Influence of Periorbital Dynamic Rhytides on Surgical Outcomes of Lower Eyelid Blepharoplasty: A Clinical Efficacy Assessment.

BACKGROUND: Lower eyelid bags and periorbital dynamic rhytides are common manifestations of periocular aging in middle-aged and older adult patients seeking aesthetic improvement. Although lower eyelid blepharoplasty corrects bag deformity, its interplay with preoperative dynamic rhytides remains understudied. This retrospective cohort study compares surgical outcomes following lower eyelid blepharoplasty in patients with varying severities of preoperative periorbital dynamic rhytides and to assess differences in treatment efficacy. METHODS: This retrospective study analyzed 56 patients (112 eyes) undergoing transcutaneous lower eyelid blepharoplasty. Patients were stratified into group A (n = 32, severe dynamic rhytides) and group B (n = 24, mild dynamic rhytides) based on the preoperative Lemperle Wrinkle Scale. Postoperative outcomes were evaluated at 1-month and 1-year intervals using Barton and Hirmand grading systems to quantify infraorbital rejuvenation. Secondary endpoints included complication rates and patient satisfaction. RESULTS: At 1-year follow-up, group A (severe rhytides) showed significantly less improvement in infraorbital contour than group B (mild rhytides) based on standardized grading systems (P < 0.05). Patient satisfaction was also lower in group A (P < 0.05). Complication rates did not differ between the groups (P > 0.05). CONCLUSIONS: The severity of preoperative periorbital dynamic rhytides is associated with less favorable aesthetic outcomes in infraorbital contour after lower eyelid blepharoplasty and predicts lower patient satisfaction. However, it does not increase surgical risks. Preoperative assessment of wrinkle severity should be integrated into surgical planning and patient counseling to optimize expectations.