title: Upper blepharoplasty with or without resection of the orbicularis oculi muscle: a randomized double-blind left-right study.
abstract: OBJECTIVE
  To compare the aesthetic outcomes of the upper blepharoplasty with or without resection of the preseptal orbicularis oculi muscle.
  
  
  METHODS
  An interventional randomized double-blind left-right study was conducted in 15 consecutive patients with dermatochalasis of the upper eyelid. One side was randomly chosen for resection of the preseptal orbicularis oculi muscle (group 1). The orbicularis oculi muscle of the contralateral side was preserved (group 2). All patients scored differences between both sides on the seventh day, the thirtieth day, and the ninetieth day after the surgery regarding the following symptoms: edema, hematoma, itching, and pain. Three masked ophthalmic plastic specialists analyzed the aesthetic outcomes by the visual analogical scale.
  
  
  RESULTS
  The scoring of symptoms was significantly higher in group 1 than in group 2 on the seventh postoperative day. On the thirtieth and ninetieth days, there were no significant differences between groups 1 and 2. The analysis by 3 masked observers showed that the aesthetic result was worse in group 1 than in group 2 on the seventh postoperative day. There were no significant differences between groups 1 and 2 on the thirtieth and ninetieth days.
  
  
  CONCLUSIONS
  Upper blepharoplasty causes more postoperative symptoms and presents worse initial aesthetic outcome when the preseptal orbicularis oculi muscle is excised. However, the final aesthetic outcome is the same when the preseptal orbicularis oculi muscle is excised or preserved.
authors.affiliation: Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil. renato.damasceno@unifesp.br
authors.forename: Renato Wendell
authors.initials: RW
authors.lastname: Damasceno
authors.forename: Angelino Júlio
authors.initials: AJ
authors.lastname: Cariello
authors.forename: Emmerson Badaró
authors.initials: EB
authors.lastname: Cardoso
authors.forename: Giovanni André
authors.initials: GA
authors.lastname: Viana
authors.forename: Midori Hentona
authors.initials: MH
authors.lastname: Osaki
mesh_terms: D000368:Aged; D019882:Blepharoplasty; D004311:Double-Blind Method; D005141:Eyelid Diseases / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000503:physiopathology / Q000601:surgery*; D017060:Patient Satisfaction; D011446:Prospective Studies; D012871:Skin Diseases / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome