A Novel Quantitative Preoperative Method for Assessing Skin Resection in Infrabrow Excision Blepharoplasty

Infrabrow excision blepharoplasty is widely performed in Asians to address dermatochalasis by directly resecting redundant skin while preserving the inherent supratarsal anatomy. Precise skin resection is critical for achieving optimal outcomes, yet traditional methods relying on forceps pinching remain subjective and inaccurate. This study proposed a novel quantitative preoperative method to assess the amount of redundant skin to be resected.

A retrospective study was conducted on patients who underwent infrabrow excision blepharoplasty using the proposed method. With eyes gently closed, the superior incision was marked along the lower brow margin. Six to 10 reference points were designated, and the resting eyebrow height (REH) from each point to the eyelid margin was measured. The inferior incision line was then determined by marking points at the same REH distance from the eyelid margin after manually elevating the eyebrow to achieve slight eyelash elevation.

Eleven patients (22 eyes) were included. No complications such as hematoma, infection, or eyelid ectropion were observed during an average follow-up of 15.18 ± 7.72 months. The median aesthetic score was 4 (4, 4). All patients with preexisting supratarsal folds (n = 11) had their lid crease restored, and 2 patients with preoperative visual field obstruction reported subjective improvement. Postoperative scarring was inconspicuous, with a mean visual analog scale score of 1 (0, 1).

The proposed preoperative quantitative method, which uses eyebrow elevation simulation and objective REH measurements, is a simple, reliable, and accurate technique for assessing skin resection in infrabrow blepharoplasty. It can achieve satisfactory aesthetic results and functional improvements, with inconspicuous scars.