Infraeyebrow excision blepharoplasty for Japanese blepharochalasis: Review of 35 patients over 60 years old

Abstract

Since 2005 we have treated many older patients with upper blepharochalasis but no obvious aponeurotic ptosis by infraeyebrow excision of skin and orbicular muscle with tucking of the orbital septum. Thirty-five patients (70 lids) were studied, age range 61-80 years (mean 68). There were 6 men and 29 women, who were followed up for 3 months to 2 years (mean 7 months). All patients reported improvement in the upper visual fields and lessening of headaches and neck stiffness. The lateral drooping of the lid also improved, and the crease was more clearly defined than before the operation. There were no serious complications. We conclude that infraeyebrow blepharoplasty with tucking of the orbital septum is a simple and effective treatment for blepharochalasis in older East Asian patients.

Extended Infrabrow Excision Blepharoplasty for Dermatochalasis in Asians

“…I NFRABROW EXCISION BLEPHAROplasty (IBEB) is common in Asians with dermatochalasis, [1][2][3] although the method is debated by surgeons. Despite its popularity in Japan and Korea, acceptance of the usefulness of IBEB in Asians was protracted.…”

Infraeyebrow Blepharoplasty for Blepharochalasis of the Upper Eyelid: Its Indication and Priority

“…However, from an aesthetic point of view, there are some shortcomings of lid crease and low lid incision in East Asian patients. As the width of the skin excision through the lid crease, or low lid in the increases, an unnatural appearance after the operation has often been reported [1, 3, 4]. One of these undesirable results is that a discrepancy between the nature and thickness of the sutured upper and lower skin in the upper lid accentuates the overhanging appearance of the upper skin on the crease line [1, 2].…”

“…One of these undesirable results is that a discrepancy between the nature and thickness of the sutured upper and lower skin in the upper lid accentuates the overhanging appearance of the upper skin on the crease line [1, 2]. Another undesirable result is that an overly defined lid crease after this operation often gives the patient's face a “surprised look” [1, 3, 4]. In patients who do not desire the double-eyelid procedure, retaining the natural East Asian flat eyelid without a lid crease is also difficult after a low incision in the upper lid [2, 4].…”

“…Another undesirable result is that an overly defined lid crease after this operation often gives the patient's face a “surprised look” [1, 3, 4]. In patients who do not desire the double-eyelid procedure, retaining the natural East Asian flat eyelid without a lid crease is also difficult after a low incision in the upper lid [2, 4]. In addition, in these incisions, to remove lateral drooping skin from the upper eyelid, an extension of the skin excision must be carried out laterally beyond the lateral canthus, or to the corner of the eyebrow in an upward angle to prevent a lateral dog-ear of skin [19].…”

“…In addition, in these incisions, to remove lateral drooping skin from the upper eyelid, an extension of the skin excision must be carried out laterally beyond the lateral canthus, or to the corner of the eyebrow in an upward angle to prevent a lateral dog-ear of skin [19]. These lateral extended operative scars are often conspicuous in East Asian patients [3, 4]. To improve the shortcomings of blepharoplasty performed through the lid crease and low area in the upper lid, infraeyebrow blepharoplasty has been commonly accepted in East Asia [1–6].…”