Asian upper blepharoplasty and dual-plane epicanthoplasty: An integrated four-step technique.

[INTRODUCTION] Double-eyelid blepharoplasty and epicanthoplasty is usually performed concurrently in Asian patients to achieve aesthetically pleasing eye appearance, but the epicanthal area is prone to scarring. This article introduces an integrated four-step technique that enlarges the eyes with minimal scarring risk.

[METHODS] One hundred and thirty-five patients who underwent Asian upper blepharoplasty and dual-plane epicanthoplasty between January 2019 and September 2020 were retrospectively reviewed. Palpebral fissure distance (PFD), inner canthal distance (ICD), and vertical height of the palpebral fissure (VHPF) were measured based on photographs taken pre- and postoperatively, with the diameter of the iris as the reference value, D. Patient-reported outcome measures (PROMs) were collected to evaluate patient satisfaction and complications.

[RESULTS] A total of 129 female and 6 male patients were included. The average follow-up duration was 12.9 months. The average increasing ratio of PFD/D was 8.1%, whereas the average shortening ratio of ICD/D was 3.5%. The average VHPF/D increased by 10.6%. Statistical analysis was conducted using a paired t-test which demonstrated statistically significant results. A total of 96 patients responded to our patient-reported outcome measures (PROMs) at 6 months postoperatively, with an average patient satisfaction score of 62.9 out of 70 (89.8%). Barely visible scarring for the upper eyelid and the inner canthus were reported by 90.6% and 85.4% of patients, respectively. Three (3.1%) patients were not satisfied with the scar in the medial canthal area 6 months after surgery.

[CONCLUSIONS] The integrated four-step blepharoplasty and dual-plane epicanthoplasty is an effective, reliable, and reproducible method with high patient satisfaction and minimal scarring risk.