Extensive Lower Eyelid Pigment Spread After Blepharopigmentation

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Abstract
To report on a complication of blepharopigmentation. Case report. An 81-year-old woman underwent cosmetic tattooing of all four eyelids. The pigment immediately spread from the right lower eyelid lash line to the nasojugal fold. The dispersion was so extensive in surface area that nonsurgical techniques for ameliorating the dispersion would not be effective. The unintentionally tattooed skin was excised and reconstructed with a lateral canthal suspension and full thickness skin grafts. Pathologic examination of the excised tissue revealed pigmentation of all layers of the skin and the surface of the orbicularis muscle. This case illustrates that extensive pigment spread following blepharopigmentation may require extensive reconstruction to correct the problem.

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