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To evaluate postoperative edema and ecchymosis after blepharoplasty surgery with or without autologous platelet gel.In this prospective, randomized, controlled trial, patients received autologous platelet concentrate in the eyelid incisions of one side during bilateral blepharoplasty surgery. The opposing eye was not treated and was used as a control.Autologous platelet concentrate was prepared by the Harvest® system (Harvest Technologies, Plymouth, MA, U.S.A.). The blood was centrifuged and platelet-rich plasma isolated. Platelet-rich plasma was mixed with thrombin and instilled in the wound on a randomly selected side before wound closure. Patients were examined and completed a questionnaire at postoperative days 1, 3, 7, and 30. Photographs were taken at each visit and were graded by masked, trained observers for edema and ecchymosis.Significantly less edema (p < 0.05) was noted by the photograders at day 1 and by the patients at day 30. There were non–statistically significant trends toward decreased ecchymosis and edema in the treated group. Questionnaire data showed no significant difference in postoperative pain between the treated and untreated sides. Photographic and questionnaire data showed no clinically meaningful difference between the treated and control sides.Although there were statistically significant differences in edema using autologous platelet gel in blepharoplasty surgery, trends toward improvement in postoperative edema and ecchymosis did not achieve clinical significance.