Combined Subbrow Excision with Upper Blepharoplasty Using a Tadpole Shaped Excision for Blepharochalasis

Abstract

BackgroundIn efforts to solve blepharochalasis, induced by aging process, various surgicalmethods have been developed over the years. Among them, classical upper blepharoplasty has a problem that severe lateral hooding may be restricted in making correction, cause of difference in thickness between the pretarsal skin and subbrow skin. And also subbrow excision (SE) blepharoplasty cannot be easily corrected in severedrooping of the medial skin. In an effort to make up for the disadvantages of thesemethods, we attempted SE–tadpole shaped excision blepharoplasty (TSEB). MethodsFifteen patients underwent SE-TSEB from January 2013 to November 2014. SE-TSEB was performed the following cases: 1) patients who showed moderate to severe blepharochasis with severe lateral wrinkles; 2) patients with a history of pre-existent SE blepharoplasty; 3) patients with a tattoo on the eyebrows, who want to makerevision; and 4) patients with eyelid skins that are thick or have overly protuberant fatpads of the retro-orbicularis oculi fat (ROOF), and have a plan to extirpate them. ResultsDuring the follow-up observation period, most patients showed amicable correctionof visibility difficulty and were aesthetically satisfied with the postoperative resultswith respect to correction of the lateral wrinkles. Scars formed in the subbrow incision line were within the scope of management. ConclusionsSE-TSEB is a treatment modality that overcomes the disadvantages and limitations of classical upper blepharoplasty and SE blepharoplasty. Furthermore, maximizing the advantage of each surgical approach is another innovative approach for correction of changes in the upper eyelid, induced by aging.