From the Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Center Groningen.
Department of Oral and Maxillofacial Surgery, Treant Scheper Hospital.
Plast Reconstr Surg. 2023 Jan 1;151(1):73-82. doi: 10.1097/PRS.0000000000009801. Epub 2022 Oct 7.
Different skin excision shapes may result in different aesthetic outcomes after upper blepharoplasty.
Two skin-only excision shapes were evaluated objectively and subjectively in 28 matched patients with laterally extended skin excision (group A) or traditional elliptical skin excision (group B). The pretarsal show, lateral eyebrow height, amount of scarring (evaluated with the Patient and Observer Scar Assessment Scale), and patient-reported aesthetic results (evaluated using FACE-Q) were scored and compared at 6 and 12 months postoperatively.
In both groups, pretarsal show improved significantly after blepharoplasty. The homogeneity of pretarsal show improved significantly in the lateral extension group (group A) together with slightly more pretarsal show (0.5 to 0.8 mm at central pupil region) at 6 and 12 months of follow-up compared with group B ( P = 0.004). A trend was observed in the exocanthion 45-degree measurement, in which group A had 0.6 mm greater pretarsal show 6 months postoperatively. Homogeneity of the pretarsal show had improved significantly in group A, but not in group B, at 12 months after blepharoplasty. No other significant differences were observed between the groups regarding pretarsal show measurements or FACE-Q scores. Both groups showed descent of the lateral eyebrow, but this was only significant in group B. Group B showed 1.4 to 2.0 mm more descent compared with group A. Scarring and adverse effects scores were low in both groups and did not differ.
Laterally extended skin excision and traditional elliptical skin excision both result in positive aesthetic results, but the laterally extended skin excision technique is accompanied by a slightly more favorable outcome.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
上睑成形术后，不同的皮肤切除形状可能会导致不同的美学效果。
在 28 例外侧延伸皮肤切除（A 组）或传统椭圆形皮肤切除（B 组）的匹配患者中，客观和主观评估了两种仅皮肤切除形状。在术后 6 个月和 12 个月时，评估术前表现、外眉高度、瘢痕量（采用患者和观察者瘢痕评估量表评估）和患者报告的美学结果（采用 FACE-Q 评估）并进行比较。
两组患者上睑成形术后术前表现均明显改善。与 B 组相比，外侧延伸组（A 组）在术后 6 个月和 12 个月时，术前表现的均匀性明显改善，同时术前表现略增加（中央瞳孔区域 0.5 至 0.8 毫米）（P = 0.004）。外眦 45 度测量值呈上升趋势，A 组术后 6 个月时术前表现增加 0.6 毫米。A 组术后 12 个月时，术前表现的均匀性明显改善，但 B 组未见改善。两组之间在术前表现测量值或 FACE-Q 评分方面无其他显著差异。两组患者的外眉均有下降，但仅在 B 组中显著。与 A 组相比，B 组下降 1.4 至 2.0 毫米。两组的瘢痕和不良反应评分均较低，且无差异。
外侧延伸皮肤切除和传统椭圆形皮肤切除均能获得良好的美学效果，但外侧延伸皮肤切除技术的效果略好。
临床问题/证据水平：治疗，III 级。
