TPS After Upper Blepharoplasty

Study Overview
=================
Brief Summary
-----------------
Increased tarsal platform show (TPS) and decreased brow fat span (BFS) are associated with favorable results in women undergoing cosmetic blepharoplasty. The authors evaluate the efficacy of a technique (brassiere sutures) to increase TPS and decrease the BFS.

Detailed Description
-----------------
This is a prospective, randomized, comparative, case series study of 100 eyelids (50 consecutive women patients) treated with cosmetic upper blepharoplasty by a single surgeon. Patients were randomized to receive traditional upper blepharoplasty with a single running suture skin closure versus orbicularis oculi muscle fixation to periosteum (brassiere sutures) prior to skin closure. Patient age, follow-up length, complications and treatment were analyzed. The mean of TPS, BFS and TPS/BFS ratio was measured before and after surgery at 3 anatomic landmarks. 56 eyelids (28 patients) were treated with traditional single suture blepharoplasty and 44 eyelids (22 patients) had brassiere sutures. After surgery, the mean change in TPS was 2.10 mm with brassiere sutures compared to 2.04 mm without (p <.001). The mean change in BFS was 3.33 mm with brassiere sutures compared to 3.19 mm without (p <.001), The mean change in TPS:BFS ratio at all 3 anatomic landmarks was statistically significant in both groups but the change was statistically greater with the use of brassiere sutures (p <.001). Brassiere sutures during upper blepharoplasty were associated with a postoperative increase in TPS decrease in BFS, and increase in TPS/BFS.

Official Title
-----------------
Tarsal Platform Show After Upper Eyelid Blepharoplasty With or Without Brassiere Sutures

Conditions
-----------------
Efficacy of a Technique (Brassiere Sutures)

Intervention / Treatment
-----------------
* Procedure: Traditional upper blepharoplasty
* Procedure: Brassiere suture with blepharoplasty


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Female underwent cosmetic upper blepharoplasty and brassiere suture with blepharoplasty Exclusion Criteria: History of thyroid eye disease, levator dehiscence ptosis, blepharospasm, facial nerve paresis, a history of previous upper facial surgery or trauma, and postoperative follow-up for less than 6 months.

Ages Eligible for Study
-----------------
Minimum Age: 35 Years
Maximum Age: 81 Years

Sexes Eligible for Study
-----------------
Female

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Traditional upper blepharoplasty<br>Patients with an odd total number of letters in their first name received traditional upper blepharoplasty. | Procedure: Brassiere suture with blepharoplasty<br>* Prior to skin closure as above, three 6-0 polyglactin sutures are passed along the lateral fourth of the orbital rim. The sutures attach the inferior orbicularis oculi edge to the arcus marginalis of lateral ROOF. Sutures are placed until there is a visible plumping of the sub-brow tissues.<br>|
| Brassiere suture with blepharoplasty<br>The rest of the patients received orbicularis oculi muscle fixation to periosteum (brassiere sutures) | Procedure: Traditional upper blepharoplasty<br>* The skin incisions were marked using a skin marking pen. Preseptal orbicularis skin and muscle were removed using a size-15 scalpel blade and scissors. Hemostasis was achieved with conservative electrocuatery. The skin was closed with a running 6-0 nylon suture.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Eyelid measurements of traditional blepharoplasty and brassiere suture, before and after surgery |  | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Asymmetry of TPS and BFS in traditional blepharoplasty and brassiere suture |  | 6 months | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Upper blepharoplasty, brassiere sutures, tarsal platform show, eyeshadow space, brow fat span