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  • Title: Objective Outcome Measurement After Upper Blepharoplasty: An Analysis of Different Operative Techniques.
    Author: Park KS, Park DD.
    Journal: Aesthetic Plast Surg; 2017 Feb; 41(1):64-72. PubMed ID: 28039500.
    Abstract:
    BACKGROUND: Upper blepharoplasty is indicated in Asians for double-eyelid fold creation, periorbital rejuvenation, and functional visual field improvement. This article introduces a technical classification for blepharoplasty methods and investigates approaches to evaluate its outcomes. METHODS: Of 535 patients undergoing aesthetic upper blepharoplasty in our institution in 1998-2011, 136 patients who were well followed up were retrospectively reviewed and categorized into four groups according to the techniques employed. Blepharoplasty with skin excision only was indicated for upper eyelid-skin redundancy patients with prominent double eyelids (n = 20). Blepharoplasty with skin excision and nonburied suture fixation was indicated for patients with upper lid-skin redundancy and weak double eyelids (n = 15). Blepharoplasty with skin excision and buried suture fixation was indicated for patients with upper lid-skin redundancy but no double-eyelid folds (n = 46). Finally, blepharoplasty with simultaneous ptosis correction was utilized for patients with senile or subclinical ptosis requesting upper blepharoplasty (n = 55). The mean age was 48.7 years at surgery; the mean follow-up period was 6 months. Digital photographs were used to compare changes in marginal reflex distance 1 (MRD1), percentage of the area of corneal exposure (%ACE), and brow height. RESULTS: MRD1 increased from 1.92 to 2.84 mm in the whole patient group after upper blepharoplasty; it increased the most in blepharoplasty with simultaneous ptosis correction (1.22 mm). %ACE increased from 62.1 to 76.6% (14.5%), whereas brow height decreased from 29.4 to 26.7 mm (9.2%). CONCLUSION: Upper blepharoplasty improves palpebral fissure. Numerically measured palpebral fissure changes facilitate operation outcome measurement. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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