Method
- Retrospective single-surgeon, single-institution case series, January 2006 to June 2016.
- 898 consecutive patients (821 female, 77 male; mean age 39.3 ± 12.7 years) who underwent primary double eyelid blepharoplasty.
- Technique: an elevated cephalad orbital septum flap, a full-incision approach.
- 6-month outcomes assessed with patient-reported measures, a 4-grade incisional-depression assessment from standardized, deidentified photographs, and recorded complications.
- Level of evidence IV, therapeutic.
Findings
- At 6 months, 845 of 898 patients (94.1%) were very satisfied or satisfied with their appearance.
- Incisional-depression grade: excellent in 805 patients (89.6%), good in 75 (8.4%), fair in 15 (1.7%), poor in 3 (0.3%).
- Fair or poor grades occurred in 18 patients (2.0%).
- 37 patients (4.1%) had a recorded complication.
- Most frequent complications: asymmetry, 12 of 898 (1.3%); partial or complete fold disappearance, 10 of 898 (1.1%); wide or narrow fold, 6 of 898 (0.7%).
- Upper-eyelid contour depression or hollowing occurred in 2 of 898 patients (0.2%), recorded separately from incisional scar depression.
What it means for a patient
- Incisional depression, a visible groove or dent along the eyelid crease scar, is a known cosmetic concern after double eyelid blepharoplasty.
- In this large single-surgeon series, this septum-flap technique was linked to a low fair-or-poor depression rate of 2.0% and an overall complication rate of 4.1%.
- Patient-reported satisfaction with appearance at 6 months was 94.1%.
- This is a retrospective case series from one surgeon, without a comparison group, so it does not show whether this technique performs better than other methods used to prevent incisional depression.
Citations
PubMed https://pubmed.ncbi.nlm.nih.gov/42623493/.
Terms
- Double eyelid blepharoplasty: surgery that creates an upper eyelid crease, most often performed for patients of Asian descent without a natural fold.
- Incisional depression: an indented or grooved scar along the eyelid crease incision.
- Orbital septum: a thin membrane behind the eyelid skin that normally holds orbital fat in place.
- Cephalad: toward the head, used here to describe the upward-positioned flap of septum tissue.
- Full-incision technique: a double eyelid technique that uses a complete incision along the crease line, as opposed to a partial-incision or suture-only method.