CC BY-NC 4.0 · Arch Plast Surg 2020; 47(02): 171-177
DOI: 10.5999/aps.2019.01102
Original Article

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

Department of Plastic and Reconstructive Surgery, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
,
Department of Plastic and Reconstructive Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
,
iWELL Plastic Surgery Clinic, Seoul, Korea
,
Joong Geel Chung Clinic of Plastic Surgery, Seoul, Korea
,
Department of Plastic and Reconstructive Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
› Author Affiliations

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-to-severe 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.



Publication History

Received: 23 August 2019

Accepted: 07 January 2020

Article published online:
22 May 2022

© 2020. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonCommercial License, permitting unrestricted noncommercial use, distribution, and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes. (https://creativecommons.org/licenses/by-nc/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • REFERENCES

  • 1 Parkes ML, Kamer FM, Merrin ML. Infrabrow lift. Laryngoscope 1976; 86: 1869-72
  • 2 Ichinose A, Sugimoto T, Sugimoto I. et al. Extended infrabrow excision blepharoplasty for dermatochalasis in Asians. Arch Facial Plast Surg 2011; 13: 327-31
  • 3 Kim YS, Roh TS, Yoo WM. et al. Infrabrow excision blepharoplasty: applications and outcomes in upper blepharoplasty in Asian women. Plast Reconstr Surg 2008; 122: 1199-205
  • 4 Park DH, Baik BS, Nahai F. et al. Cosmetic and reconstructive oculoplastic surgery. 3rd ed. Seoul: Koonja; 2009
  • 5 Lee D, Law V. Subbrow blepharoplasty for upper eyelid rejuvenation in Asians. Aesthet Surg J 2009; 29: 284-8
  • 6 Har-Shai Y, Hirshowitz B. Extended upper blepharoplasty for lateral hooding of the upper eyelid using a scalpel-shaped excision: a 13-year experience. Plast Reconstr Surg 2004; 113: 1028-35
  • 7 Lee EJ, Hwang K. Depressor muscle division through a subbrow excision for the improvement of brow ptosis. J Craniofac Surg 2013; 24: 1987-90
  • 8 Fang YH, Liao WC, Ma H. Infraeyebrow blepharoplasty incorporated browpexy in an Asian population. Ann Plast Surg 2013; 71 Suppl 1: S20-4
  • 9 Sugamata A, Yoshizawa N. Infraeyebrow excision blepharoplasty for Japanese blepharochalasis: review of 35 patients over 60 years old. Scand J Plast Reconstr Surg Hand Surg 2010; 44: 17-20
  • 10 Kim YS. Subbrow blepharoplasty using supraorbital rim periosteal fixation. Aesthetic Plast Surg 2014; 38: 27-31
  • 11 Strasser EJ. An objective grading system for the evaluation of cosmetic surgical results. Plast Reconstr Surg 1999; 104: 2282-5
  • 12 Hwang K, Kim DJ, Hwang SH. Thickness of Korean upper eyelid skin at different levels. J Craniofac Surg 2006; 17: 54-6
  • 13 Wang J, Su Y, Zhang J. et al. Subbrow blepharoplasty combined with periorbital muscle manipulation for periorbital rejuvenation in Asian Women. Plast Reconstr Surg 2019; 144: 760e-769e
  • 14 Amrith S. Oriental eyelids: anatomical and surgical considerations. Singapore Med J 1991; 32: 316-8
  • 15 Starck WJ, Griffin Jr JE, Epker BN. Objective evaluation of the eyelids and eyebrows after blepharoplasty. J Oral Maxillofac Surg 1996; 54: 297-302
  • 16 Gunter JP, Antrobus SD. Aesthetic analysis of the eyebrows. Plast Reconstr Surg 1997; 99: 1808-16
  • 17 Kunjur J, Sabesan T, Ilankovan V. Anthropometric analysis of eyebrows and eyelids: an inter-racial study. Br J Oral Maxillofac Surg 2006; 44: 89-93
  • 18 Yuzuriha S, Matsuo K, Kushima H. An anatomical structure which results in puffiness of the upper eyelid and a narrow palpebral fissure in the Mongoloid eye. Br J Plast Surg 2000; 53: 466-72
  • 19 Kim JH, Lee IJ, Park MC. et al. Aesthetic blepharoptosis correction with release of fibrous web bands between the levator aponeurosis and orbital fat. J Craniofac Surg 2012; 23: e52-5
  • 20 Shadfar S, Perkins SW. Surgical treatment of the brow and upper eyelid. Facial Plast Surg Clin North Am 2015; 23: 167-83
  • 21 Hahn S, Holds JB, Couch SM. Upper lid blepharoplasty. Facial Plast Surg Clin North Am 2016; 24: 119-27
  • 22 Shu M, He L, Su Y. et al. A novel supra-brow combined with infra-brow lift approach for Asian Women. Aesthetic Plast Surg 2016; 40: 343-8
  • 23 Burroughs JR, Bearden WH, Anderson RL. et al. Internal brow elevation at blepharoplasty. Arch Facial Plast Surg 2006; 8: 36-41
  • 24 Leatherbarrow B. Oculoplastic surgery. 2nd ed. New York: Informa Healthcare; 2011
  • 25 Yun S, Son D, Yeo H. et al. Changes of eyebrow muscle activity with aging: functional analysis revealed by electromyography. Plast Reconstr Surg 2014; 133: 455e-463e