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Sagar Yatin Patel, Ronald Mancini; Geometry of the Blepharoplasty Incision. Invest. Ophthalmol. Vis. Sci. 2016;57(12):685.
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© ARVO (1962-2015); The Authors (2016-present)
Our study evaluted the affects of the blepharoplasty incision and its result on eyelid aesthetics, specifically eyebrow and eyelid positioning, which both play a pivotal role in facial beauty, perception of aging, and patient satisfaction.
This was a prospective study that included individuals undergoing upper lid blepharoplasty. Patients were excluded if they had eyelid ptosis and/or brow ptosis repair. Standard frontal plane full face digital photographs before and after surgery were obtained of the subjects with eyes open and closed. Patients were analyzed in two cohorts depending on timing of post-operative evaluation, 6-weeks or 3-months. Every patient had an operative photograph with their eyes closed outlining the blepharoplasty incision. Images were processed using ImageJ software (v1.48) developed by the National Institute of Health. The measurements examined before and after surgery were Brow Position Index (Image 1), Palpebral Fissure, Margin-Reflex Distance-1, Margin-Reflex Distance-2, and Eyelid Skin Surface Area (Image 2). The measurements examined at the time of surgery were Operative Skin Surface Area, Operative Superior Distance, and Operative Inferior Distance. A paired t-test of each measurement was performed to evaluate differences before and after surgery in each cohort.
The average age was 67.4 years. The 6-week cohort revealed a statistically significant increase in margin fold distance and decrease in eyelid surface area as would be anticipated. The differences in the margin fold distance and eyelid surface area remained statistically significant in the 3-month cohort. The 3-month cohort also revealed statistically significant increases in MRD1 and lowering of brow position. Statistical analysis evaluating the blepharoplasty incision and its distance from superior and inferior eyelid landmarks yielded no statistically significant differences between pre- and post-operative measurements at 6 weeks or 3 months.
At 3 months, we found statistically significant changes in brow position, MRD1, margin fold distance, and eyelid surface area. Minor changes in the blepharoplasty incision did not affect the eyelid or eyebrow position. These findings will help in educating patients and setting expectations, particularly regarding lowering of brow position and increase in MRD1. Minor adjustments can be made to the shape of the blepharoplasty incision without significantly impacting eyelid or eyebrow position.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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