Comprehensive considerations in blepharoplasty in an Asian population: a 10-year experience.
BACKGROUND
This article discusses the effectiveness, patient selection criteria, complications, and the appropriate procedures for lower blepharoplasty in an Asian population.


METHODS
During the past 10 years (1998-2008), a total of 2400 patients underwent lower blepharoplasty in our department. Four different types of lower-blepharoplasty procedures were performed, including the traditional transcutaneous skin flap procedure (n = 862), the transcutaneous skin-muscle flap procedure (n = 738), the transconjunctival procedure (n = 433), and Hamra's procedure (septal reset and fat-replacing technique) (n = 367). Among these 2400 patients, 925 were available for follow-up. The length of follow-up ranged between 1 month and 10 years.


RESULTS
Most of the patients were satisfied with the result, but 32 patients had some postoperative complications, including five patients with ectropion, five with hollow eyes, two with dry eyes, and 20 with retraction.


CONCLUSIONS
Transconjunctival blepharoplasty is the first choice for primary eyelid bags. Transcutaneous lower blepharoplasty (skin flap or skin-muscle flap procedures) is indicated for the senile eyelid with excess skin and muscles. If supporting structures (skin, muscle, and septum) show laxity and other aging stigma are present, including tear trough deformity and obvious skeleton rim, Hamra's procedure (septal reset and fat-replacing technique) is performed.
Department of Plastic Surgery, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai, China.
Lingli
L
Guo
Hongda
H
Bi
Chunyu
C
Xue
Junhui
J
Li
Chao
C
Yan
Jianxing
J
Song
Mingli
M
Zhang
Xin
X
Xing
D000293:Adolescent; D000328:Adult; D044466:Asian People; D019882:Blepharoplasty / Q000009:adverse effects / Q000379:methods*; D005143:Eyelids / Q000033:anatomy & histology; D006801:Humans; D011183:Postoperative Complications; D013524:Surgical Flaps; D055815:Young Adult