Aesthetic Analysis of Alteration of Eyebrow Position After Double Eyelidplasty.

[BACKGROUND] There is an anecdotal belief among some surgeons performing Asian eyelid surgery that double eyelid surgery itself decreases eyebrow position. However, the exact amount of descent and the specific changes in the proportion of facial aesthetics are unknown.

[PURPOSE] The goal of this study is to determine whether there indeed is a change in brow position after double eyelidplasty and to quantify the proportional differences associated with the change. The three-point double eyelids surgery method was used so that the change in the brow position is solely attributed to the surgery itself and not to the excision of redundant skin.

[METHODS] From January 2016 to December 2017, double eyelid surgery using the three-point technique was performed on 204 patients who did not require skin excision. Their pre- and postoperative photographs were standardized and analyzed. The ratio of the length between the upper edge of the eyebrow and the edge of the lower eyelid (A) and the length between the edge of the lower eyelid and the nasal base (B) as well as the subsequent change in the midfacial proportion was measured and analyzed.

[RESULTS] There was a statistically significant brow descent after double eyelidplasty. The average preoperative A/B was 0.71 and the average postoperative A/B was 0.67 (P < 0.001). Although the eyebrow distance did not change in 32.5% of patients, the remaining cohort showed average brow descent of 5.6%. And in this cohort that showed descent, linear regression showed that there was a correlation between the ratio of pre- and postoperative eyebrow distance CONCLUSION: Double eyelid surgery can lower the eyebrow in patients with foldless eyelids. This is in accordance with clinical observation in Asian blepharoplasty. In addition, there are associated changes in the proportion of midfacial aesthetics after the surgery. Such knowledge can be helpful in preoperative consulting with patients as well as in predicting postoperative results.

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