Assessment Of Clinical Outcome Of Blepharoplasty On Patients With Abnormal Upper Eyelid Structure Using FACE-Q

With the great development of material life,people begin to pay more attention to the appearance.Blepharoplasty is one of the most widely performed plastic surgeries in Asia,and it has a very good effect from the perspective of doctors and patients.However,for patients with tumors,trauma,or congenital malformations,the goal of surgeons and patients is to pursue functional repair and minimize the occurrence of complications.Therefore,patients’ conditions are complicated and various,which brings difficulties to the surgery,so it is generally not considered to give patients a second stage cosmetic blepharoplasty.Yet these patients usually have strong cosmetic needs.Therefore,we propose the following questions:What is the effect of cosmetic blepharoplasty on such patients?How does appearance improvement improve the psychological and social function of patients?Objective:To explore the clinical effect of cosmetic blepharoplasty for patients with abnormal upper eyelid structure and to evaluate the improvement of patients’psychological and social function levels through subjective investigation.Methods:From September 2019 to December 2021,patients with eyelid deformities requiring cosmetic blepharoplasty were selected in our department.Among them,12 patients met the inclusion criteria and their clinical data was fully collected.In the same period,16 patients with cosmetic blepharoplasty with normal eye anatomy were randomly selected and their clinical data were fully collected.The age of the above patients ranges 18-50 years old.For patients with abnormal upper eyelid structure,cosmetic blepharoplasty is performed at the same time or in the second stage according to eyelid characteristics.For patients with normal anatomical structure,routine cosmetic blepharoplasty was performed.General data of patients were collected as follows:age,BMI,marital status,education level and operation time.All patients were followed up for 6-36 months,with an average of 9.87 months.Photographs of patients’ postoperative follow-up were taken,and another doctor who had no relation to the operation evaluated the postoperative effect of patients objectively.The FACE-Q questionnaire was collected by telephone or during face-to-face follow-up to evaluate the patients’postoperative self-appearance evaluation and psychosocial function.The clinical outcome of cosmetic blepharoplasty on patients with abnormal upper eyelids were statistically analyzed using the data collected.p<0.05 indicates statistical significance.Results:（1）Patients with structural abnormalities of the upper eyelid were followed up for more than 6 months after surgery,and the results were based on the last follow-up visit,with a total of 8 patients（66.67%）in the "very satisfied"group and 3 patients（66.67%）in the "basic satisfaction" group.3 people in the"basic satisfaction" group,accounting for 25.00%,and 1 person in the"dissatisfaction" group,accounting for 8.33%.（2）In the subjective results evaluated by FACE-Q,patients with structural abnormalities of the upper eyelid were assessed in terms of appearance,"satisfaction with upper eyelid appearance","satisfaction with eyelash appearance",and "facial aging in appearance".The preoperative and postoperative scores of "satisfaction with upper eyelid appearance," "satisfaction with eyelash appearance," and "facial aging evaluation" were statistically different（p<0.05）,and "satisfaction with eye appearance" was statistically different（p<0.001）.In terms of psychosocial function,there were statistically significant differences in "social function","psychological function" and "stress in appearance"（p<0.001）.（3）There was no statistical difference in "preoperative expectation"and "self-perceived symptoms" between the structurally abnormal group and the structurally normal group,and there was a statistically significant difference in"early life impact" in terms of postoperative psychological function.There was no statistical difference in "postoperative outcome satisfaction" and "surgical decision satisfaction"（p>0.05）.Comparing the degree of improvement in appearance evaluation between the structurally abnormal group and the structurally normal group,there was a statistically significant difference in "eye appearance".In psychosocial function aspect,there were statistically significant differences in "social function","psychological function" and "appearance pressure"（p<0.001）.Conclusion:（1）The possibility of cosmetic blepharoplasty for patients with upper lid defects or poor appearance due to tumors,trauma,or congenital malformations should not be abandoned and it is important to improve the appearance and function of the patient’s eyelids.（2）After cosmetic blepharoplasty in patients with structural abnormalities of the upper eyelid,cosmetic evaluation of ""satisfaction with upper eyelid appearance,""satisfaction with eye appearance,""satisfaction with eyelash appearance,"was improved.In terms of psychosocial function,there was a significant improvement in the ratings of "social function," "psychological function," and "cosmetic stress.（3）When comparing patients with abnormal upper eyelid structure with patients with normal upper eyelid structure,patients with abnormal upper eyelid structure showed more improvement in the evaluation of aging indexes.In terms of all psychosocial functioning（"social functioning," "psychological functioning," "appearance stress"）,patients with structural upper eyelid abnormalities improved significantly more than patients with normal upper eyelid structure.