Abstract
Dermatochalasis, or the excess of skin of the upper eyelid, may cause obstruction of the visual axis or patient dissatisfaction with cosmesis. Prominence of the nasal orbital fat compartment and/or the pre-aponeurotic fat pad often accompanies these age-related cutaneous changes. Upper eyelid blepharoplasty may be performed to either improve the superior visual field or for cosmesis. Patients should be educated about the risks of the procedure, including alternatives. It is important to recognize when blepharoplasty alone is sufficient to address the patient’s complaints and when it is necessary to perform adjunctive procedures such as eyelid and brow ptosis repair to optimize surgical outcomes.