Effect of Orbicularis Muscle Resection during Blepharoplasty on the Position of the Eyebrow

Abstract

Dermatochalasis is a skin excess in the upper eyelid which may be associated with either an aesthetic and functional defect, blocking the peripheral vision. Upper blepharoplasty is the gold standard procedure for correction of dermatochalasis and to restore youthful contours to the periorbita. It is one of the most commonly performed procedures in aesthetic plastic surgery; however, there is still a lack of consensus about this procedure. The excess skin is sometimes removed alone or in conjunction with a strip of orbicularis oculi muscle. The rationale for both muscle and skin resection or skin alone preserving the muscle is uncertain. Some authors have studied the aging influence in brow position, and a few studies pointed out the influence of the upper blepharoplasty on brow height. The true effects, regarding the position of the eyebrow, of both techniques, with or without resection of the preseptal orbicularis oculi muscle, are unclear. The authors present a review of the literature to find the rationale for resecting or preserving the orbicularis oculi muscle in upper eyelid blepharoplasty and its relation to eyebrow position.

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

“…They found that the brow tends to move upward or remain at the same level one year after the upper eyelid blepharoplasty with the excision of 5 mm of the orbicularis oculi strip. [12] They thought the opposition of forces between the elevator and the eyebrow depressors was liable for their result. After the 5 mm orbicularis strip resection cause weakened the depressor mission of the orbicular muscle.…”

“…Some authors suggest that muscle should be resected as much as skin, while others recommend resectioning a part approximately 2 mm that will expose only the septum. [11,12,13]. Authors who argue for the preservation of orbicular muscle during surgery emphasize that muscle is important for improving esthetic outcomes and maintaining a youthful appearance.…”

“…However, the actual effects concerning the position of the eyebrow, of both techniques, with or without excision of the orbicularis oculi muscle strip, still need to be determined. [11][12][13][14] To the best of our knowledge, several studies of brow level after blepharoplasty can be found in the literature; [12,[15][16][17][18][19] however, we need help nding an analysis of brow position after narrow (3 mm) orbicularis oculi resection in the Also, we could not nd any study in the literature that included only patients with cosmetic complaints and without visual eld complaints. Therefore, the rst aim of this study is to evaluate the effect of excision of the narrow (only 3 mm) orbicularis oculi strip in cosmetic upper eyelid blepharoplasty on eyebrow position.…”

Long-Term Effects of Extended Upper Blepharoplasty Combined With Subbrow Skin Removal for Correction of Lateral Hooding in Asian Women

“…Aside from affecting its appearance, this also makes the eyelid deformed, forming triangular eyes. In severe cases, the pupil is blocked, and the eyelid function is affected, causing the patient’s visual field in the lateral upper quadrant to be impaired 13–15 …”

Intraoperative Significance of Lower Eyelid Positions in Levator Advancement to Prevent Overcorrection

“…Previous studies [1][2][3][4][5][6][7][8][9][10] have reported on the position of the upper eyelids or eyebrows before and several months after upper blepha-roplasty or ptosis surgery, but currently no studies have reported on the eyelid position during or immediately after surgery. To our knowledge, there are currently no reports that have focused on the lower eyelid position in upper eyelid surgery.…”