Is an eye shield importance for upper and lower blepharoplasty?

Eyelid surgeons who are not board certified in ophthalmology (e.g. general plastic surgeons, facial plastic surgeons, dermatologic surgeons) are very uncomfortable operating near the cornea surface.  They are also uncomfortable placing corneal shields on the cornea.  Oculoplastic surgeons are board certified ophthalmologists who are also fellowship trained in eyelid and facial plastic surgery.  They are very comfortable working near the eye.  They have been extensively trained to perform microsurgery on the eye itself.  Generally a corneal shield is not specifically needed for corneal protection.  The reason for this is simple.  When performing transconjunctival lower blepharoplasty exposure of the back of the lower eyelid requires the eyelid to be pulled gently away from the eye.  Also a retractor called an eye plate (think of a small flat spatula) is coated with opthalmic ointment and placed against the cornea,  The plate protects the eye and is also used to move the eye back to make the room necessary, in conjunction with the eyelid retractor, to carry out the surgery.  So protection of the eye is built into how this surgery is performed.Upper blepharoplasty usually does not require a cornea shield because it is considered sufficiently far away from the eye that it is not necessary.  However there are situations that change this.  Primarily if upper eyelid ptosis surgery is also performed at the time of upper blepharoplasty, a shield may be used to protect the cornea when sutures are being placed in the upper eyelid tarsus.

My personal answer is no but you will likely see different responses here on RealSelf and during consultations. There are strong proponents of either practice and this is often based on training - what our mentors taught us to do, we continue to do. As far as I am aware there are no data or study results to suggest that one practice is superior to another. As with your question on anesthesia, if you trust your surgeon and they are experienced and produce great results, I would recommend following their advice.Stephen Weber MD, FACSDenver Facial Plastic Surgeon