BLEPHAROPLASTY: OPHTHALMOLOGICAL AND AESTHETIC INDICATIONS FOR THE SURGICAL PROCEDURE

Abstract

Blepharoplasty is a surgical procedure that aims to correct aesthetic or functional problems in the eyelids, such as excess skin, pockets of fat, sagging or poor positioning. Surgery can be performed on the upper, lower eyelids or both, depending on each patient's needs and goals. Blepharoplasty can improve the appearance of the eyes, giving a more youthful and rested appearance, in addition to improving peripheral vision, when this is impaired by excess skin on the upper eyelids. Blepharoplasty is normally indicated after the age of 40, when signs of aging become more evident in the eye area, due to the loss of skin elasticity. However, it can also be performed on younger people, when there are genetic factors that favor the appearance of fat pads or drooping eyelids. Additionally, blepharoplasty can be used to harvest skin grafts when necessary. Objective: to analyze the ophthalmological and aesthetic indications for blepharoplasty. Methodology: based on the PRISMA checklist. The PubMed, Scielo and Web of Science databases were consulted, using the following descriptors: blepharoplasty, eyelids, eye plastic surgery, indications, results. Articles published in the last 10 years, in Portuguese, English or Spanish, that addressed blepharoplasty in its ophthalmological and aesthetic aspects were selected. The inclusion criteria were: original articles, reviews, case reports, case series, which presented data on indications, results, complications and satisfaction of patients undergoing blepharoplasty. The exclusion criteria were: duplicate articles, articles that did not address blepharoplasty in its ophthalmological and aesthetic aspects, articles that did not present sufficient or reliable data, articles that were not relevant to the topic. Results: 12 studies were selected. The ophthalmological indications for blepharoplasty are: eyelid ptosis, blepharochalasis, dermatochalasis, ectropion, entropion, lagophthalmos, xanthelasma, eyelid tumors, among others. The aesthetic indications for blepharoplasty are: facial rejuvenation, correction of asymmetries, harmonization of the look, increased self-esteem, among others. The results of blepharoplasty are generally satisfactory, both from a functional and aesthetic point of view. Surgery improves patients' quality of life by reducing ophthalmological symptoms, such as irritation, tearing, feelings of heaviness, visual difficulties, and by increasing confidence, self-image and self-acceptance. Blepharoplasty can also improve facial expression, by smoothing wrinkles, dark circles and apparent tiredness. Complications of blepharoplasty are rare and generally transient, but may include: infection, bleeding, hematoma, hypertrophic scarring, keloid, changes in sensitivity, asymmetry, difficulty closing the eyes, dry eye, keratitis, diplopia, ectropion, entropion, residual ptosis , between others. Conclusion: Blepharoplasty is a safe and effective surgical procedure, which can bring both ophthalmological and aesthetic benefits to patients who have eyelid problems. Surgery can improve patients' vision, appearance, self-esteem and quality of life, with a low rate of complications and a high degree of satisfaction. However, it is important that patients are well informed about the indications, risks, results and limitations of blepharoplasty, and that they choose a qualified and experienced professional to perform the procedure.