Abstract ID: 26-600
Beyond Static Measurements: A Dynamic Approach to Predicting Eyelid Crease Position
Author: Marzena Wysocka-Kosmulska Base Hospital / Institution: ¹ Clinical Department of Ophthalmology, St. Barbara Trauma Center, Sosnowiec, Poland ² Medical University of Silesia in Katowice, Poland
Presentation Type: ePoster Presentation
Purpose
To investigate the limitations of static preoperative planning in upper blepharoplasty and propose a dynamic method for predicting postoperative eyelid crease position.
Methods
Patients undergoing upper blepharoplasty were evaluated with standardized preoperative photography including downgaze views. Patients undergoing simultaneous ptosis or brow surgery were excluded. Cases demonstrating discrepancy between the planned incision and the final postoperative crease were analyzed. Variability related to brow position, landmark selection, pretarsal skin laxity, and skin tension during assessment was evaluated. A dynamic preoperative maneuver was developed to simulate postoperative crease formation.
Results
Patients with pretarsal skin laxity demonstrated a consistent discrepancy between the planned incision and the final functional crease. In selected cases, the postoperative crease formed inferior to the surgical scar, corresponding to a reproducible zone of dynamic pretarsal skin collapse. Final crease position appeared to correlate more closely with tissue biomechanics and levator-induced skin movement than with static measurements alone.
Conclusion
Upper eyelid crease formation appears to be governed by dynamic tissue behavior rather than static anatomical measurements alone. Pretarsal skin laxity may contribute to postoperative mismatch between scar position and functional crease location. Dynamic assessment of pretarsal skin behavior may improve surgical planning in upper blepharoplasty.