Patient-Specific Factors for Deformity after Upper Blepharoplasty in an Asian Population

Background: The success of upper blepharoplasty depends on both surgeon experience and skill and on patient factors. Therefore, the authors aimed to identify patient-specific characteristics that may contribute to poor prognoses by analyzing data derived from patients with various deformities after undergoing upper blepharoplasty. Methods: This study included 202 patients who underwent revision surgery for upper blepharoplasty. The authors explored relationships between types of deformities before revisions and relevant patient factors before initial surgery using statistical analyses. Results: Age older than 30 years, thick upper lid skin, medial epicanthus, and other patient factors were significantly associated with the deformities. Asymmetric crease, crease disappearance, shallow crease, and low crease were the most prevalent deformities. For these 4 most prevalent deformities, the concordance indices and 95% confidence intervals (95% CI) of the risk prediction models were 0.654 (95% CI, 0.575 to 0.734), 0.724 (95% CI, 0.637 to 0.810), 0.783 (95% CI, 0.702 to 0.863), and 0.750 (95% CI, 0.655 to 0.844), respectively. Conclusions: Among the 4 most prevalent prognostic deformities, significant patient factors included medial epicanthus, thick upper eyelid skin, weak levator palpebrae superioris, age older than 30 years, and a short gap between eyes and brows. The authors also attempted to clarify the clinical importance of these patient factors. The authors’ findings provide a guide and reference for future investigations into upper blepharoplasty. CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.