Upper blepharoplasty performed to rejuvenate the eyes is a technique that must be adapted to the anatomy. Indeed, there are changes in the volume of the orbital fat (roll organ) and the suborbicular fat in the eyebrow (Charpy's organ), a relaxation of the skin and sometimes also of the fascia of the levator muscle as well as fibrous expansions between the skin and this muscle. In the case presented here, there is an excess of skin, an excessive internal fat pocket but no abnormality in the volume of the suborbicular fat, the median portion of the orbital fat or the levator muscle.
On the other hand, there is the beginning of a shift due to a decrease in orbicularis tone and a loosening of the inferior tarso ligament strap. An external canthopexy is therefore performed to support the external angle.