Preservation of Medial and Central Preseptal Orbicularis Oculi in Aging Blepharoplasty

Background: Conventional upper blepharoplasty typically involves removal of the skin, orbicularis oculi muscle and, frequently, portions of the periorbital fat. In the elderly, the orbicularis oculi muscle is always thin. The hollowness and high adhesion fold were observed in some patients of complete excision of the underlying orbicularis oculi muscle. Aim and Objectives: We aim to preserve of medial and central preseptal orbicularis oculi to prevent these two common unfavorable results. Materials and Methods: Between July of 2013 and June of 2014, 35 patients, ranged from 53 to 80 years old, had aging upper eyelids. Upper blepharoplasty was performed with conservative excision of preseptal orbicularis oculi. Results: No significant complications, such as high adhesion of the upper eyelid crease or lagophthalmus, occurred. There were 4 patients of minor postoperative ecchymosis and 2 patients of mild asymmetry, which improved after several months. All of the patients were satisfied with results. Conclusion: In aging upper blepharoplasty, preservation of partial preseptal orbicularis oculi could prevent high adhesion fold and superior sulcus hollowness of orbital cavity with satisfactory results.