Blepharoplasty and Brow Lifting

The eyes are often described as “windows to the soul.” A youthful soul in a more mature person implies vitality, no matter the age. Consequently, aesthetic eyelid and periocular surgery has long been a desirable portion of the anti-aging process.

In the past two decades, emphasis has shifted from “performing a blepharoplasty” to rejuvenation of the entire periocular area (when indicated) using safe and reliable methods. Current “cutting edge” technology explores the relationship of volume loss (bony and soft tissue), the weakening of the ligamentous structures of the upper face and midface, and gravitational descent.

In addition, social fashions have changed. No longer is a high, sculpted eyelid fold a universal desire. In addition, personal and ethnic variations in aesthetic surgery of the brow, eyelid, and midface complex vary from patient to patient. Periocular rejuvenation in a person of Asian, Middle Eastern, Hispanic, or African-American descent may require variations in surgical, injection, and ancillary techniques (such as laser).

Also, in this era, price and time away from activities may, for some patients, modulate the desire to look as “good as possible.” Often there is a compromise between the best possible result and the need to keep price and/or recovery times minimal.

Obviously, every aspect of periocular rejuvenation cannot be covered in a single journal issue (nor, for that matter, in a comprehensive textbook). The attempt in this issue of Facial Plastic Surgery is to present the techniques of experienced authors on the cutting edge of technology with an emphasis on safety. Some of these articles are evidence based, and others are practice oriented.

My thanks go to Dr. Sclafani and the editors of Facial Plastic Surgery for allowing me to assemble the works of this talented group of authors into this issue. My thanks also go to the authors, many of whom submitted articles that reflected previously unpublished practices that they have consented to share.