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Sforza et al. Plast Aesthet Res 2018;5:2 I http://dx.doi.org/10.20517/2347-9264.2017.35 Page 5 of 9

Figure 5. Picture showing the insertion of a needle capturing all the supraperiostal tissue

Figure 6. Picture showing the needle including only half of the thickness of the orbicularis muscle avoiding dimples on the skin

in 2 to 3 months. No patients needed any potential revision surgery for this procedure. No patients presented
laghophtalmos or any eyelid closure difficulties. Hence, a favorable result could also be confirmed with the
absence of revisions as no patients returned with the complaints that the eyebrow has dropped to the original
position [Figures 9 and 10]. The patients were followed up for a period of 3 months to 2 years. Additional
information about patient demographics, types of procedures and complications can be found in Table 1.

DISCUSSION
Blepharoplasty is one of the top 5 cosmetic procedures performed in the United States with over 209,000
cases in the year of 2016 . Notwithstanding it’s considered a very simple procedure, there are two very
[5]
common unfavorable results: remaining lateral excess of skin and medial fat bags. In the majority of upper
blepharoplasties cases, the remaining excess of lateral skin is not provenient of a limited skin removal, but
from an undiagnosed ptosis of the lateral portion of the eyebrow.