Subbrow Blepharoplasty to Augment Blepharoptosis Repair in East Asian Patients.

BACKGROUND: This study analyzed the outcome of combined ptosis repair with adjunctive subbrow blepharoplasty in a predominantly East Asian population that is frequently characterized by bulky upper eyelid tissue. METHODS: A retrospective study of 160 eyelids of 80 patients who underwent bilateral aponeurotic ptosis repair with subbrow blepharoplasty at 1 center by 1 surgeon (A.L.) from March 2021 to December 2023 was performed. RESULTS: The mean age of the patients included in the study was 56.5 ± 12.5 years; 95% of the patients were women, and 97.5% were of Chinese ethnicity. There was a statistically significant increase in marginal reflex distance 1 of 2.35 ± 1.15 mm postoperatively (P < 0.001). Postoperatively, the mean lagophthalmos measurement at 3 months was 0.025 ± 0.16 mm. None of the patients had exposure keratopathy or postoperative complications. Three eyelids underwent revision surgery for residual ptosis. The mean subjective grading by patients was 8.6 ± 1.5, and the median score was 8 (interquartile range, 8-10). The mean objective score by the blinded independent observer was 2.6 ± 0.6, with 67.5% and 27.5% achieving an excellent score of 3 and a good score of 2, respectively. The median objective score was 3 (interquartile range, 2-3). CONCLUSIONS: Subbrow blepharoplasty is a useful adjunct to ptosis surgery in the East Asian population. It achieves greater tissue debulking and yields a "lighter" aesthetic outcome with good functional results. This technique achieves good subjective patient response and objective observer grading and has low revision and complication rates.