Infrabrow excision to correct upper eyelid dermatochalasis in middle-aged and elderly patients

AIM: To evaluate the effects, advantages, disadvantages, and indications of infrabrow skin excision to correct upper eyelid dermatochalasis in middle-aged and elderly Chinese women.METHODS: Sixty eyelids in 30 patients were subjected to this surgical procedure from January to June 2018. All patients had upper eyelid dermatochalasis, and the functions of their levator palpebrae were all normal. The primary indications of the procedure were upper lid dermatochalasis with lateral hooding. All 30 patients underwent infrabrow skin excision at Shanxi Eye Hospital. The degree of skin relaxation before and after surgery was evaluated in all patients, and surgical outcomes and postoperative complications were also assessed.RESULTS: All patients were female, ranging from 40 to 64(mean: 53.20±7.10)years old. Skin relaxation of the upper eyelid was improved in all 30 patients. One month after the operation, 52 lids(86.7%)showed good results and 8 lids(13.33%)showed fair results. The objective Strasser system was applied to evaluate surgical results at 1 and 6mo. All patients had scores between 0 and 1 point, indicating good results. Preoperative unsatisfactory position and shape of the eyebrows were improved, and crow's feet and frontal lines were reduced. All patients were satisfied with the results. No complications related to wound dehiscence, lagophthalmos, or hypertrophic scars were observed.CONCLUSION: Infrabrow skin excision is a simple, useful operation to reconstruct the upper eyelids in selected patients of Chinese ancestry. This procedure not only retains the advantages of classic blepharoplasty, but also alleviates many eyebrow problems at the same time, and maintains the original shape of the eyelid, minimizes scarring, and produces a smoother, more youthful appearance.