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There are multiple ways to mark an upper blepharoplasty. This includes the pinch technique and using calipers. Most importantly, the eyelid crease should be symmetrical, the amount of skin remaining should be symmetrical, and enough skin should remain to prevent post-operative lagophthalmos. The technique in this video is my current preference for marking upper eyelid blepharoplasties. A written transcript of this video is as follows: This is Richard Allen at oculosurg.com. This video demonstrates one of many techniques in the marking of an upper blepharoplasty. The skin is cleaned with an alcohol swab and a fine tip marker is used. The eyelid crease is first marked. I will usually use the existing crease or place it a little lower. In general, a male’s crease should be about 6-8 mm and a female’s crease should be about 8-10 mm. This, of course is different in Asian patients. In this case, the crease is placed about one mm below the natural crease. It is important to follow the contour of the existing crease from the level of the punctum medially to the lateral canthus laterally. The marking is the measured with calipers, and transferred to the contralateral side, where the crease is marked again. Asymmetrical creases should be noted preoperatively, if present. Again, the crease is marked and these markings should be symmetrical. The redundant skin is then marked. There are multiple ways to do this. Currently, I mark the skin fold at the level where it rests just above the lid crease marking with the patient looking straight ahead. This extends from the level of the punctum medially, and does not extend outside the lateral orbital rim. The lateral lower marking is then connected to the upper marking with a gentle up-slope. It can be difficult to mark the skin medially with the redundancy, and stretching is laterally allows marking. This is then performed on the opposite side. Again, this is just one way to mark. Some surgeons use the pinch technique or just measure from the brow. I think it is important to ensure the same amount of skin is left on each side, and this amount should measure between 18 to 22 mm, depending on the patient. After marking, I always measure from the inferior brow cilia on each side to ensure that the markings are symmetrical and that enough skin will be left on each side.