Blepharoplasty: Rejuvenating the Male Periorbital Area

Abstract

Aims and Background

Blepharoplasty is among the fastest-growing aesthetic procedures in male patients, reflecting shifting cultural norms and increasing demand for facial rejuvenation that preserves masculine features. This review outlines the anatomical and aging patterns specific to the male periorbital region and discusses contemporary surgical techniques tailored to this population.

Anatomy

The gender-specific anatomical differences in the periorbital region influence both surgical planning and outcomes are highlighted.

Male Periorbital Aging Patterns

Aging in men involves distinct patterns that must be addressed to preserve masculine facial identity.

Surgical Techniques

Surgical strategies emphasize conservative tissue excision, preservation of eyelid fullness, and avoidance of feminizing features.

Complications

Men are predisposed to complications like lower lid malposition, visible scarring, and wound dehiscence due to anatomical factors and skin characteristics. Overcorrection may lead to feminization, necessitating a conservative surgical philosophy and meticulous technique.

Conclusion

A deep understanding of sex-specific anatomy and aging, coupled with meticulous surgical technique, is essential for achieving natural, harmonious outcomes that align with the male aesthetic ideal.

Keywords

male blepharoplasty - periorbital rejuvenation - periorbital aging

Publication History

Received: 22 July 2025

Accepted: 23 August 2025

Accepted Manuscript online:
25 August 2025

Article published online:
08 September 2025

• References

• 1 Triana L, Palacios Huatuco RM, Campilgio G, Liscano E. Trends in surgical and nonsurgical aesthetic procedures: a 14-year analysis of the International Society of Aesthetic Plastic Surgery-ISAPS. Aesthetic Plast Surg 2024; 48 (20) 4217-4227
• 2 Scheuer III JF, Matarasso A, Rohrich RJ. Optimizing male periorbital rejuvenation. Dermatol Surg 2017; 43 (Suppl. 02) S196-S202
• 3 Alghoul M. Blepharoplasty: anatomy, planning, techniques, and safety. Aesthet Surg J 2019; 39 (01) 10-28
• 4 Pessa JE, Desvigne LD, Lambros VS, Nimerick J, Sugunan B, Zadoo VP. Changes in ocular globe-to-orbital rim position with age: implications for aesthetic blepharoplasty of the lower eyelids. Aesthetic Plast Surg 1999; 23 (05) 337-342
• 5 Gunter JP, Antrobus SD. Aesthetic analysis of the eyebrows. Plast Reconstr Surg 1997; 99 (07) 1808-1816
• 6 Sedgh J. The aesthetics of the upper face and brow: male and female differences. Facial Plast Surg 2018; 34 (02) 114-118
• 7 Warren RJ. Upper blepharoplasty and brow rejuvenation in men. Clin Plast Surg 2022; 49 (02) 197-212
• 8 Kempa J, Kasielska-Trojan A, Gabryszewski M. et al. Understanding the impact of eyebrow and lateral canthal height on the perception of character traits: a rating-based analysis of 2081 participants. J Plast Reconstr Aesthet Surg 2025; 104: 417-425
• 9 Lohakitsatian P, Tunlayadechanont P, Tantitham T. Decoding periorbital aging: a multilayered analysis of anatomical changes. Aesthetic Plast Surg 2025; 49 (03) 664-671
• 10 Şahan MH, Bayar Muluk N, Akşamoğlu M. Infraorbital fat tissue volume and density changes in different age groups: evaluation with computed tomography. J Plast Reconstr Aesthet Surg 2022; 75 (10) 3826-3835
• 11 Keaney TC. Aging in the male face: intrinsic and extrinsic factors. Dermatol Surg 2016; 42 (07) 797-803
• 12 De Biasio F, Miotti G, Zingaretti N, Castriotta L, Parodi PC. Study on the aging dynamics of the periorbital region: from observation to knowledge of physiopathology. Ophthalmic Plast Reconstr Surg 2019; 35 (04) 333-341
• 13 Wysong A, Kim D, Joseph T, MacFarlane DF, Tang JY, Gladstone HB. Quantifying soft tissue loss in the aging male face using magnetic resonance imaging. Dermatol Surg 2014; 40 (07) 786-793
• 14 Jacobs LC, Liu F, Bleyen I. et al. Intrinsic and extrinsic risk factors for sagging eyelids. JAMA Dermatol 2014; 150 (08) 836-843
• 15 Kahn DM, Shaw Jr RB. Aging of the bony orbit: a three-dimensional computed tomographic study. Aesthet Surg J 2008; 28 (03) 258-264
• 16 Zoumalan CI, Roostaeian J. Simplifying blepharoplasty. Plast Reconstr Surg 2016; 137 (01) 196e-213e
• 17 Fagien S. The role of the orbicularis oculi muscle and the eyelid crease in optimizing results in aesthetic upper blepharoplasty: a new look at the surgical treatment of mild upper eyelid fissure and fold asymmetries. Plast Reconstr Surg 2010; 125 (02) 653-666
• 18 Drolet BC, Sullivan PK. Evidence-based medicine: blepharoplasty. Plast Reconstr Surg 2014; 133 (05) 1195-1205
• 19 Crumley RL, Torkian BA, Karam AM. (2009). Lower eyelid blepharoplasty. In: I. D. Papel, J. L. Frodel, R. I. G. Holt, W. F. Larrabee Jr., N. E. Nachlas, S. S. Park, J. M. Sykes, & D. M. Toriumi (Eds.), Facial Plastic and Reconstructive Surgery (3rd ed., pp. 271–285). Thieme;
• 20 Rao V, Sullivan PK. Lower lid blepharoplasty in men. Clin Plast Surg 2022; 49 (02) 213-220
• 21 Hashem AM, Couto RA, Waltzman JT, Drake RL, Zins JE. Evidence-Based Medicine: A Graded Approach to Lower Lid Blepharoplasty. Plast Reconstr Surg 2017; 139 (01) 139e-150e
• 22 Barrera JE, Most SP. Management of the lower lid in male blepharoplasty. Facial Plast Surg Clin North Am 2008; 16 (03) 313-316
• 23 Loeb R. Fat pad sliding and fat grafting for leveling lid depressions. Clin Plast Surg 1981; 8 (04) 757-776
• 24 Hamra ST. The role of orbital fat preservation in facial aesthetic surgery. A new concept. Clin Plast Surg 1996; 23 (01) 17-28
• 25 Lelli Jr GJ, Lisman RD. Blepharoplasty complications. Plast Reconstr Surg 2010; 125 (03) 1007-1017
• 26 Homer NA, Zhou S, Watson AH, Durairaj VD, Nakra T. Wound dehiscence following upper blepharoplasty: a review of 2,376 cases. Ophthalmic Plast Reconstr Surg 2021; 37 (3S): S66-S69
• 27 Somenek M, Romero NJ. Brow lift and brow position for gender affirmation. Otolaryngol Clin North Am 2022; 55 (04) 797-808