Preoperative Measurements in Upper Blepharoplasty: Patient Selection

Abstract

When examining the blepharoplasty patient preoperatively, special attention should be paid to the brows. The MRD obtained with eyebrows manually raised (referred to as MRDb) is highly predictive of the postblepharoplasty MRD. Examine for lagophthalmos by having the patient passively close his or her eyelids as if sleeping. It is important to note brow position, the superior sulcus, and lateral hooding.

Reprinted from Chen WPD, Khan JA, McCord, Jr, CD. Color Atlas of Cosmetic Oculofacial Surgery. Philadelphia, PA: Butterworth Heinemann/Elsevier; 2004. With permission from Elsevier.

• When examining the patient preoperatively, special attention should be paid to the brows.

• The MRD obtained with eyebrows manually raised (referred to as MRDb) is highly predictive of the postblepharoplasty MRD.

• While the brows are manually raised, the superior sulcus is examined for evidence of herniating nasal and preaponeurotic fat pads and to search for lacrimal gland prolapse.

• Ballottement of the globe while examining the superior sulcus helps determine which fat pads should be resected. Any preexisting eyebrow ptosis, eyelid ptosis, or nasal webbing should be both documented and emphasized to the patient.

• Finally, the extent of lateral hooding and retro-orbicularis oculi fat (ROOF) should be noted.

• Examine for lagophthalmos by having the patient passively close his or her eyelids as if sleeping.