What it means for a patient
- Some people with single eyelids lift their brows and forehead each time they open their eyes.
- Double-eyelid surgery alone reduced this habit in some patients. Adding levator release corrected it in more patients.
- Satisfaction with the new eyelid crease was similar with either method.
- No patient in the study was left unable to close the eye fully.
- Limits: one randomized trial of 90 patients with 6 to 12 months of follow-up.
Why this paper matters
It reported levator palpebrae superioris release as an addition to double-eyelid surgery for habitual brow and forehead raising, tested against double-eyelid surgery alone.
Overview
Some healthy people with single eyelids, which have no upper lid crease, raise their eyebrows and forehead every time they open their eyes. The authors state this has a negative effect on appearance and psychology. They randomized patients to conventional open double-eyelid surgery or the same surgery with release of the levator palpebrae superioris muscle.
Findings
- 90 patients with single eyelids, randomized between March 2019 and March 2020.
- Control group: 45 patients, conventional open double-eyelid surgery.
- Observation group: 45 patients, the same surgery plus levator palpebrae superioris release.
- Both techniques immediately reduced eyebrow and forehead movement.
- The observation group showed significantly more restricted eyebrow movement during eye opening.
- All incisions healed primarily, with no lagophthalmos.
- Follow-up: 6 to 12 months (mean 9.38 ± 1.56 months).
- Satisfaction with the double eyelid: 93.02% observation vs 88.10% control (P > 0.05).
- Correction of involuntary brow and forehead raising: 81.40% observation vs 47.62% control (P < 0.05).
- The authors conclude that adding levator release improves functional and cosmetic outcomes for this habit.
Terms
- Single eyelid: an upper eyelid with no visible crease.
- Double-eyelid blepharoplasty: surgery that creates an upper eyelid crease.
- Levator palpebrae superioris: the main muscle that lifts the upper eyelid.
- Levator release: loosening part of the levator muscle's attachments during eyelid surgery.
- Lagophthalmos: inability to close the eyelids fully.
- Primary healing: a wound that heals cleanly with its edges together, without opening or infection.
- Randomized: patients assigned to groups by chance.