History

Technically, blepharoplasty is an operation to restore defects of the eyelids. In this broader sense, blepharoplasty includes surgeries designed to reconstructive abnormalities of the lids leading to abnormal appearance and function. These abnormalities may be due to injury, infection, disease and family traits. The modern blepharoplasty term is almost exclusively reserved for a procedure designed to reverse aging-related changes of the eyelids. This may be done for functional and cosmetic reasons.

Anecdotally, the Roman scientist Celsus described the excision of excess lid skin during the first century AD. Nine hundred years later, Arabic physicians are credited with performing lid fold removals to improve vision obstruction. In 1812, the English surgeon William Adams performed a blepharoplasty-like procedure when he corrected an ectropion (a condition where the lower lid hangs down and the inside is turned out). The first reconstructive blepharoplasties according to our modern understanding were proposed and performed almost simultaneously by Carl Heinrich Dzondi (Private Surgical Clinic in Halle, Germany) and Karl Ferdinand von Graefe (Charite in Berlin, Germany) in 1818.

In the mid-nineteen hundreds, Sichel advanced the understanding of eyelid anatomy through his description of contribution of orbital fat in hanging upper eyelids. With the beginning of the 20th century, removal of excess upper lid skin was popularized by various surgeons. American physician Charles Conrad Miller was one of the first truly cosmetic surgeons. In 1907, he published a book on cosmetic surgery with descriptions on aesthetic blepharoplasty. Further editions of this first cosmetic surgery book included illustrations of incisions that are similar to many of today’s techniques. Parisian facial cosmetic surgeon Julian Bourguet is credited with accurate description of eyelid fat and its removal through the trans-conjunctival approach. Dr. Castanares described the anatomy of orbital fat compartments in 1951 including a classification system for various eyelid constellations. The last decades have seen advances in “fine-tuning” of eyelid lift procedures. In addition, the goal of a natural look made surgeons seek innovative ancillary eyelid procedures and advanced eyelid lifts for the most normal and youthful look after blepharoplasty.

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