Histological and ultrasonographic alterations in skin and soft tissue in upper eyelid excised blepharoplasty due to ipsilateral eyebrow tattooing: (preliminary findings)

Abstract

Background: Eyebrow tattooing (ET) is a relatively common cosmetic procedure for middle-aged women which can hide age-related ptosis. Aims:We aimed to evaluate the periocular soft tissue changes following ET and its effects on upper eyelid blepharoplasty (UEBL).Patients/Methods: In this non-randomized prospective case-controlled study, 28 subjects recruited, 14 with ET for at least 5 years and 14 without ET. Eyebrows ultrasonography was performed to measure the periocular soft tissue thickness including skin and subcutaneous tissue on the medial and lateral side of the eyebrow. Then, UEBL was performed with extended eyelid skin incisions. So, the excised tissues being evaluated histopathologically. Results:The mean age of patients was 50.6 ± 0.6 and 51.2 ± 5.59 years in non-eyebrow tattooing (NET) and ET groups, respectively (P = .78). In the ET group, soft tissue thickness was, respectively, equal to 5.90 ± 1.10 and 6.3 ± 0.95 mm on the lateral and medial side of the eyebrow, which were significantly thicker compared to the NET group (4.68 ± 0.69 and 4.78 ± 0.56 mm, respectively)(P = .001). Histopathological findings were ranging from edema-congestion to chronic inflammation and dermal fibrosis which were more frequently seen in ET group. However, this difference was statistically significant only for dermal fibrosis (P = .02). Surgical wound complications were observed in 3 patients who were in the ET group (P = .22). Conclusion:Subjects with eyebrow tattooing, as compared to a control group, showed a thicker eyebrow skin on ultrasonography and higher upper eyelid dermal fibrosis on histopathological examination.

Eyebrow and Eyelash Alopecia: A Clinical Review

“…Due to deposition of foreign bodies, tattooing causes an inflammatory reaction that can be seen as lymphocytic infiltrate in the dermis on histopathology [ 118 ]. In a study of 28 patients undergoing blepharoplasty, histopathologic analysis of excised upper eyelid tissue revealed significant dermal fibrosis in patients with eyebrow tattoos compared to those without ( p = 0.02) [ 119 ]. Ultrasonography of this tissue before excision also revealed increased soft tissue thickness in patients with eyebrow tattoos ( p < 0.001) [ 119 ].…”

“…In a study of 28 patients undergoing blepharoplasty, histopathologic analysis of excised upper eyelid tissue revealed significant dermal fibrosis in patients with eyebrow tattoos compared to those without ( p = 0.02) [ 119 ]. Ultrasonography of this tissue before excision also revealed increased soft tissue thickness in patients with eyebrow tattoos ( p < 0.001) [ 119 ]. In addition to these local skin reactions, other risks are involved.…”