The Prevalence of Blepharoptosis in Facial Rejuvenation Patient Population

Aesthetic Plast Surg. 2020 Apr 30. doi: 10.1007/s00266-020-01732-z. Online ahead of print.


Background: Facial rejuvenation results, commonly seen in publications or national presentations, are fraught with uncorrected eyelid ptosis. This study was conducted to investigate the frequency of blepharoptosis in the rejuvenation population and to help increase awareness in recognizing this under corrected condition.

Methods: Fifty-nine consecutive patients being evaluated for facial rejuvenation were included in the study. Patients who had previous eyelid or forehead surgery, congenital abnormalities, or post-traumatic deformities were excluded. Standard preoperative photographs were obtained. Each photograph was analyzed to determine blepharoptosis by measuring the distance between the upper eyelid margin and the upper limbus in each eye using Adobe Photoshop. Patient age, gender, and race were reported. Ptosis was defined as more than 1.0 mm overlap between the upper eyelid margin and the upper limbus.

Results: Mean age was 63.7. Among 59 patients, 34 patients (57.6%) had blepharoptosis and 25 patients did not. Patients with blepharoptosis were likely to be older and male.

Conclusion: Blepharoptosis becomes more common as patients age due to involution of eyelid and orbital tissue. It is commonly missed due to patient compensation by recruiting the frontalis muscle to lift the eyelids. It is imperative for the patient and the plastic surgeon to be aware of existing blepharoptosis and discuss expectations and formulate a comprehensive surgical plan. Awareness of the high prevalence of ptosis in the facial rejuvenation population allows plastic surgeons to provide better outcomes and higher patient satisfaction.

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

Keywords: Blepharoptosis; Eyelid; Facial rejuvenation; Informed consent; Patient education.