Comparative analysis of pretarsal and sub-brow blepharoplasty for correction of age-related upper eyelid changes in Asian race patients

The purpose of a study was to compare the blepharoplasty methods of pretarsal (Asian eyelid blepharoplasty) and sub-brow approaches in patients of the Asian ethnic group based on the analysis the surgical correction results of age-related upper eyelids changes. Material and methods. The prospective clinical study included 133 mongoloid race people aged 45 to 71 years in the period up 2019 to 2024. The study participants were randomly divided into two groups. The 1st group (72 people) underwent age-related Asian blepharoplasty using a pretarsal approach, the 2nd group (61 people) underwent blepharoplasty using a sub-brow approach. The validated FACE-Q Satisfaction with Eyes questionnaire was used to assess the treatment results before, 3 and 6 months after blepharoplasty. Results. Comparison of preoperative groups with blepharoplasty did not reveal statistically significant differences in satisfaction with eye appearance (p = 0.089). After blepharoplasty, we were unable to find differences between the study groups when assessing the degree of satisfaction with the appearance of the eyes after 3 months (92 (92–100) in patients of the 1st group and 92 (92–100) in patients of the 2nd group, p = 0.192). The score 6 months after blepharoplasty was statistically significantly higher in patients of 2nd group than in study participants from 1st group 100 (92–100), 96 (92–100) points, respectively, p = 0.027). No complications such as postoperative brow ptosis or recurrence of lateral blepharochalasis were observed performing blepharoplasty using a sub-brow approach (group 2). This fact indicates that the risk of these complications is minimized. Conclusion. Blepharoplasty using a sub-brow approach is a promising method of surgical correction of agerelated upper eyelids changes in patients of the Asian ethnic group, showing comparable effectiveness in comparison with age-related blepharoplasty of Asian eyelids. Using myo-periosteal fixation, this technique gives fewer complications in the form of postoperative brow ptosis.