ABSTRACT
BACKGROUND: Upper eyelid aging results from comprehensive changes, and studies have failed to comprehensively address these changes. OBJECTIVES: This study proposes a comprehensive approach to the surgical treatment of aging upper eyelids. METHODS: Data of 116 patients with aging upper eyelids were analyzed. Each eye was scored on upper eyelid laxity, degree of blepharoptosis, and upper eyelid socket depression at preoperation and 6 months after surgery. Based on average scores of both eyes, three degrees of aging were considered: mild, moderate, and severe. All patients underwent comprehensive surgical treatments. Depending on its condition, loose skin was appropriately removed, and the levator palpebrae superioris (LPS) was corrected in patients with degenerative ptosis. Meanwhile orbital septum fat was released or periumbilical fat mass was used as a filler to correct upper eyelid socket depression. All cases were summarized based on a classification and grading system. Scores were reassessed, and satisfaction survey was conducted after 6 months follow-up. RESULTS: The preoperative and postoperative scores of the three groups were significantly different (p < 0.05), and the difference in preoperative and postoperative scores between the three groups was also statistically significant (p < 0.05). The severe aging group had the greatest difference in score. Aside from 8 patients requiring reoperation, patients reported satisfied results after the 6 month follow-up. CONCLUSIONS: Comprehensive surgical treatment for patients with different grades of upper eyelid aging can achieve a satisfactory effect of upper eyelid rejuvenation. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
