Upper Blepharoplasty With Or Without Ptosis Correction: An Analysis Of Outcomes In 533 Consecutive Procedures At An Academic Hospital
Liset Falcon Rodriguez, B.A.1, Doga Kuruoglu, M.D.2, Lilly H. Wagner, M.D.3, Elizabeth A. Bradley, M.D.3, Samir Mardini, M.D.2, Uldis Bite, M.D.2, Basel A. Sharaf, M.D.2.
1Mayo Clinic Alix School of Medicine, Jacksonville, FL, USA, 2Mayo Clinic Division of Plastic Surgery, Rochester, MN, USA, 3Mayo Clinic Department of Ophthalmology, Rochester, MN, USA.
PURPOSE: Eyelid ptosis may present along with upper lid dermatochalasis and brow ptosis. When indicated, ptosis correction (PC) is advocated during upper blepharoplasty (UB). In this study, we aimed to report outcomes following UB with PC.
METHODS: A retrospective review of consecutive patients that underwent UB from November 2018 to March 2020 was performed. Patient demographics, clinical characteristics as well as revisions were recorded. Cox-regression was performed to assess predictors of revision surgery.
RESULTS: Overall, 278 patients with 533 primary UB were included. The mean age was 67.3 years and mean follow-up was 8.3 months. In 169 (31.7%) cases, a brow lift was performed. UB with PC was performed in 109 (20.5%), of which 60 (55%) involved Müller's muscle conjunctival resection and 49 (45%) were levator repairs. There were no wound complications. New dry eye symptoms lasting ≥3 months occurred in 4 (0.8%) cases all of which resolved. A revision was performed in 3.8% after UB alone (residual skin [n=11], hypertrophic scar [n=4], Herring's law related ptosis [n=1]); versus 9.2% in the UB with PC group (overcorrection [n=4], residual skin [n=4], asymmetry [n=2]). The multivariable analysis demonstrated increased rate of revision when UB was combined with PC (adjusted HR: 4, 95% CI [1.8-8.8], p= 0.008). There was no difference in revision rates between the different techniques of ptosis correction.
CONCLUSIONS: Upper blepharoplasty with PC is safe regardless of which PC technique is used. The revision rate of combined UB and PC was 9.2%, which is comparable to the literature.
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