Can you explain the difference between tarsal fixation and normal upper blepharoplasty?

Tarsal fixation is when the tissue of the eyelid crease is fixated to the tarsus. This can include skin, levator aponeurosis, and orbicularis. This is often used to aid in lid crease formation.

Hi and thanks for your question

Some people with loose eyelid skin have poor connections between the eyelid skin and the muscle that opens up the eye by lifting the upper eyelid. As a result, the eyelid skin hangs down when the eye opens. The tarsal fixation technique recreates the connections between the muscle and the skin to pull the skin into the eyelid crease, reducing the overhanging skin and improving the aesthetics of the eyelid.

Standard blepharoplasty just removes the chess skin and fat from the upper eyelid. It still produces improved aesthetics and an equivalent result in those who already have good connections between their eyelid elevating muscle and the skin.

I hope that helps.

Dr Mark Hanikeri MBBS FRACS
Perth Specialist Plastic Surgeon

The difference in the technique between an upper blepharoplasty with or without a supra-tarsal fixation is determining where you want to place the "fold" of the upper eyelid. You suture the tarsal apponeurosis to the edge of the orbicularis muscle. This is common in the Asian eyelid that historically lacks an upper eyelid fold/crease.You can be conservative or rather bold by making it what the patient so desires