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An Integrated Surgical Strategy to Lower Blepharoplasty With Quantitative Classification and Assessment in Asian
Jiaqi Wang1, Liang Peng1, Jingdong Guo1
1From the Department of Plastic and Burn Surgery, Shenzhen Hospital, Southern Medical University, Shenzhen, Guangdong, China.
Plastic and Reconstructive Surgery. Global Open
|August 6, 2026
Summary
This study developed a grading system and surgical strategy for lower blepharoplasty in Asian patients, achieving high satisfaction and aesthetic improvement for eyelid bag deformities. Personalized assessment is key for successful outcomes.
Area of Science:
- Plastic Surgery
- Ophthalmology
- Aesthetic Medicine
Background:
- Lower eyelid bag deformities present significant patient variability.
- Standardized procedures are often insufficient for optimal results.
- Tailored surgical approaches are essential for lower blepharoplasty.
Purpose of the Study:
- To establish a clinical grading system for lower eyelid deformities.
- To develop an integrated surgical strategy for Asian patients.
- To achieve personalized and satisfactory outcomes in lower blepharoplasty.
Main Methods:
- A cohort of 504 Asian patients with grades I-III lower eyelid deformities were analyzed.
- A combined surgical procedure involving transconjunctival orbital fat removal, minced orbital fat grafting, and skin excision was performed.
- Preoperative and postoperative assessments included photographs, patient satisfaction, aesthetic improvement, and statistical analysis.
Main Results:
- High overall patient satisfaction (4.456 ± 0.22) was reported, with the highest scores in grade III deformities.
- Significant aesthetic improvement was observed (90.98 ± 2.23), particularly in grade II patients.
- Specific preoperative measurements (AC/AB, ∠EDO, AF/AB, ∠GOH) predicted marked aesthetic improvement.
Conclusions:
- Precise preoperative assessment and individualized planning are crucial for successful lower blepharoplasty.
- A quantitative grading system and integrated surgical strategy yield satisfactory outcomes for Asian patients.
- Preoperative quantitative assessment aids in standardizing descriptions and guiding surgical planning for expectation management.