Evaluation of upper blepharoplasty outcome ‒ objective measurements and patient satisfaction

  • Jelena Nikolić University Clinical Center of Vojvodina, Clinic for Plastic and Reconstructive Surgery
  • Marija Marinković University Clinical Center of Vojvodina, Clinic for Plastic and Reconstructive Surgery
  • Mladen Jovanović University Clinical Center of Vojvodina, Clinic for Plastic and Reconstructive Surgery
  • Ivana Mijatov University Clinical Center of Vojvodina, Clinic for Maxillofacial Surgery
  • Teodora Božić ; University Clinical Center of Vojvodina, Clinic for Anesthesiology, Intensive Care, and Pain Therapy
Keywords: blepharoplasty, eyelids;, patient satisfaction;, treatment outcome;, surgical procedures, operative;, surveys and questionnaires

Abstract


Background/Aim. Upper blepharoplasty is one of the most often performed aesthetic operations and is indicated for periorbital rejuvenation or correction of some functional problems. The aim of the study was to evaluate the outcome of this procedure and to assess patients’ satisfaction and possibilities of objective measurement of operative results. Methods. A two-year prospective observational study was conducted among female patients who had upper blepharoplasty done by the same surgeon. Data were collected from medical documentation, questionnaire, and objective measurements conducted via standardized digital photographs taken before and two months after surgery. Tarsal platform show (TPS) and brow fat span (BFS) were measured at three points (P1, P2, P3) before and two months after the surgery. A questionnaire conducted before surgery and two months after it included general complaints considering upper eyelids (visual field narrowing, fallen eyelids, the sensation of heavy eyelids, raising head backward in order to enhance vision, headache), patientsʼ assessment of eyelid asymmetry and an additional questionnaire after surgery included questions for the surgeon and patients concerning satisfaction with treatment outcome. Results. This study involved 50 female patients aged between 33 and 67 years (49.98 ± 8.6 years). There was a statistically significant difference in all points for TPS and BFS measurements before and after the operation. No significant asymmetries were noticed between eyes neither before nor after surgery. There was a statistically significant difference in operation success among 3 age categories in TPS-P1 (c2 = 13.089, df = 2, p = 0.001) and TPS-P2 (c2 = 8.386, df = 2, p = 0.015) with best results achieved in older patients (> 55 years). There was strong positive, statistically significant correlation between patient’s and surgeon’s satisfaction (r= 0.704, p = 0.002), as well as between patients’ satisfaction and their age (r = 0.704, p = 0.002). Conclusion. Realistic expectations, adequate information about the surgery and possible complications, are essential to satisfied patients. Objective measurements correlate with patientsʼ satisfaction and together with photographs can be a useful tool in communication with them.

Author Biographies

Jelena Nikolić, University Clinical Center of Vojvodina, Clinic for Plastic and Reconstructive Surgery

Clinic for Plastic and Reconstructive surgery, Clinical center of Vojvodina, Novi Sad, Serbia

Ivana Mijatov, University Clinical Center of Vojvodina, Clinic for Maxillofacial Surgery

Clinic for maxillofacial surgery, Clinical center of Vojvodina, Novi Sad, Serbia

Teodora Božić, ; University Clinical Center of Vojvodina, Clinic for Anesthesiology, Intensive Care, and Pain Therapy

Clinic for anesthesiology, intensive care and pain therapy, Clinical center of Vojvodina, Novi Sad, Serbia

 

References

Troell RJ. Peri-orbital Aesthetic Rejuvenation Surgical Proto-col and Clinical Outcomes. Am J Cosmet Surg 2017; 34(2): 81–91.

Briceño CA, Zhang-Nunes SX, Massry GG. Minimally Invasive Surgical Adjuncts to Upper Blepharoplasty. Facial Plast Surg Clin North Am 2015; 23(2): 137–51.

Papadopulos NA, Hodbod M, Henrich G, Kovacs L, Papadopoulos O, Herschbach P, et al. The Effect of Blepharoplasty on Our Pa-tient's Quality of Life, Emotional Stability, and Self-Esteem. J Craniofac Surg. 2019; 30(2):377-83.

Hwang K. Surgical anatomy of the upper eyelid relating to up-per blepharoplasty or blepharoptosis surgery. Anat Cell Biol 2013; 46(2): 93‒100.

Hoorntje LE, Lei BV, Stollenwerck GA, Kon M. Resecting orbic-ularis oculi muscle in upper eyelid blepharoplasty-a review of the literature. J Plast Reconstr Aesthet Surg 2010; 63(5): 787‒92.

Fagien S. The role of the orbicularis oculi muscle and the eye-lid crease in optimizing results in aesthetic upper blepharoplas-ty: a new look at the surgical treatment of mild upper eyelid fissure and fold asymmetries. Plast Reconstr Surg 2010; 125(2): 653–66.

Fagien S. Advanced rejuvenative upper blepharoplasty: en-hancing aesthetics of the upper periorbita. Plast Reconstr Surg 2002; 110 (1): 278‒91; discussion 292.

Gulyás G. Improving the lateral fullness of the upper eyelid. Aesthetic Plast Surg 2006; 30(6): 641–8, discussion 649–50.

Damasceno RW, Cariello AJ, Cardoso EB, Viana GA, Osaki MH. Upper blepharoplasty with or without resection of the orbicularis oculi muscle: a randomized double-blind left-right study. Ophthalmic Plast Reconstr Surg 2011; 27(3): 195‒7.

Saadat D, Dresner SC. Safety of blepharoplasty in patients with preoperative dry eyes. Arch Facial Plast Surg 2004; 6(2): 101‒4.

Kiang L, Deptula P, Mazhar M, Murariu D, Parsa FD. Muscle-sparing blepharoplasty: a prospective left-right comparative study. Arch Plast Surg 2014; 41(5): 576‒83.

Saalabian AA, Liebmann P, Deutinger M. Which Tissue Should Be Removed in Upper Blepharoplasty? Analysis and Evalua-tion of Satisfaction.World J Plast Surg 2017; 6(3): 324–31.

D’Assumpção EA. Blepharoplasty: a personal tactical approach. Aesthetic Plast Surg 1999; 23(1): 28–31.

Maximovich SP. Composite resection of the skin, orbicularis oculi, and retro-orbicularis oculi fat in upper eyelid blepharo-plasty. Plast Reconstr Surg 2006; 117(2): 695.

Thomas CB, Pérez-Guisado J. A new approach: resection and su-ture of orbicularis oculi muscle to define the upper eyelid fold and correct asymmetries. Aesthetic Plast Surg 2013; 37(1): 46‒50.

Widgerow AD. Upper blepharoplasty with lateral segmental or-bicularis excision. Ann Plast Surg 2003; 50(5): 471‒4.

Figueiredo MN, Tao J, Akaishi P, Limongi RM. Tarsal platform show after upper eyelid blepharoplasty with or without bras-siere sutures. Arq Bras Oftalmol 2017; 80(6): 345‒9.

Jacobsen AG, Brost B, Vorum H, Hargitai J. Functional benefits and patient satisfaction with upper blepharoplasty - evaluated by objective and subjective outcome measures. Acta Oph-thalmol 2017; 95(8): 820‒5.

Herruer JM, Prins JB, van Heerbeek N, Verhage-Damen G, Ingels K. Patient-reported outcome measurement in up-per blepharoplasty: How to measure what the patient sees. J Plast Reconstr Aesthet Surg 2018; 71(9): 1346‒51.

Blepharoplasty Medicare Fraud Attorneys https://www.whistleblowerfirm.com/medicare-fraud/falsification-of-medical-necessity-for-blepharoplasty-eyelid-surgery-when-performed-for-strictly-cosmetic-purposes/2019.

Published
2022/02/28
Section
Original Paper