Patient-reported outcome measurement in upper blepharoplasty: How to measure what the patient sees

Blepharochalasis is very common and affects not only appearance but also visual function. Upper blepharoplasty is therefore the most frequently performed facial cosmetic procedure worldwide. It is generally seen as a small procedure with good patient acceptance and postoperative satisfaction. Research concerning the outcome of this procedure in terms of satisfaction and quality of life is lacking, as well as a recommendation on which assessment tools to use in this patient group.

A prospective study was performed on patients who underwent blepharoplasty. They were requested to complete a questionnaire preoperatively and at 3-6 months postoperatively. The Blepharoplasty Outcome Evaluation (BOE) and the Derriford Appearance Scale (DAS59) were used preoperatively and postoperatively. Visual analog scales (VAS) were also used preoperatively and postoperatively to measure visual impairment and aesthetic aspects of the eyelids. The Glasgow Benefit Inventory (GBI) was used postoperatively.

Thirty-six patients completed all questionnaires. They had a mean age of 55 years (range 25-73 years) and 31 were female.

Reliability of all questionnaires was moderate to good. Both satisfaction with the eyes and self-esteem improved significantly. Patients reported significant benefits afterwards. All scales showed significant correlations with the exception of several DAS59 subscales.

Upper blepharoplasty can result in great improvement in patient satisfaction, self-consciousness of appearance and benefit in daily life. Only the general subscale of the DAS59 seems relevant to use in this patient group. The BOE and GBI are brief but excellent tools to use in patients who underwent blepharoplasty to measure satisfaction and benefit in daily life.