Surgical Outcomes of Aesthetic Upper Blepharoplasty With Anterior Plication Ptosis Repair Performed Under General Anesthesia in Facial Plastic Surgery Private Practice

Anterior plication ptosis repair is a well-recognized technique but there is a paucity of literature using this technique in a Facial Plastic Surgery private practice where the majority of ptosis patients are having their repair in conjunction with other major cosmetic facial surgery under general anesthesia. The objective is to evaluate revision rates of combined aesthetic upper blepharoplasty with anterior plication ptosis repair in this practice setting. This study is a retrospective review of patients between 2010 and 2015 in a private practice Facial Plastic Surgery office who underwent primary upper blepharoplasty with and without anterior plication ptosis repair by the senior author (S.W.P). Patients were identified by Current Procedural Terminology (CPT) code. Average follow-up was 15 months with a range of 3 months to 63 months. Main outcome measure was need for skin pinch revision and/or ptosis revision. Three hundred twenty-six patients were identified. Patients were excluded who had previous upper blepharoplasty (n = 48) and less than 3 months of follow-up (n = 53). Patients were categorized into 2 groups: upper blepharoplasty with anterior plication ptosis repair (33 eyelids, 23 patients) and upper blepharoplasty without ptosis repair (402 eyelids, 202 patients). Of patients who underwent upper blepharoplasty with anterior plication ptosis repair, 15% of eyelids (5/33 eyelids) required revision ptosis repair for abnormal eyelid contour. Seventy percent of patients who underwent this technique were under general anesthesia for multiple procedures. Overall, there was a 7% dermatochalasis revision rate (31/435 eyelids). There was no significant difference in dermatochalasis revision rates of upper blepharoplasty with or without anterior plication ptosis repair (P = .07). In our Facial Plastic Surgery private practice, upper blepharoplasty with anterior plication ptosis repair may be safely and effectively performed in conjunction with major cosmetic facial surgery under general anesthesia to address aging dermatochalasis and ptosis.