Subbrow blepharoplasty for lateral hooding in White patients

This paper looks at subbrow blepharoplasty, a technique usually applied to Asian patients, to address lateral hooding in patients who are White.

Study design

This is a retrospective case series of White patients who underwent subbrow blepharoplasty for moderate to severe dermatochalasis with lateral hooding.

Outcomes

Fifty patients underwent a modified subbrow blepharoplasty technique (18 women, 32 men). The average age of the patients was 71.4 years and minimum follow-up was 3 months. Of the 50 patients, 22 underwent an internal browpexy as well. Patient satisfaction was measured in all 50 patients, all of whom were satisfied with the results.

Limitations

This is a retrospective case series. Ideally, a prospective randomized design comparing this procedure to a standard blepharoplasty would have been performed. The subjective result of patient and surgeon satisfaction is difficult to quantify. There are a number of scar grading scales that could have been used as well as judging of postoperative photographs by masked oculoplastic surgeons that could have given more meaningful results.

Clinical significance

Subbrow blepharoplasty has been traditionally applied in Asian patient populations to preserve the natural eyelid crease. In general, it is effective in addressing lateral hooding. The benefit of preserving the eyelid crease has been thought to outweigh the potential noticeable subbrow scar. This paper demonstrates its effective use in White patients with lateral hooding. A concurrent browpexy may be needed to prevent brow descent. This should likely be performed only in older patients with severe lateral dermatochalasis with excessive redundancy of the infrabrow skin.