Parallel-excision infrabrow blepharoplasty with extensive excision of the orbicularis oculi muscle in an Asian population

Abstract

Background Infrabrow blepharoplasty has become a common surgical method used to rejuvenate aged upper eyelids in Asians. In this paper, we describe the parallel excision method for infrabrow blepharoplasty as a useful alternative to the conventional elliptical excision method. The authors' experience over a 3-year period is presented and reviewed. Methods A retrospective review of parallel excision infrabrow blepharoplasty cases at our hospital between 2014 and 2017 was performed. Three oculoplastic surgeons compared preoperative and postoperative photographs using the Strasser grading system. Results From the medical records of 123 patients, a total of 93 patients with moderate-tosevere bilateral dermatochalasis were selected as subjects. The exclusion criterion was levator function less than 8 mm. The total mean follow-up period was 2 years (range, 0.5-3.5 years). The mean skin excision height and width were 9.75 mm (range, 5-16 mm) and 58.51 mm (range, 42-75 mm), respectively. All patients who underwent surgery recovered without major complications, and all patients had high levels of satisfaction and improvements in their visual field. In the Strasser evaluation performed by the oculoplastic surgeons, most patients were found to have excellent results. Conclusions The parallel excision method for infrabrow blepharoplasty is a safe and effective technique that yields more natural-and youthful-looking eyelids than the conventional elliptical excision method. In our method, more effective manipulation of the orbicularis oculi muscle led to a reduction in frontalis compensation, resolution of sunken eyelids, and correction of lateral hooding.

Shortened Infrabrow Excision Blepharoplasty Combined with the Removal of Orbicularis Oculi Muscle for Dermatochalasis in Asians

“…In the sIBEB incision design, the inner boundary (point A) is marked ~22 to 25 mm from the median line around the supraorbital point. Besides, the orbicularis oculi muscle removal area is even more lateral than the skin incision which is ~3 cm from the median line, allowing the procedure to precisely avoid the alignment area of the supraorbital nerve and the talocrural nerve, which as a result makes postoperative numbness evitable 21. In our surgical experience, better postoperative outcomes have been achieved through a tear-shaped incision starting from the junction point between the infrabrow and the projection line of the bony orbital rim (point A).…”

Blepharoplastik bei asiatischen Augen

“…Obwohl vereinzelt Techniken die Beibehaltung eines "single eyelid" beschreiben, ist dies technisch schwierig umzusetzen [4,6]. Um die asiatischen Charakteristika nicht zugunsten eines europäischen Aussehens verschwinden zu lassen, müssen die Charakteristika der asiatischen Lidumschlagsfalte respektiert und durch den Eingriff betont und nicht "auskorrigiert" werden [8]. Eine klassisch ausgeführte Blepharoplastik wird ein nicht asiatisches Aussehen erzeugen, was bei alternden Patienten im Gegensatz zu jüngeren Patienten keineswegs als erstrebenswert, sondern als störend empfunden wird.…”