A New Classification of the Lateral Dermatochalasis of Upper Eyelids

Abstract

Background: Eyelid dermatochalasis is an abnormal distention of the upper eyelid. This article presents a new classification of the lateral dermatochalasis (LDC) of the upper eyelids, which compares the pre- and post-blepharoplasty results and matches its results with those of the well-established Jacobs classification (JEC). Methods: LDC classification includes four degrees: grade zero—absence of dermatochalasis; grade 1—lower edge of dermatochalasis above the intersection of the lacrimal caruncle with the edge of the upper eyelid; grade 2—between the intersection of the lacrimal caruncle with the edge of the upper eyelid and the lower edge of the iris at the pupillary midpoint; and grade 3—lower edge of dermatochalasis below the lower edge of the iris. This study was conducted in 100 dermatochalasis cases in patients between 38 and 79 years of age (mean = 59.3) and submitted to upper blepharoplasty. Results: No statistically significant association was found between the LDC and JEC methods (P = 0.583). In both classifications, the eyelid dermatochalasis was reduced after blepharoplasty (P < 0.001). However, changes in the degrees of dermatochalasis before blepharoplasty were detected in 100% by LDC, and 41% by JEC. The degree of improvement of dermatochalasis observed by LDC after blepharoplasty showed greater specificity. Conclusions: This new classification, LDC, is specific for the lateral eyelid dermatochalasis, which is based on exact anatomical points, and is easy to perform. LDC is superior to JEC, easy to be applied, and effective and specific in detecting variations in dermatochalasis after blepharoplasty.

Minibleph, A Non-Incisional Blepharoplasty Technique For Skin Tightening Of Eyelids With The Use Of Fractional CO2 Laser

“…Adverse effects included erythema that resolved in 4 weeks in 80% of patients as well as edema that resolved after 4 to 6 weeks, indicating quite a long recovery period, probably due to the fact that nonfractionated laser technology was used. A study by Bonan et al 19 with the SmartXide DOT (DEKA-M.E.L.A., Calenzano, Italy) fractional CO2 laser focused on the results of eyelid tightening. In their study, 35.6% achieved marked to excellent improvements of laxity and texture (75-100% improvement).…”

“…Lid measurements pretreatment and 3 months post-treatment included: measurement of the Margin to Re ex Distance (MRD) 1 and 2, Eyelid Fold, and Palpebral Fissure. Asymmetry was measured by taking the absolute value of MRD1 and the Eyelid Folds between the two eyes at pretreatment and 3 months post-treatment, in the same manner as previously performed by Pool et al 18 Grading of dermatochalasis was based on the Lateral Dermatochalasis Classi cation (LDC) system by Santos Silva et al 19 which described four degrees: grade zero-absence of dermatochalasis; grade 1-lower edge of dermatochalasis above the imaginary line intersecting the lacrimal caruncle and the edge of the upper eyelid; grade 2-lower edge of dermatochalasis located between two imaginary lines: one line intersecting the lacrimal caruncle and the edge of the upper eyelid, and another parallel to the previous line located at the inferior limbus; and grade 3-lower edge of dermatochalasis below the inferior limbus.…”

The effect of blepharoplasty surgery is that the skin and orbicular muscle are resected together on the eyebrow position

“…All had grade 2 lateral dermatochalasis according to Silva's new classi cation; all had dermatochalasis with only cosmetic complaints. [20] Each patient underwent preoperative evaluation. Only those patients with a follow-up of at least six months were included.…”