Applications of Magnetic Resonance Imaging in Upper Eyelid Anatomy and Upper Eyelid Blepharoplasty: A Systematic Review.

[BACKGROUND] Current upper eyelid blepharoplasty techniques vary widely, and many revision patients lack information of the initial procedure, making reparability assessment and surgical planning challenging. In such complex procedures, perioperative analysis of eyelid anatomy is crucial. Although magnetic resonance imaging (MRI) is valuable for studying upper eyelid anatomy and function, significant variations exist in MRI protocols, research methods, and objectives across studies. This systematic review aimed to explore MRI applications in upper eyelid anatomy and blepharoplasty and summarize factors limiting its clinical use.

[METHODS] A systematic review of clinical studies utilizing MRI for upper eyelid anatomy and blepharoplasty was conducted by searching PubMed and Web of Science until January 5, 2025. Publications were categorized by research objectives. The study types, populations, observational tools, MRI protocols, outcomes, and conclusions were summarized.

[RESULTS] Of the 12 articles reviewed, 7 detailed normal anatomy and functions, 2 identified racial anatomical disparities, 1 assessed tumor extent, and 2 highlighted anatomical changes postblepharoplasty. Dynamic MRI had proven effective for functional eyelid analysis, whereas surface microscopy coils improved spatial resolution. Limitations included protocol inconsistencies, small samples, artifacts, and cost.

[CONCLUSIONS] Dynamic high-resolution MRI excels in evaluating upper eyelid anatomy through superior soft-tissue contrast and quantitative analysis. It supports personalized surgical planning and objective postoperative assessments in revision and complex cases. By visualizing structural changes, it optimizes upper blepharoplasty techniques. Standardized protocols and larger cohort studies are needed to advance clinical adoption.