Personalized preoperative design for reducing complications after upper blepharoplasty.

[BACKGROUND] Upper eyelid blepharoplasty is a common cosmetic surgery among Asians and is associated with several complications that are possibly related to the anatomical characteristics of the eyes.

[METHODS] A total of 364 upper eyelid blepharoplasties were performed at the Department of Plastic and Reconstructive Surgery between January 2018 and December 2019. The postsurgery complications and related eyelid types were classified as follows: upper eyelid crease too high (too high crease), upper eyelid crease too low (too low crease), medial upper eyelid crease too high (too high medial crease), bloated upper eyelid (bloated crease), and upper eyelid crease asymmetry (asymmetric crease). The correlation between the anatomical characteristics of the upper eyelid and complications was analyzed. Patients seeking upper eyelid blepharoplasty were preoperatively categorized into five types according to their anatomical characteristics, and modified surgical strategies were applied to 117 new blepharoplasties performed between January 2020 and December 2020. Five senior plastic surgeons evaluated the pre- and postoperative photographs of the previous (2018-2019) and modified (2020-2021) blepharoplasties and scored the results on the basis of specific criteria.

[RESULTS] The postoperative scores in the modified group increased significantly after the modifications compared to that of the previous surgeries (p ≤ 0.01).

[CONCLUSION] Preoperative classification based on the anatomical characteristics of the eyelid and surgical modifications can reduce the occurrence of the five common complications of double eyelid blepharoplasty.

[LEVEL OF EVIDENCE] IV.