[Blepharoplasty with special reference to correction of xanthelasma]

Tissues in the periorbital region commonly change due to aging. We examined 31 patients for scar formation and symmetry after blepharoplasty and looked for symptoms of keratoconjunctivitis sicca by means of the Schirmer's I test. In eight patients the operation was done because of xanthelasma formation. Visible scars remained in the upper eyelid if the incision was placed too far medially or too far laterally beyond the lateral orbital rim or too close to the lid margin. In the lower eyelid, the scar is unsightly when near the lid margin. Since in all patients visible scars were left after correction of xanthelasma, the CO2 laser was used in four patients in addition to the surgical procedure in order to avoid extension of scars.