Papanikolaou Georgios E, Bouranta Konstantina, Smiris Thomas Iraklis, Varvarousis Dimitrios N
Plastic Surgery, Private Practice, Ioannina, GRC.
Medical School, University of Ioannina, Ioannina, GRC.
Cureus. 2025 Feb 28;17(2):e79817. doi: 10.7759/cureus.79817. eCollection 2025 Feb.
Upper blepharoplasty is a common aesthetic procedure aimed to address dermatochalasis of the eyelid and improve visual acuity. During the postoperative period, patients may experience complications that are usually minor and transient. However, these complications may adversely affect the healing process, delaying the desired result. Accordingly, we present a case of a 57-year-old female with late and transient unilateral blepharoptosis after cosmetic upper blepharoplasty. Preoperative examination revealed the presence of bilateral upper eyelid dermatochalasis and mild prolapse of the nasal fat pad, normal function of the orbicularis oculi, levator palpebrae superioris and frontalis muscles, without evidence of ptosis. Medical history included hyperlipidemia without other significant comorbidities. We hypothesize that the additional local anesthetic injection at the affected eyelid in combination with the persistent edema could have caused the development of ptosis. Therefore, we emphasize the careful use of local anesthetic solution in cases of blepharoplasty and the detailed preoperative examination of the patients to exclude the presence of preexisting blepharoptosis. Moreover, we propose an intraoperative strategy to reduce the possibility of injury of the levator palpebrae superioris muscle and aponeurosis, and therefore to improve postoperative recovery in upper blepharoplasty.
上睑成形术是一种常见的美容手术，旨在解决眼睑皮肤松弛问题并提高视力。在术后期间，患者可能会经历一些通常较为轻微且短暂的并发症。然而，这些并发症可能会对愈合过程产生不利影响，延迟预期效果。因此，我们报告一例57岁女性在美容性上睑成形术后出现迟发性和短暂性单侧上睑下垂的病例。术前检查发现双侧上睑皮肤松弛以及鼻侧脂肪垫轻度脱垂，眼轮匝肌、上睑提肌和额肌功能正常，无睑下垂迹象。病史包括高脂血症，无其他重大合并症。我们推测，患侧眼睑额外注射局部麻醉剂并伴有持续性水肿可能导致了上睑下垂的发生。因此，我们强调在进行上睑成形术时要谨慎使用局部麻醉溶液，并对患者进行详细的术前检查以排除既往存在的睑下垂。此外，我们提出一种术中策略，以减少上睑提肌及其腱膜损伤的可能性，从而改善上睑成形术的术后恢复情况。
