Personalized preoperative design reducing complications after upper blepharoplasty

Abstract

BackgroundUpper eyelid blepharoplasty is a common cosmetic surgery among Asians, and is associated with several complications that are possibly related to the anatomical characteristics of the eyes. MethodsA total of 364 upper eyelid blepharoplasties were performed at the Department of Plastic and Reconstructive Surgery between January 2018 and December 2019. The post-surgery complications and the related eyelid types were classified as follows: upper eyelid crease too high (too high crease, THC), upper eyelid crease too low (too low crease, TLC), medial upper eyelid crease too high (too high medial crease, THMC), bloated upper eyelid (bloated crease, BC), and upper eyelid crease asymmetry (asymmetric crease, AC). The correlation between the anatomical characteristics of the upper eyelid and the complications was analyzed. The patients seeking upper eyelid blepharoplasty were preoperatively categorized into five types according to their anatomical characteristics, and the modified surgical strategies were applied to 117 new blepharoplasties performed between January 2020 and December 2020. Five senior plastic surgeons evaluated the pre- and post-operative photographs of the previous (2018-2019) and modified (2020-2021) blepharoplasties and scored the results on the basis of specific criteria. ResultsThe postoperative scores in modified group increased significantly after the modifications compared to that of the previous surgeries (p≤0.01). ConclusionPreoperative classification based on the anatomical characteristics of the eyelid and surgical modifications can reduce the occurrence of the five common complications of double eyelid blepharoplasty. Level of EvidenceIV