Will the patient's double eyelid shape be like that of the surgeon performing the procedure? A study of surgeons' aesthetics in East Asian Blepharoplasty.

[BACKGROUND] No reports of the potential areas of surgeons' aesthetics in blepharoplasty.

[AIMS] To explore the association between the surgeons' own double eyelid morphology and their aesthetics and surgical outcome.

[METHODS] An investigation of 1605 patients was carried collecting the data of double eyelid shape, based on which to propose a preliminary double eyelid classification for analyzing the aesthetics of surgeons. Ten double eyelid surgical cases were randomly collected from each surgeon according to the inclusion criteria, whose double eyelid shape, ideal shape, the selection tendency of surgical approach, most cared factor during surgery, and design concept of eyelid shape were collected. Structural equation modeling (SEM) was performed to assess the association between participants' double eyelid shape, aesthetics, and blepharoplasty outcome.

[RESULTS] Fifty-three double eyelid surgeons were enrolled for study, whose double eyelids shapes mostly were obviously fan-shaped (37.74%) and low-parallel eyelid (26.42%), and the ideal shapes were obviously fan-shaped (41.51%) and high-parallel eyelid (24.53%). 54.72% of the subjects preferred to use the full-incisional method. 45.28% cared for long-term outcome most. Regarding blepharoplasty outcome style, 49.06% of the subjects preferred obviously fan-shaped type and 24.53% for high-parallel type. SEM showed that aesthetics rank increased by 0.692 points for surgeons' shape (P < .001), and surgical outcome rank increased by 0.861 points for aesthetics (P < .001). However, their eyelid shape had no direct contribution to surgical outcome (P = .96).

[CONCLUSIONS] The findings indicated that surgeons' double eyelid shape positively affected their aesthetics, which affected their surgical outcomes further, but their double eyelid shape failed to affect the surgical outcomes directly.