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World J Clin Cases. Mar 16, 2023; 11(8): 1719-1729
Published online Mar 16, 2023. doi: 10.12998/wjcc.v11.i8.1719
Modern blepharoplasty: From bench to bedside
Giovanni Miotti, Marco Zeppieri, Giacomo Pederzani, Carlo Salati, Pier Camillo Parodi
Giovanni Miotti, Giacomo Pederzani, Department of Medical, Surgical and Health Sciences, Plastic and Reconstructive Surgery Unit, University of Trieste, Trieste 34123, Italy
Giovanni Miotti, Pier Camillo Parodi, Department of Plastic Surgery, University Hospital of Udine, Udine 33100, Italy
Marco Zeppieri, Carlo Salati, Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
Author contributions: Miotti G wrote the outline, did the research, wrote the paper, and approved the final version of the article; Zeppieri M assisted in the conception and design of the study, writing and outlining of the manuscript, approved the final version of the article to be published, and completed the English and scientific editing (a native English speaking MD, PhD, BSc); Pederzani G assisted in the research and writing of the manuscript; Salati C and Parodi PC assisted in the editing and critical revisions of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marco Zeppieri, BSc, MD, PhD, Doctor, Department of Ophthalmology, University Hospital of Udine, p.le S. Maria della Misericordia 15, Udine 33100, Italy. markzeppieri@hotmail.com
Received: December 16, 2022
Peer-review started: December 16, 2022
First decision: January 3, 2023
Revised: January 7, 2023
Accepted: February 22, 2023
Article in press: February 22, 2023
Published online: March 16, 2023
Abstract

The demand for procedures aiming to rejuvenate the upper third part of the face and the periocular region has increased in the past several years. Blepharoplasty is one of the most frequently performed procedures worldwide to date. Surgery is currently the first choice in order to achieve permanent and effective results; however, it is burdened by potential surgical complications feared by patients. There is an increasing trend in individuals to request less invasive, non-surgical, effective, and safe procedures for eyelid treatment. The aim of this minireview is to present a brief overview of non-surgical blepharoplasty techniques that have been reported in the literature in the past 10 years. Numerous modern techniques that provide a rejuvenation of the entire area have been described. Numerous less invasive methods have been proposed in the current literature and in modern-day routine clinical settings. Dermal fillers are a commonly chosen option for providing enhanced aesthetic results, especially considering that volume loss can be one of the main underlying causes of facial and periorbital aging. Deoxycholic acid use may be considered when the problem is represented by periorbital excess fat deposits. The simultaneous excess and loss of elasticity of the skin can be assessed with techniques such as lasers and plasma exeresis. Furthermore, techniques such as platelet-rich plasma injections and the insertion of twisted polydioxanone threads are emerging as viable methods to rejuvenate the periorbital region.

Keywords: Non-surgical blepharoplasty, Laser treatment, Dermatochalasis, Aesthetic, Non-invasive procedures, Hyaluronic acid, Plasma exeresis, Eyelids

Core Tip: Non-surgical procedures represent a valid alternative to surgery in the rejuvenation of the periorbital area. When the problem can be corrected by ‘filling’ more and ‘removing’ less, fillers may be of use. Laser treatment and microsurgical techniques can provide a viable solution when the main concern is based on excess and/or inelasticity of the skin.