Current Upper Blepharoplasty and Ptosis Management Practice Patterns Among The Aesthetic Society Members
Patients presenting for upper blepharoplasty can exhibit different aging patterns and we have anecdotally observed wide variability in upper blepharoplasty approaches among surgeons. However, upper blepharoplasty practice patterns have not been systematically analyzed among members of The Aesthetic Society.
The aim of this study was to report upper blepharoplasty practice patterns, the recognition of different patient presenting features, and to assess the incidence and management of ptosis as reported by members of The Aesthetic Society.
A 29-item electronic questionnaire was distributed to 1729 Aesthetic Society members with available email addresses.
In total, 214 Aesthetic Society members submitted the questionnaire, for a response rate of 12.4%. There was a significantly increased rate of volume preservation among surgeons with greater experience (≥10 years in practice) and a high-volume (≥100 cases in past 12 months) of upper blepharoplasty cases. Furthermore, high-volume upper blepharoplasty surgeons were significantly more likely to perform concomitant upper lid fat grafting (P = 0.03), browlift (P = 0.02), and ptosis repair (P = 0.01). Ninety-five percent of respondents reported a mild/moderate ptosis (MRD1 2 to <4mm) incidence of <25%. Among surgeons who perform ptosis repair, 97.4% utilize levator advancement or plication as their most commonly used technique.
High-volume upper blepharoplasty surgeons are more likely to preserve upper lid volume and perform concomitant browlift and ptosis repair. Our data suggest that different upper eyelid aging patterns and mild/moderate ptosis are underrecognized.
We read “Current Upper Blepharoplasty and Ptosis Management Practice Patterns Among The Aesthetic Society Members” 1 with interest and commend Drs Vaca et al on their important contribution to the literature. This represents the first and largest collation of the standards of our peers for ptosis management amongst board-certified plastic surgeons. Their article raises many important considerations in approaching the patient with upper eyelid aging, notably the importance of identifying and appropriately managing involutional ptosis. In our opinion, an understanding of the complex mechanisms that underlie the clinical appearance of ptosis is vital to achieve the desired aesthetic result…..