Modified Sub-Brow Blepharoplasty Reduces Early Postoperative Directional Wrinkles Without Compromising Surgical...

Sub-brow blepharoplasty has become the preferred surgical approach for moderate-to-severe upper eyelid aging. Over the years, numerous modifications and innovations have been introduced to achieve more natural, durable, and precise postoperative outcomes.

We conducted a prospective randomized controlled study to demonstrate that our modified sub-brow blepharoplasty technique can achieve a more natural upper eyelid contour in the early postoperative period while maintaining surgical outcomes during the available 6 month follow-up.

Between June 2024 and June 2025, 60 patients were enrolled and randomly assigned to either the experimental group (modified sub-brow blepharoplasty) or the control group (orbicularis oculi muscle flap crossover fixation blepharoplasty). In addition to preoperative baseline characteristics, postoperative outcomes were evaluated using both subjective and objective measures.

There were no significant differences between the two groups in sex distribution, mean age, or upper eyelid skin laxity grading at baseline. At 3 months postoperatively, the experimental group showed a significantly lower incidence of abnormal directional wrinkles in the upper eyelid, higher physician GAIS scores, and lower anxiety levels. At 6 months postoperatively, the early between-group differences were no longer observed, no significant differences were observed between the two groups in any subjective or objective outcome measures.

In this study, the modified sub-brow blepharoplasty technique provided more natural short-term aesthetic results while maintaining comparable surgical outcomes during the available 6 month follow-up.

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