Cautery of the orbital septum during blepharoplasty

Purpose: Application of a grid of electrocautery to the orbital septum to treat anteriorly prolapsed eyelid fat pads during blepharoplasty has been previously described. A review of patients who underwent this technique was performed to determine if this technique led to a higher incidence of postoperative eyelid retraction. Methods: A retrospective case series of patients who underwent application of a grid of electrocautery to the orbital septum during blepharoplasty from 1979 to 1999 was reviewed. Results: There were 1492 patients (3018 eyelids) who underwent an application of a grid of electrocautery to the orbital septum during this period, Five hundred twenty-nine patients (1036 eyelids) underwent upper blepharoplasty, 91 patients ( 174 eyelids) underwent lower blepharoplasty, 149 patients (596 eyelids) underwent combined upper and lower blepharoplasty, and 723 patients (1212 eyelids) underwent a combined upper blepharoplasty and ptosis repair. All patients were followed for at least 3 months. Follow-up ranged from 3 months to 20 years. No patient had postoperative eyelid retraction. Conclusions: The application of a grid of electrocautery to the orbital septum during blepharoplasty, to treat anteriorly prolapsed eyelid fat pads is effective, safe, and does not lead to late postoperative eyelid retraction.