A graded approach in East Asian personalized lower blepharoplasty: A retrospective study spanning 12 years

PURPOSE: The aim of the study was to describe a graded approach for assessment and specific treatment, which can achieve satisfactory postoperative result in East Asian personalized lower blepharoplasty. METHODS: We reviewed 913 patients who underwent lower blepharoplasty from 2008 to 2020. We preoperatively classified patients with different characteristics to provide personalized treatment. RESULTS: There were 163 patients with fat herniation but no lower eyelid skin laxity, 259 patients with lower eyelid skin laxity accompanied by mild fat herniation, 313 patients with sagging lower eyelid skin accompanied by mild fat herniation and tear troughs, and a total of 178 patients with sagging skin accompanied by moderate to severe fat herniation and tear troughs. The overall success rate was 97.81%. Postoperative complications included the following: conjunctival chemosis, dry eye symptoms, and more. CONCLUSION: For East Asian patients with different characteristics, we achieved satisfactory postoperative results through accurate preoperative clinical grading and personalized surgical plans. The success of the operation not only depends on correct manipulation during the procedure but also on the surgeon’s accurate assessment and full grasp of the anatomy of each patient preoperatively.