Background: Asian Blepharoplasty (AB) is one of the most commonly performed aesthetic procedures today. Despite the increasing demand for AB and advancements in surgical techniques, creating an optimal upper eyelid crease remains difficult. This study aimed to determine whether removing the preaponeurotic fat pad (PAF) had any effect on the revision surgery rates following primary Asian blepharoplasty. Methods: A retrospective comparative analysis was conducted on patients who underwent primary AB between January 2016 and December 2020. Patients were divided into PAF removed and PAF not removed groups. The outcomes in the groups were compared by the frequency of revision surgery following primary AB using the chi-square test (p < 0.05) with IBM SPSS version 21.0. Results: The study included 480 patients, 442 (92%) female and 38 (8%) male, and the final outcome was evaluated after 6 months postoperatively. 412 (86%) patients were observed to have PAF pads intraoperatively, while 68 (14%) had minimal/no PAF pads. In total, 115 (24%) patients underwent revision surgery, of whom 31 (27%) had PAF removed, 66 (57%) had PAF not removed, and 18 (16%) had minimal/no PAF noted. When compared to the PAF not removed group, the PAF removed group showed a significantly lower frequency of revision surgery between the two groups of patients (p = 0.0001). Conclusion: In the final outcome, not removing the PAF in primary AB indicated a strong association with an increase in revision surgery. The removal of PAF in primary AB showed a better overall outcome and patient satisfaction.
References
[1]
Chen, W.P.D. (2006) Asian Blepharoplasty and the Eyelid Crease. 2nd Edition, Elsevier, New York.
[2]
McCurdy, J.A. (1990) Cosmetic Procedure of the Asian Face. Thieme Medical Publishers, New York.
[3]
Mikamo, M. (1997) Mikamo’s Double-Eyelid Operation: The Advent of Japanese Aesthetic Surgery. Plastic and Reconstructive Surgery, 99, 664-669.
[4]
Mikamo, M. (1896) Plastic Operation of the Eyelid. Journal of Chugai Iji Shimpo, 17, 1197.
[5]
Lee, Y.J., Baek, R.M. and Chung, W.J. (2003) Nonincisional Blepharoplasty Using the Debulking Method. Aesthetic Plastic Surgery, 27, 434-437. https://doi.org/10.1007/s00266-003-3096-9
[6]
Yang, S.Y. (2001) Oriental Double Eyelid: A Limited-Incision Technique. Annals of Plastic Surgery, 46, 364-368. https://doi.org/10.1097/00000637-200104000-00002
[7]
Megumi, Y. (1997) Double Eyelid Procedure by Removal of Trans Conjunctival Orbital Fat and Buried Sutures Combined with Sling Technique to Avoid Wounding the Eyelid. Aesthetic Plastic Surgery, 21, 254-257. https://doi.org/10.1007/s002669900120
Bae, K.H., Baek, J.S. and Jang, J.W. (2021) Non Incisional Blepharoplasty for Asians. Facial Plastic Surgery Clinics of North America, 29, 523-532. https://doi.org/10.1016/j.fsc.2021.06.005
[10]
Nguyen, M.Q., Hsu, P.W. and Dinh, T.A. (2009) Asian Blepharoplasty. Seminars in Plastic Surgery, 23, 185-197. https://doi.org/10.1055/s-0029-1224798
[11]
Maruo, M. (1929) Plastic Construction of a “Double Eyelid”. Japanese Review of Clinical Ophthalmology, 24, 393-406.
[12]
Chen, W.P. (2007) The Concept of a Glide Zone as It Relates to Upper Lid Crease, Lid Fold, and Application in Upper Blepharoplasty. Plastic and Reconstructive Surgery, 119, 379-386. https://doi.org/10.1097/01.prs.0000244908.04694.32
[13]
Chen, W.P. (2016) Visual, Physiological, and Aesthetic Factors and Pitfalls in Asian Blepharoplasty. Aesthetic Surgery Journal, 36, 275-283. https://doi.org/10.1093/asj/sjv186
[14]
Oestreicher, J. and Mehta, S. (2012) Complications of Blepharoplasty: Prevention and Management. Plastic Surgery International, 2012, Article ID: 252368. https://doi.org/10.1155/2012/252368
[15]
Weng, J. (2009) Oriental Upper Blepharoplasty. Seminars in Plastic Surgery, 23, 5-15. https://doi.org/10.1055/s-0028-1110096
[16]
Collin, J.R., Beard, C. and Wood, I. (1978) Experimental and Clinical Data on the Insertion of the Levator Palpebrae Superioris Muscle. American Journal of Ophthalmology, 85, 792-801. https://doi.org/10.1016/S0002-9394(14)78107-3
[17]
Morikawa, K., Yamamoto, H., Uchinuma, E., et al. (2001) Scanning Electron Microscopic Study on Double and Single Eyelids in Orientals. Aesthetic Plastic Surgery, 25, 20-24. https://doi.org/10.1007/s002660010088
[18]
Chen, W.P. (2016) Literature on Double Eyelid Surgeries: Appendix 1,2,3. In: Asian Blepharoplasty and the Eyelid Crease, 3rd Edition, Elsevier, Edinburgh/New York, 345-365.
[19]
Cheng, J. and Xu, F.Z. (2001) Anatomic Microstructure of the Upper Eyelid in the Oriental Double Eyelid. Plastic and Reconstructive Surgery, 107, 1665-1668. https://doi.org/10.1097/00006534-200106000-00004
[20]
Kim, H.S., Hwang, K., Kim, C.K. and Kim, K.K. (2013) Double-Eyelid Procedure Using Septoaponeurosis Junctional Thickening Outcomes in Dynamic Fold in Asians. PRS GO, 1, e14. https://doi.org/10.1097/GOX.0b013e318293dc69
[21]
Chen, W.P.D. (2019) Techniques, Principles and Benchmarks in Asian Blepharoplasty. Plastic and Reconstructive Surgery—Global Open, 7, e2271. https://doi.org/10.1097/GOX.0000000000002271
