Transbrow Excision Blepharoplasty for Upper Eyelid Dermatochalasis

Backgrounds: Many aging women with upper lid dermatochalasis pluck their lower lateral eyebrows to combat lateral drooping. The authors present and evaluate outcomes of a modified excision blepharoplasty method performed using a transbrow excision approach instead of infra/suprabrow access to more efficiently correct upper eyelid dermatochalasis. Methods: The authors conducted a retrospective review of 192 patients who underwent transbrow excision blepharoplasty (TBEB) between 2014 and 2019 at the Plastic Surgery Hospital of Beijing in China. The clinical features, complications, and outcomes of patients were reviewed. The Strasser grading system was used to evaluate surgical results postoperatively. Aesthetic improvement was subjectively judged by the patients. Results: All 192 patients (aged 25–72 years old, mean 46 years old) were reviewed and followed up for 6 months to 2 years. Patients were evaluated after 1 week and after at least 6 months. All patients reported an improved aesthetic appearance of the lateral periorbital area, and 174 patients (90.6%) rated their results as satisfactory. No serious complications were related to the procedure. Conclusions: TBEB is used to correct problems that are not adequately managed by conventional excision blepharoplasty. Among 192 patients evaluated over 5 years, excision of the transbrow skin pad sufficiently reduced the redundancy of the upper eyelid and achieved an acceptable appearance of the periorbital area, where the postoperative location of a subtle scar defined a desired youthful brow position. In selected patients, this is an effective and safe method that uses patient-observed features to provide an alternate cosmetic approach.