Shortened Infrabrow Excision Blepharoplasty Combined with the Removal of Orbicularis Oculi Muscle for Dermatochalasis in Asians

The periorbital area tends to be the first and most visible facial part where senility occurs and therefore is of great concern. Various blepharoplasty incisions are applied to correct upper eyelid dermatochalasis. In this study, we applied and evaluated the shortened infrabrow excision blepharoplasty (sIBEB) combined with the removal of the orbicularis oculi muscle to achieve more satisfactory effects. This retrospective study included 40 women who underwent sIBEB treatment at the Plastic Surgery Hospital of Beijing between February 2019 and June 2021. Preoperative and postoperative photographs, complications, objective Strasser system, and self-assessed subjective evaluations by the patient (on a scale of 1-10) were used to assess the results of the procedure. During the follow-up (6-16 mo; average, 12 mo), all 40 patients (age, 26-68 y; 47 +/- 9.44 y) presented effective correction of the dermatochalasis. The objective Strasser evaluation showed that all patients had a score of 0 to 4, and the subjective feedback revealed that 37 patients (92.5%) scored the procedure 9/10, indicating high satisfaction. No complications were detected, and repair surgery was not required in any patient. The application of a shortened incision enables the surgeon to accurately locate the excision area, resulting in less visible scars. Furthermore, removal of the orbicularis oculi muscle allows for the sagittal lifting of the superficial musculoaponeurotic system layer, adjusting the swelling and sagging appearance. The modified sIBEB may achieve more effective, sustainable, and satisfactory outcomes.