Usefulness of mirror image processing software for creating images of expected appearance after blepharoptosis surgery

PURPOSE: This study aims to evaluate the usefulness of creating images of expected appearance after blepharoptosis surgery using mirror image processing software. METHODS: This prospective, observational study included 60 sides from 30 patients with bilateral aponeurotic blepharoptosis who underwent levator resection or aponeurotic repair on both sides. Before surgery, facial photographs were taken after the eyelid on one side was lifted with a curved hook. The mirror images were created from these photographs and were merged with the original photographs for making the whole facial images, which were shown to each patient at the preoperative counseling. At 1 month postoperatively, we asked patients about the usefulness of the mirror images to predict the postoperative appearance at the preoperative counseling and the similarity between the expected and the resultant postoperative appearance using questionnaires. Margin reflex distance-1, eyebrow height, and pretarsal skin height measured on predictive images were compared with those measured at 1 month postoperatively. RESULTS: Twenty-nine patients (96.7%) favorably responded to the usefulness of the mirror images to predict the postoperative appearance, and twenty-five patients (83.3%) accepted the similarity between the expected appearance and the actual postoperative appearance. The predictive images showed significantly lower margin reflex distance-1, higher eyebrow height, and higher pretarsal skin height than the postoperative results (P < 0.001). CONCLUSION: The creation of expected postoperative images was a useful simulation procedure before blepharoptosis surgery for patients to predict the probable postoperative appearance. SUPPLEMENTARY MATERIAL: The online version contains supplementary material available at (10.1007/s10792-020-01671-3).