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Page 22 of 23 Farber et al. Plast Aesthet Res 2020;7:20 I http://dx.doi.org/10.20517/2347-9264.2020.05

A B

Figure 32. Patient with acquired left ptosis after left upper lid hematoma treated conservatively for a year (A). She had left
tarsoaponeurectomy and was slightly overcorrected, which can easily be treated with downward lid massage (B).

should be verified prior to application. Postoperatively, adequate ocular lubrication should be ensured if
lid closure is incomplete. Should an ocular injury occur, diagnosis is critical. Once a diagnosis is made,
ophthalmologic referral is necessary.

Xerophthalmia
Transient dry eyes are a common finding following blepharoplasty with or without ptosis repair. However,
if not appropriately treated, patients may suffer long-term morbidity. Lubricating eye drops and ointments
should be prescribed. In more severe cases, patients can be prescribed a cyclosporine ophthalmic emulsion
[15]
(i.e., Restasis; Allergan, Inc., Irvine Calif.) to stimulate tear production .

CONCLUSION
With periorbital rejuvenation and blepharoplasty being a common request among aesthetic surgery
patients, it is critical that the plastic and oculoplastic surgeon understand the preexisting conditions and
potential complications that will affect the ultimate postoperative result. Commonly, patients presenting
for blepharoplasty also have blepharoptosis. Failure to diagnose and treat lid ptosis will result in a less than
ideal result and a dissatisfied patient. In this article, we reviewed the preoperative workup, the operative
approach, and the postoperative management of concomitant blepharoptosis. By comprehensively
addressing all age-related periorbital changes, the aesthetic plastic surgeon can expect to enjoy optimized
results and satisfied patients.

DECLARATIONS
Authors’ contributions
Manuscript drafting: Farber SE
Manuscript revisions, figures, videos: Codner MA