Blepharoplasty. A refined technique emphasizing accuracy and control

Although these techniques may seem demanding in controlling bleeding and avoiding use of local anesthetic, they provide distinct advantages: (1) Morbidity of tissue staining and subsequent ecchymosis is dramatically reduced. (2) Although edema still occurs, additional resolution time for breakdown of hemoglobin in the tissues is reduced, and the patient can resume normal activities with less camouflage makeup more rapidly. (3) Intraoperatively, lack of tissue staining and lack of distortion by local infiltration enable the surgeon to see anatomic structures, detail, and contour irregularities that are simply not visible or identifiable when infiltration has been performed, increasing both the accuracy and safety of the procedure. (4) Strict adherence to the principles of avoiding any dissection and of controlling bleeding deep to the plane of the orbital septum avoids the most dangerous potential complications of blepharoplasty while improving aesthetic results by avoiding overresection of soft-tissue components of the eyelids. (5) All of these techniques increase the accuracy, control, predictability, and safety of blepharoplasty.