Estimation of skin removal in aging Asian blepharoplasty

To describe a novel method for estimating the amount of skin to resect in upper blepharoplasty in the aging Asian eyelid and to report our experience with this technique.

Retrospective review of patients in a single private practice.

Resection of skin in upper blepharoplasty in an Asian eyelid can often be less forgiving than in other ethnicities due to the unique anatomy of the supratarsal fold. Excising a maximal amount of excess skin will result in an unfavorable appearance of the upper eyelid in an Asian patient. We applied a technique of pinching the skin while the patient is awake until the patient is satisfied with the appearance. The skin is then measured and the precise amount resected during blepharoplasty. The supratarsal crease is always recreated even in patients who have a preexisting crease. We conducted a retrospective review of 99 consecutive patients who underwent upper blepharoplasty using this technique. All patients were Asian and aged 40 years or older.

The study group included 99 patients with a mean age of 55.7 years (range, 42-78 years). The mean follow-up time was 24 months (range, 12-30 months). The amount of desired skin overhang superior to the supratarsal crease varied considerably among patients. Complications included asymmetry in nine patients (9.1%), scarring in three patients (3.0%), and unfavorable cosmetic result in two patients (2.0%). No patients experienced infection, bleeding, or visual changes.

In upper blepharoplasty in the aging Asian eyelid, it is necessary to resect less skin than in the Caucasian patient to achieve the desired appearance of the upper eyelid complex. Using a patient-assisted approach to estimate the amount of skin to remove, a favorable cosmetic result with a low incidence of complications was achieved in a consecutive series of patients.