Current surgical techniques for correction of age-related upper eyelid changes in Asian patient race

Objective. To identify current surgical techniques for correction of age-related upper eyelid changes in Asian patients through analysis of available information in scientific databases. Material and methods. Available literature data were reviewed in the PubMed, Google Scholar and the Russian State Library databases. The inclusion criteria were clinical studies describing surgical correction of age-related upper eyelid changes in Asian patients and possible intraoperative and postoperative complications. There were 64 (100%) manuscripts including 30 (46.8%) ones devoted to age-related Asian blepharoplasty, 21 (32.8%) — blepharoplasty through subbrow approach, 4 (6.2%) — combination of techniques, 4 (6.2%) — blepharoplasty through supraciliary approach, 5 (8%) — upper eyelid lipofilling. Results. The most common methods of surgical correction of age-related upper eyelid changes in Asian patients are upper blepharoplasty (several variations of techniques), blepharoplasty through subbrow approach, blepharoplasty through supra-ciliary approach, combination of techniques with lipofilling and/or excision of fatty hernias. The most common techniques are upper blepharoplasty with creation of palpebral fold and blepharoplasty through subbrow approach for excision of lateral hood-shaped overhang without palpebral fold correction. Blepharoplasty through supra-ciliary approach is less common since it does not allow excision of large volume of dermatochalasis. Conclusion. Available literature does not describe the algorithm of preoperative management using non-invasive diagnostic methods and postoperative management of Asian patients. There are no indications and contraindications for various surgical options taking into account the characteristics of age-related changes in these patients. There is no algorithm for choosing surgical technique depending on eyelid shape and personal wishes of patients with age-related changes. Blepharoplasty through subbrow approach is effective for lateral upper eyelid ptosis and preferable for lateral dermatochalasis in Southeast Asians. However, myoperiosteal sutures or fixation to frontal muscle creates a high risk of damage to vascular-nerve bundles. It is necessary to refine modern techniques to reduce the incidence of possible complications.