicity of design should always be a goal, while nonessential complexity is best avoided.
Or, to say it more directly, "Keep it Simple, Stupid!"
As Albert Einstein once observed, "Everything should be made as simple as possible, but not simpler." In other words, while simplicity for the sake of simplicity alone is not the goal, unnecessarily complex solutions should be shunned.
But why? Is there something wrong with complexity?
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No, there's nothing inherently wrong with complexity, just as long as it's really required.
Think back to Rube Goldberg's cartoons of those wildly complicated "non-KISS" machines, ultimate examples of complexity created just for the heck of it.
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So what does all of this have to do with blepharoplasty? Ask any experienced revision expert who provides care to patients unhappy with their results after cosmetic eyelid surgery.
While improper execution of an operation by the first surgeon is typically the primary cause of many mishaps, a not infrequent and major contributing factor is often poor judgment in the very selection of the procedure that was undertaken.
Most surgeons like to think of themselves as practicing at the forefront of their specialties by offering only the latest and greatest. Despite increased invasiveness, surgical difficulty, and lack of a long-term track record, some new procedures become quickly touted as superior replacements for more reliable and less destructive techniques.
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A related form of misjudgment is simple overkill -- employing multiple procedures when a single procedure would work as well or even better.
Antoine de Saint Exupéry, author of The Little Prince, noted that "It seems that perfection is reached not when there is nothing left to add, but when there is nothing left to take away."
In many cases, doing less is actually more, while doing more is not only superfluous but an invitation for trouble.
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Throwing everything but the kitchen sink at a common problem with a straightforward fix can result in delayed healing, an unnatural appearance, higher rates of both immediate and late-term complications, not to mention increased costs. While this may seem rather obvious, some surgeons act quite to the contrary. For instance,
Brow elevation, a euphemism for upper face lift, is far too commonly recommended to thirty year olds with slightly baggy upper lids and brows that sit exactly where they did the day they turned twenty-one.
Canthopexy has, in some practices, become a mandatory component of every lower blepharoplasty, even though it increases swelling and delays recovery.
Aggressively repositioning fat out of the orbit to partially fill in a modest cheek depression can and often does result in later eyelid hollowness.
Laser skin resurfacing on a young patient with next to no wrinkling can cause prolonged recovery time, pigmentary changes, and even scarring.
Even though commercial fillers provide a simple and safe remedy for many minor flaws, patients are still undergoing multiple rounds of fat injections, placement of silicone cheek implants, and midface lifting to try to hide anatomic indentations so subtle they can hardly be recognized.
Richard Williams, the three time Oscar-winning animator behind the Pink Panther and Roger Rabbit, noted that inexperienced animators tend to "overanimate." The same seems to hold true in plastic surgery. Whether established or fresh out of their training, cosmetic surgeons inexperienced with frequent blepharoplasty seem to be the very ones most likely to offer overly complicated solutions.
In the end, the number and complexity of procedures performed says little about the result. Proper selection and skilled execution are what matter.
Of course, some patients do indeed have anatomical conditions that require more aggressive or multiple procedures. However, the large majority of patients do not.
While always hoping for a nice improvement, most realistic patients are not expecting to turn out looking like a college sophomore. They want to appear more refreshed while looking natural and still recognizable. Most could care less about a few stray wrinkles or a "touch" of a tear trough (expected features on the face of even the most attractive forty year old). In most instances, the KISS Blepharoplasty will serve them well.
In the words of Colin Chapman, the founder of Lotus Software, "Simplify, and add lightness."
So how exactly is a KISS Blepharoplasty performed? As you may have figured out by now, the specific technique most appropriate for any given patient will vary while KISS principles discussed above should not. To learn more about the approaches we most favor and why, browse through our site's different sections that can be accessed directly below.
