Combined Subbrow Excision with Upper Blepharoplasty Using a Tadpole Shaped Excision for Blepharochalasis

In efforts to solve blepharochalasis, the problem of droopy eyelids that happens as people age, various surgical methods have been developed and disclosed over the years. Among them, classical upper blepharoplasty, the most fundamental procedure, involves excision of redundant eyelid skin in the upper palpebrae [1-4]. This operation utilizes an approach through the lid crease line of the upper eyelids, and hence excess skin can be excised relatively evenly throughout the entire eyelid. Also aponeurotic ptosis can be corrected by aponeurotic surgery through this incision opening [5,6]. Furthermore, new double eyelids may be created, or the width of a preexisting double eyelid may be adjusted, by either the surgeon in charge or the demand of a patient. Nevertheless, postoperative appearance may look unnatural and severe lateral hooding may be restricted in making correction. Moreover, owing to differences in thickness between the pretarsal skin and subbrow skin, it may lead to an appearance of the eyelids being seen as overhanging and protuberant [7,8]. Subbrow excision (SE) blepharoplasty has been performed to improve on the disadvantage of classical upper blepharoplasty. Parkes et al.[9] first introduced this procedure in the mid Hwa Young Oh, In Ho Lee, Soo Chung Hong, Syeo Young Wee, Chang Yong Choi