Optimizing Upper Eyelid Contour: Outcomes of Combined Blepharoplasty and Lacrimal Gland Repositioning

Abstract

Background:
Lacrimal gland prolapse (LGP) is an underrecognized condition that may compromise both functional and aesthetic outcomes in upper eyelid blepharoplasty. Timely identification and surgical management of LGP are crucial in achieving optimal contour and patient satisfaction.

Objective:
To determine the incidence, risk factors, and postoperative outcomes of LGP in patients undergoing upper eyelid blepharoplasty, and to evaluate the efficacy of concurrent lacrimal gland repositioning.

Methods:
This retrospective cohort study included 300 patients who underwent upper blepharoplasty at King Faisal University Hospital between 2020 and 2023. Data were collected on demographic features, surgical indications, comorbidities, intraoperative findings, and postoperative complications. Patients diagnosed with LGP were either managed conservatively or underwent surgical repositioning. Patient satisfaction and functional outcomes were assessed during a 12-month follow-up.

Results:
LGP was identified in 34 patients (11.3%), with 28 undergoing surgical repositioning. Repositioning achieved a 96.4% success rate with no recurrence in 27 cases. Postoperative complications were minimal (6.7%), with transient dry eye being the most common. Aesthetic improvement in lateral upper eyelid contour was noted in 89.3% of repositioned cases. Overall, 95% of patients reported satisfaction or high satisfaction with surgical outcomes.

Conclusion:
LGP is a clinically relevant finding in upper blepharoplasty and should be systematically evaluated. Surgical repositioning is safe, effective, and enhances both cosmetic and functional outcomes. Incorporating LGP assessment into blepharoplasty planning optimizes upper eyelid contour and maximizes patient satisfaction.