Blefaroplastia superior estendida com preservação da comissura lateral para tratamento do capuz palpebral lateral

Abstract

Introduction: The superior extended blepharoplasty, in the lateral region shows good results, but its scar is longer, with an increase in the inclination of the eyelid fissure (IEF). Objective: To describe and evaluate a technical modification, the extended upper blepharoplasty that preserves the lateral commissure (EUBP), with adequate correction of lateral eyelid dermatochalasis, preservation of natural IEF, and better esthetic results. Method: Coorte study of 50 patients undergoing modified EUBP evaluated 12 months postoperatively. The intensity of dermatochalasis was classified using the predictive validity criterion in relation to the postoperative outcome. Preoperative and postoperative IEF was measured and compared. The esthetic aspect was verified through patient satisfaction with their lateral scars, using the questionnaire adapted from the Patient and Observer Scar Assessment Scale (POSAS) and by two independent evaluators – a plastic surgeon and an ophthalmologist. Results: There was a predominance of women (84%), age 61.31 ± 8.04 years, length of lateral scars of 30.61 ± 5.08 mm, decrease in the degree of dermatochalasis in 90% of the cases and variation in IEF of 0,28 ± 1,77 degrees. Patient satisfaction with scars was 1.2 ± 0.4, while evaluator satisfaction was 1.34 ± 0.65. Conclusion: Extended preserved upper blepharoplasty shows a minimal change in the inclination of the palpebral fissure and results in almost unnoticeable lateral scars, with high functional and esthetic satisfaction expressed by both patients and evaluators. This procedure proved to be effective in treating eyelid dermatochalasis in grades 1, 2 and 3, with greater efficacy in the most intense cases.