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Preoperative asymmetry of upper eyelid thickness in young Chinese women undergoing double eyelid blepharoplasty
Journal of Plastic, Reconstructive & Aesthetic Surgery (2012) 65, 1181
INVITED COMMENTARY
Preoperative asymmetry of upper eyelid thickness in young Chinese women undergoing double eyelid blepharoplasty Francisco G. Bravo* Department of Plastic Surgery, Doce de Octubre University Hospital, Av. De Andalucia s/n, 28041 Madrid, Spain Received 22 March 2012; accepted 8 April 2012 The authors present a large series of 1217 patients undergoing double eyelid blepharoplasty in young asian women operated by a single surgeon.1 In order to evaluate the presence of eyelid asymmetries preoperatively the authors develop an original method to analyze the differences in thickness of both upper eyelids through MRI imaging. These differences are later confirmed through intraoperative weighing of the resected specimens. Although, as the authors acknowledge in their text, the intraoperative weighing is highly susceptible to researcher bias, their preoperative results through MRI imaging showing a high incidence of upper eyelid asymmetries are an important finding for plastic surgeons performing double eyelid blepharoplasty procedures. The importance of performing an objective preoperative analysis of asymmetries was first stressed for breast augmentation surgery in 2003.2 A later study3 demonstrated the high incidence of lower eyelid asymmetries prior to surgery with nearly two thirds of the population studied having a right lower eyelid in an inferior position to the left. The present study shows a significant difference in thickness in the upper eyelids of the patients treated, being
the right upper eyelid consistently thicker than the left. The importance of these studies1e3 which objectively detect and evaluate asymmetries is twofold: (1) it makes the patient aware preoperatively of their asymmetry, making him more likely to accept the postoperative result and (2) it allows the surgeon to modify the procedure on each side according to the preoperative assessment, in order to achieve better results.
References 1. Zhou Q, Zhang L, Wang P J, Yang S, Bi Y L. Preoperative asymmetry of upper eyelid thickness in young Chinese women undergoing double eyelid blepharoplasty. J Aesth Plast Recon Surg. 2. Rohrich RJ, Hartley W, Brown S. Incidence of breast and chest wall asymmetry in breast augmentation: a retrospective analysis of 100 patients. Plast Reconstr Surg 2003 Apr 1;111(4): 1513e9. 3. Bravo FG, Kufeke M. Incidence of lower eyelid asymmetry: an anthropometric analysis of 204 patients. Presented at the American Society for Aesthetic Plastic Surgery, The Aesthetic Meeting 2010, April 27, 2010. Washington DC.
DOI of original article: 10.1016/j.bjps.2012.03.047. * Tel.: þ34 91 7792239; fax: þ34 91 4231591. E-mail address: [email protected]. 1748-6815/$ - see front matter ª 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjps.2012.04.010
INVITED COMMENTARY
Preoperative asymmetry of upper eyelid thickness in young Chinese women undergoing double eyelid blepharoplasty Francisco G. Bravo* Department of Plastic Surgery, Doce de Octubre University Hospital, Av. De Andalucia s/n, 28041 Madrid, Spain Received 22 March 2012; accepted 8 April 2012 The authors present a large series of 1217 patients undergoing double eyelid blepharoplasty in young asian women operated by a single surgeon.1 In order to evaluate the presence of eyelid asymmetries preoperatively the authors develop an original method to analyze the differences in thickness of both upper eyelids through MRI imaging. These differences are later confirmed through intraoperative weighing of the resected specimens. Although, as the authors acknowledge in their text, the intraoperative weighing is highly susceptible to researcher bias, their preoperative results through MRI imaging showing a high incidence of upper eyelid asymmetries are an important finding for plastic surgeons performing double eyelid blepharoplasty procedures. The importance of performing an objective preoperative analysis of asymmetries was first stressed for breast augmentation surgery in 2003.2 A later study3 demonstrated the high incidence of lower eyelid asymmetries prior to surgery with nearly two thirds of the population studied having a right lower eyelid in an inferior position to the left. The present study shows a significant difference in thickness in the upper eyelids of the patients treated, being
the right upper eyelid consistently thicker than the left. The importance of these studies1e3 which objectively detect and evaluate asymmetries is twofold: (1) it makes the patient aware preoperatively of their asymmetry, making him more likely to accept the postoperative result and (2) it allows the surgeon to modify the procedure on each side according to the preoperative assessment, in order to achieve better results.
References 1. Zhou Q, Zhang L, Wang P J, Yang S, Bi Y L. Preoperative asymmetry of upper eyelid thickness in young Chinese women undergoing double eyelid blepharoplasty. J Aesth Plast Recon Surg. 2. Rohrich RJ, Hartley W, Brown S. Incidence of breast and chest wall asymmetry in breast augmentation: a retrospective analysis of 100 patients. Plast Reconstr Surg 2003 Apr 1;111(4): 1513e9. 3. Bravo FG, Kufeke M. Incidence of lower eyelid asymmetry: an anthropometric analysis of 204 patients. Presented at the American Society for Aesthetic Plastic Surgery, The Aesthetic Meeting 2010, April 27, 2010. Washington DC.
DOI of original article: 10.1016/j.bjps.2012.03.047. * Tel.: þ34 91 7792239; fax: þ34 91 4231591. E-mail address: [email protected]. 1748-6815/$ - see front matter ª 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjps.2012.04.010