Subbrow Blepharoplasty in Caucasians.

[SUMMARY] Subbrow blepharoplasty is widely used in Asian patient populations to preserve the natural upper lid crease while addressing dermatochalasis with lateral hooding. The authors describe the first use of this technique in Caucasians with dermatochalasis and lateral hooding. This is a retrospective case series of Caucasian patients who underwent subbrow blepharoplasty for moderate to severe dermatochalasis with lateral hooding. Patients were included when the skin excess of the upper lid was noted predominantly as a lateral hooding over the lateral half of the upper lid. A modified subbrow blepharoplasty technique was used and will be described in detail. Fifty patients underwent the procedure from January of 2017 to June of 2018, 18 female and 32 male patients. The average age of the patients was 71.4 years (range, 59 to 84 years). Minimum patient follow-up was 3 months. An internal browpexy and a periosteal fixation were combined with subbrow blepharoplasty for 22 patients (14 men and eight women). Patient satisfaction with the result of the procedure and incision line were assessed. All 50 patients were satisfied with the surgical results. No patients noted any issues with the incision. No patients complained of incision problems, but the surgeon noted two patients with redness in the scar at 3 months that improved over a 12-month follow-up. Subbrow blepharoplasty may be an alternative to the classic upper lid blepharoplasty in older Caucasian patients, as it can address moderate to severe dermatochalasis with lateral hooding.

[CLINICAL QUESTION/LEVEL OF EVIDENCE] Therapeutic, IV.