ABSTRACT
Surgical blepharoplasty can change the look of the palpebral aperture, especially when patients want their eyes to look more ‘cat-like’. A second blepharoplasty can make the tarsal region of the upper lid slightly darker. A third blepharoplasty can be disastrous: the palpebral aperture loses its elasticity and narrows, the eye becomes smaller and less mobile, the skin above the tarsus of the upper eyelid takes on a very dark color that stops abruptly on the scar because of the altered distribution of dilated vertical blood vessels (Figure 36.1). Lagophthalmia entropion or ectropion can develop.
