A prospective study on the role of removal of pretarsal tissue in Asian blepharoplasty

Abstract

Background: Surgical creation of a superior palpebral fold, known as the double-eyelid operation (Blepharoplasty), has become the most popular cosmetic surgery in Asia. One of the distinguishing features between an individual of Asian descent and western descent is the absence or presence of an upper eyelid crease. An eye with a double-eyelid looks fresh, youthful, and attractive. Several techniques to create a unique esthetic kind of double eyelid in the Asian population has been reported. Aims: Keeping up with the recent evolving techniques, our study is designed to study the role of removal of pretarsal tissue in Asian Blepharoplasty and to analyze the esthetic outcome. Materials and Methods: Study Variables used were age, sex, address, maximum crease height, height of eyebrow, intercanthal distance, and interpupillary distance. Outcome Measures were symmetry of both the eyelid crease and subjective aesthetic appearance. Settings and Design: An interventional prospective study was a tertiary hospital setup in Manipur, India, or a period of 2 years. Double-eyelid operation (Blepharoplasty) was performed on a total of 91 cases, with removal of pretarsal tissues along with a strip of pretarsal orbicularis oculi. Statistical Analysis: The data analyzed with IBM SPSS Statistics 21 developer. Descriptive statistics mean were used for statistical analysis and paired t-test for quantitative data. Results: A total of 91 operated cases were analyzed, taking variables - age, sex, address, maximum crease height, height of eyebrow, intercanthal distance, and interpupillary distance. Outcome measures were symmetry of both the eyelid crease and subjective esthetic appearance. It was found out that majority of the crease height remain unchanged from the intraoperative marking level. Making the preoperative planning a reliable representation of final outcome, and 76 cases (83.5%) were in Grade I subjective esthetic outcome and only 1 case was in Grade III (unsatisfied). Conclusion: Remove the pretarsal connective tissue and part of orbicularis muscle allowed for better fixation, smooth skin surface and leaving less tissue to become postoperatively edematous. Along with minimal fat excision helps to avoid a sunken sulcus. This technique gives good esthetic outcome. The procedure makes the newly created double-eyelid appear natural and more beautiful after complete recovery.