The Prevalence of Undiagnosed Ptosis Among the Candidates for Upper Eyelid Blepharoplasty
Bahram Eshraghi, Mohsen Pourazizi, Akbar Taghian, Samira Chaibakhsh, Ali Aghajani- General Medicine
Abstract
Background
Since the upper eyelid blepharoplasty has become a popular aesthetic facial surgery, surgeons should be aware that the age-related changes of the eyelid are not confined to skin laxity and orbital fat prolapse.
Objectives
This study was designed to assess the prevalence of undiagnosed ptosis among blepharoplasty candidates as one of the causes of unsatisfactory surgical results.
Methods
Since December 2018, blepharoplasty candidates were meticulously assessed for their upper eyelid and eyebrow position. Patients who were aware of their ptosis were excluded and the other patients were classified as mild, moderate, or severe ptotic based on the margin reflex distance 1 (MRD1). The eyebrow height was also assessed in the midpupillary line to assess the relationship between the severity of ptosis and eyebrow asymmetry.
Results
The authors found that 13.7% of the 2530 blepharoplasty candidates in this study have undiagnosed ptosis. Most of these patients have mild ptosis (85.5%), and they were significantly older than non-ptotic patients. The prevalence of ptosis was significantly higher in patients with eyebrow asymmetry (75.3% vs 3.7%); however, the ptosis severity was not associated with the severity of eyebrow asymmetry.
Conclusions
Ptosis should be cautiously looked for and addressed for treatment in candidates for upper blepharoplasty. In most of the patients with masked ptosis, the severity of eyelid drooping is mild and could remain undiagnosed until after the surgery and cause unsatisfactory aesthetic results. Presence of eyebrow asymmetry could be a key feature to unmask an undiagnosed ptosis.