Objectives: There are two types of eyelid aging: muscle aging and skin aging. The facial appearance of Asian ptosis, in which the eyelid is thicker and heavier, is characterized by raised eyebrows and a longer distance from the upper eyelid margin to the eyebrow. In the case of dermal laxity, the elevation of the eyebrows is mild, but the drooping skin covers the eyelashes. I would like to share a useful algorithm which I deviced for the selection of techniques for aging upper eyelid in Asians.
Introduction: Knowing the primary site of eyelid aging - ptosis or dermal laxity?
: Many patients presenting with complaints of "heavy eyelids" may have elements of both ptosis and dermal laxity. Prioritization of surgical procedures for ptosis or dermal laxity should begin with a correct assessment of whether the primary site of aging is in the anterior or posterior lobe of the eyelid.
Materials / method: I will introduce and follow the algorithm I devised for technique selection.:One indicator is whether the eyelid margin is exposed to the base of the eyelid in the frontal view (eyelid margin visible) or not (eyelid margin not visible due to excess skin covering the eyelid). If the eyelid margin is exposed and the MRD-1 (MRD) is 2 mm or less, surgery for blepharoplasty is preferred. If the eyelid is not exposed (not visible due to excess skin covering) and the MRD is 3 mm or more, surgery for skin laxity is preferred.
Results: In reality, there are many intermediate cases in which the eyelid margin is exposed but the width of the eyelid is narrower than before, or the eyelid is partially covered. However, my algorithm will make the choice of surgical technique clearer.
Conclusion: I will introduce the importance of surgical technique selection for Asian's aging eyelid in order to achieve an aesthetically satisfactory result by showing actual cases.
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