Modified Infrabrow Blepharoplasty for Periorbital Rejuvenation in Asia Women

OBJECTIVE: The infrabrow blepharoplasty is a common surgical operation indicated in Asians for periorbital rejuvenation. This operation alone is difficult to achieve the correction of crow's feet. Therefore, the authors elucidate the authors' experiences of applying infrabrow blepharoplasty combined with the subcutaneous undermining of the lateral periorbital region to treat upper eyelid dermatochalasis with lateral hooding deformity and alleviate crow's feet, including its indications, operative procedures, and postoperative outcomes. METHODS: Retrospective review of patients undergoing infrabrow blepharoplasty incorporated with subcutaneous undermining of the lateral periorbital region between January 2019 and December 2023. Thirty-nine patients who were well followed up were retrospectively reviewed. The surgical procedure is described in depth. Frontal and lateral view photographs were obtained to evaluate the curative effect. The following data were collected preoperatively and at postoperative 6 months: distance between the pupil centre and the supratarsal fold, distance between the pupil centre and lower margin of eyebrow, distance between the lateral canthus and the supratarsal fold, distance between the lateral canthus and lower margin of eyebrow, the rating of Crow's Feet Grading Scale (CFGS) at rest and at a maximum smile. RESULTS: The study included 78 eyelids of 39 patients ranging in age from 37 to 56 years, with a mean age of 46.25 years. The mean follow-up for the patients was 6.7 months. Compared with the postoperation with the preoperation, distance between the pupil centre and the supratarsal fold increased from 5.45 ± 1.31 to 5.98 ± 1.62 mm, distance between the lateral canthus and the supratarsal fold increased from 3.93 ± 1.24 to 6.13 ± 1.87 mm, no evidence of significant changes in distance between the pupil centre and lower margin of eyebrow and distance between the lateral canthus and lower margin of eyebrow. The average change in the rating of CFGS was -0.62 ± 0.11 at maximum contraction and -0.24 ± 0.08 at rest. No significant complications occurred in any patient postoperatively. CONCLUSION: The combination of infrabrow blepharoplasty with the subcutaneous undermining of the lateral periorbital region was effective in addressing moderate dermatochalasis with lateral hooding and improve crow's feet in middle-aged Chinese patients, resulting in a rejuvenated periorbital area and flattening of the eyebrow is not noted at the same time. The anthropometric measurement of the upper eyelid and CFGS facilitate operation outcome assessment.