Blepharoplasty Course

Lesson 1 • Eyelid Layers and Tissue Planes

Identifies each anatomical layer from skin to conjunctiva and their surgical relevance. Establishes the tissue-plane framework used throughout all blepharoplasty procedures.

Lesson 2 • Vascular and Nerve Supply

Maps arterial, venous, and lymphatic networks alongside sensory and motor innervation of the eyelids. Prevents inadvertent vessel or nerve injury during dissection.

Lesson 3 • Periorbital Fat Compartments

Describes the distinct fat pads of the upper and lower eyelids and their boundaries. Correct fat-compartment identification prevents over-resection and contour irregularities.

Lesson 4 • Applied Surgical Topography

Translates anatomical knowledge into surface landmarks used for marking and incision placement. Bridges cadaveric study to live operative decision-making.

Lesson 1 • Medical History and Risk Stratification

Reviews systemic conditions, medications, and bleeding risk factors that affect surgical safety. Stratifies patients into low, moderate, and high perioperative risk categories.

Lesson 2 • Psychological Evaluation and Consent

Assesses patient motivation, body dysmorphic tendencies, and realistic expectation alignment. Structures informed consent to cover risks, alternatives, and expected recovery.

Lesson 3 • Functional vs. Aesthetic Indications

Distinguishes dermatochalasis causing visual field obstruction from purely cosmetic ptosis and skin excess. Guides documentation required for functional surgical justification.

Lesson 4 • Ophthalmic History and Examination

Screens for dry eye, glaucoma, prior ocular surgery, and contact lens use. Identifies conditions that elevate surgical risk or alter postoperative management.

Lesson 1 • Upper Lid Skin Excision Planning

Calculates safe skin excision amounts using pinch test and crease-to-brow distance measurements. Prevents lagophthalmos by preserving adequate skin for full eyelid closure.

Lesson 2 • Photographic Documentation Standards

Establishes standardised preoperative photo sets with consistent lighting, angles, and expressions. Accurate documentation supports outcome comparison, medicolegal records, and teaching.

Lesson 3 • Supratarsal Crease Design

Defines crease height and shape tailored to gender, ethnicity, and individual anatomy. Crease design determines the aesthetic character of the postoperative upper lid.

Lesson 4 • Lower Lid Approach Selection

Compares transcutaneous and transconjunctival approaches based on skin laxity, fat herniation, and snap-test results. Approach selection minimises ectropion risk and optimises fat access.

Lesson 1 • Sedation and Monitored Anaesthesia Care

Reviews sedation levels, monitoring requirements, and communication with anaesthesia providers. Appropriate sedation depth ensures patient cooperation and airway safety.

Lesson 2 • Local Anaesthesia Principles

Covers pharmacology of local anaesthetics and vasoconstrictors used in periorbital blocks. Correct agent selection and dosing minimise pain, bleeding, and systemic toxicity.

Lesson 3 • Injection Technique and Nerve Blocks

Demonstrates supraorbital, supratrochlear, and infraorbital nerve block techniques for complete periorbital anaesthesia. Precise injection reduces patient discomfort and intraoperative movement.

Lesson 4 • Patient Positioning and Eye Protection

Establishes head positioning, corneal lubrication, and protective shield placement for the operative eye. Prevents corneal abrasion and optimises surgeon access throughout the case.

Lesson 1 • Crease Formation and Wound Closure

Creates a defined supratarsal crease through skin-to-levator fixation sutures and closes the wound in layers. Proper closure determines scar quality, crease permanence, and symmetry.

Lesson 2 • Intraoperative Complication Recognition

Identifies and manages bleeding, levator injury, and lagophthalmos risk during the procedure. Early recognition and correction prevent permanent functional deficits.

Lesson 3 • Levator Aponeurosis Assessment

Evaluates levator aponeurosis integrity and identifies dehiscence requiring concurrent ptosis repair. Recognising aponeurotic defects prevents residual ptosis after blepharoplasty.

Lesson 4 • Incision and Skin Excision

Performs the skin incision along marked lines and excises the predetermined skin ellipse. Precise incision depth and beveling preserve orbicularis and prevent scar widening.

Lesson 1 • Canthal Support Procedures

Performs lateral canthopexy and canthoplasty to restore and maintain lower lid position. Canthal support is critical in patients with laxity, negative vector, or prior ectropion.

Lesson 2 • Lower Lid Closure and Finishing

Closes the transcutaneous incision with fine sutures and applies dressings to minimise oedema. Final inspection confirms lid position, contour symmetry, and absence of ectropion.

Lesson 3 • Transcutaneous Approach and Skin Excision

Executes a subciliary incision with skin-muscle flap elevation to address skin laxity and fat excess. Requires precise skin excision to avoid ectropion from over-resection.

Lesson 4 • Transconjunctival Approach

Accesses lower lid fat pads through a conjunctival incision, avoiding external scars. Indicated for patients with adequate skin tone and isolated fat herniation.

Lesson 1 • Scar Management and Revision Planning

Applies silicone gel, steroid injection, and laser therapy to optimise scar maturation. Establishes criteria and timing for surgical revision when primary outcomes are suboptimal.

Lesson 2 • Follow-Up Schedule and Milestones

Defines visit intervals at 1 week, 1 month, 3 months, and 1 year with specific assessment goals. Structured follow-up tracks healing progression and identifies late complications.

Lesson 3 • Recognising and Managing Complications

Identifies haematoma, infection, lagophthalmos, ectropion, and dry eye as key postoperative complications. Prompt recognition and intervention prevent permanent functional or aesthetic deficits.

Lesson 4 • Immediate Postoperative Management

Covers cold compress application, head elevation, and eye lubrication in the first 24 hours. Early interventions reduce oedema, protect the cornea, and minimise discomfort.

Lesson 1 • Asian and Ethnic Eyelid Surgery

Adapts technique for the single-eyelid anatomy, epicanthal fold, and ethnic crease preferences. Cultural sensitivity and anatomical understanding guide individualised surgical planning.

Lesson 2 • Blepharoplasty in High-Risk Patients

Modifies technique and perioperative protocols for patients with thyroid eye disease, prior facial palsy, or anticoagulation. Risk-adapted planning maintains safety without sacrificing outcomes.

Lesson 3 • Revision Upper Blepharoplasty

Corrects asymmetric creases, residual skin excess, and contour irregularities from prior surgery. Scar tissue and altered anatomy demand modified dissection strategies.

Lesson 4 • Ectropion Correction Techniques

Addresses cicatricial and paralytic ectropion with skin grafting, canthopexy, and midface lifting. Technique selection depends on ectropion aetiology and lid laxity degree.

Lesson 5 • Lagophthalmos and Corneal Exposure

Manages incomplete eyelid closure through conservative measures and surgical skin grafting when needed. Prevents corneal ulceration and vision loss from chronic exposure.