Subbrow Blepharoplasty for Upper Eyelid Rejuvenation in Asians

Abstract

SBB is a useful operation to rejuvenate the upper eyelids in selected patients while maintaining harmony with their ethnic facial features. This refinement overcomes some of the shortcomings of other upper blepharoplasty methods employed for the same purpose.

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].…”

“…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].…”

“…To perform infraeyebrow excision, blepharochalasis can be improved without dramatic changes to the facial appearance after the operation. In addition, no conspicuous operative scars are produced in the lower lateral portion of the upper eyelid as a result of the operation and a more natural aesthetic appearance can therefore be obtained [1, 3, 4]. …”

“…We think that this design is not adequate because it will not improve lateral drooping of the skin sufficiently. Other authors [1–3] have described a marginal incision line of the eyebrow with an S-shaped lower incision line. This design makes it possible to excise the greatest width at the midpoint between the lateral canthus and the lateral limbus.…”