Preface: Functional and Cosmetic Eyelid Surgery ix

Gregory H. Branham

Surgical Anatomy of the Eyelids 89

Jordan P. Sand, Bovey Z. Zhu, and Shaun C. Desai

Slight alterations in the intricate anatomy of the upper and lower eyelid or their underlying structures can have pronounced consequences for ocular esthetics and function. The understanding of periorbital structures and their interrelationships continues to evolve and requires consideration when performing complex eyelid interventions. Maintaining a detailed appreciation of this region is critical to successful cosmetic or reconstructive surgery. This article presents a current review of the anatomy of the upper and lower eyelid with a focus on surgical implications.

Surgical Anatomy of the Eyelids 89

Jordan P. Sand, Bovey Z. Zhu, and Shaun C. Desai

Slight alterations in the intricate anatomy of the upper and lower eyelid or their underlying structures can have pronounced consequences for ocular esthetics and function. The understanding of periorbital structures and their interrelationships continues to evolve and requires consideration when performing complex eyelid interventions. Maintaining a detailed appreciation of this region is critical to successful cosmetic or reconstructive surgery. This article presents a current review of the anatomy of the upper and lower eyelid with a focus on surgical implications.

Evaluation of Eyelid Function and Aesthetics 97

Michael G. Neimkin and John B. Holds

The eyes and periocular area are the central aesthetic unit of the face. Facial aging is a dynamic process that involves skin, subcutaneous soft tissues, and bony structures. An understanding of what is perceived as youthful and beautiful is critical for success. Knowledge of the functional aspects of the eyelid and periocular area can identify pre-preoperative red flags.

Periorbital Surgery: Forehead, Brow, and Midface 107

John J. Chi

Periorbital rejuvenation requires a careful understanding of the interplay between the eyelids, brow, forehead, and midface. Reversing periorbital signs of aging requires a correction of volume loss, soft tissue ptosis, and skin changes. Many surgical and nonsurgical techniques exist to treat the aging periorbital region; however, careful consideration of the patient’s complaints and existing anatomy is critical to achieving a safe and esthetically pleasing outcome.

Upper Lid Blepharoplasty 119

Samuel Hahn, John B. Holds, and Steven M. Couch

Upper lid blepharoplasty is a common procedure for restoration and rejuvenation of the upper eyelids that can be performed safely and reliably. Understanding the anatomy and aging process of the brow–upper lid aesthetic unit along with properly assessing the excesses and deficiencies of the periorbital region helps to formulate an appropriate surgical plan. Volume deficiency in the aging upper lid may require corrective augmentation. Preexisting asymmetries and ptosis need to be identified and discussed before surgery. Standardized photography along with a candid discussion regarding patients’ desired outcomes and realistic expectations are essential to a successful outcome.