Scar Assessment After Upper Eyelid Blepharoplasty Using the Vancouver Scar Scale: The Influence of Fitzpatrick Skin...

To evaluate the effect of Fitzpatrick skin type on late postoperative scar appearance following upper eyelid blepharoplasty using the Vancouver Scar Scale (VSS).

Upper eyelid blepharoplasty cases in which only skin excision was performed between January 2024 and June 2025 were retrospectively reviewed. Patients whose incision lines were closed with interrupted 6-0 vicryl sutures were divided into four groups according to Fitzpatrick Skin Types II-V. All cases were evaluated at postoperative month 6 by the same surgeon using the VSS. Total VSS scores and subparameters (vascularity, pigmentation, pliability, and height) were compared among the groups.

A total of 200 patients were evaluated. Of these, 140 (70%) were female and 60 (30%) were male, with a mean age of 42.1 ± 2.6 years. Age and sex distributions did not differ significantly among the groups (p > 0.05). Total VSS scores increased significantly with darker skin types (p < 0.001); the Type V group had significantly higher scores than all other groups. In the subparameter analysis, only pigmentation scores showed significant differences (p < 0.001), while vascularity, pliability, and height did not differ among the groups (p > 0.05).

Darker Fitzpatrick skin types carry an increased risk of more visible scar formation following blepharoplasty, likely driven by greater pigmentation changes. Skin type should be considered during preoperative assessment and in planning individualized scar-management strategies.

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