Purpose

To evaluate the difference between the preoperative design height of the upper blepharoplasty incision and the final postoperative scar position, as well as to analyze the influence of pretarsal laxity on this variation.

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Methods

A prospective observational study was conducted including 227 patients (454 eyes) who underwent upper blepharoplasty without associated techniques by a single surgeon between January 2022 and December 2024.

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Results

A total of 227 patients who underwent upper blepharoplasty were included, with a mean age of 61.51 ± 10.21 years at the time of surgery, of whom 88.5% were female. The mean distance from the lower edge of the blepharoplasty incision to the eyelid margin was 6.5 mm ± 0.95 at rest and 8.85 mm ± 0.99 with the skin stretched. The difference between the means of both measurements was 2.35 mm (paired Student’s t-test, p < 0.001). It is proposed that pretarsal skin laxity is responsible for this difference, which was 1 mm or greater in all cases (range: 1–4 mm). A positive correlation was found between a greater degree of pretarsal skin laxity and superior displacement of the blepharoplasty scar at 3 months of follow-up (correlation coefficient: 0.198, p < 0.001). Multiple linear regression analysis was also performed, confirming that scar elevation was greater in patients with higher laxity (β = 0.22; p < 0.001) and in male patients (β = −0.29; p < 0.001).

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Conclusion

High pretarsal skin laxity may contribute, among other factors, to superior displacement of the upper blepharoplasty scar, thereby affecting the aesthetic outcome of the procedure.

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Additional Authors

First name	Last name	Base Hospital / Institution
Hae-Ryung	Won Kim	Clínica Rementería
Constanza	Barrancos Julián	Hospital Ramón y Cajal
Marco	Sales Sanz	Hospital Ramón y Cajal

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