Nuances of aesthetic blepharoplasty.

The orbits and surrounding tissues form the emotional and expressive center of the human face. Eye contact forms a large part of human interaction and, unfortunately, it is often this region that first surrenders to the aging process. A successful blepharoplasty depends on the careful evaluation of a patient's eyes, correct assessment of the cosmetic problems, and the surgical dexterity to repair such defects adequately. Consistent success may be achieved only with mastery of aesthetic consideration of the eyes, which aid in the diagnosis of the deformity of asymmetry. From that, the appropriate surgical intervention may ensue. This discussion will review the anatomy related to different orbital expressions, delineate the effects of aging, and briefly touch on techniques in our surgical armamentarium to correct and improve eyes through blepharoplasty.