Modified Infrabrow Blepharoplasty Incorporating Skin-Orbicularis Repositioning

Treatment for upper eyelid dermatochalasis is commonly performed by an infrabrow blepharoplasty with an elliptical skin excision. However, this design has the drawback of causing abnormal skin wrinkles. Considering the pathophysiology of dermatochalasis of the upper eyelid, it is necessary to lift the lateral skin and orbicularis oculi muscle in a superior medial direction to achieve a satisfactory postoperative outcome. The author presents a modified infrabrow blepharoplasty incorporating skin-orbicularis repositioning.

Forty-one patients who underwent this surgical procedure and were followed for at least six months were retrospectively reviewed. The indication for the procedure was defined as cases where the levator muscle function was more than10 mm. Surgical outcomes were evaluated using the Strasser Grading System (SGS) based on photographs taken at 3 and 6 months postoperatively, and patient satisfaction was assessed at 6 months post-surgery using the questionnaire based on the evaluation of 6 items: infrabrow scar, difficulty closing the eyelids, ease of opening the eyelids, asymmetry in eyebrow height, skin overhanging the eyelashes and eyelid drooping.

The upper eyelid contour was smooth from the early postoperative period, and patients were satisfied with the results throughout the post operative follow-up period. Surgical scar assessment using the SGS at 6 months post-surgery showed a good to excellent result. The postoperative patient satisfaction with infrabrow scars and overall satisfaction showed satisfied results.

The modified infrabrow blepharoplasty is an effective method for severe upper eyelid skin laxity, which avoids the postoperative eyelid deformities observed with conventional infrabrow blepharoplasty.

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