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Is Orbicularis Oculi Muscle Resection Necessary in Upper Blepharoplasty? A Systematic Review

  • Review
  • Oculoplastic
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Our objective is to evaluate the evidence on the aesthetic effect and complications of skin-OOM strip resection compared to skin only upper blepharoplasty.

Methods

A systematic search of EMBASE, PubMed, Cochrane and Google Scholar databases was performed using our search strategy through to 31 December 2019. Only comparative studies of the two upper blepharoplasty techniques were included. Three reviewers performed study selection process, data extraction, and quality assessment.

Results

A total of six articles were eligible for final inclusion. The included studies consist of two controlled retrospective cohorts and four small randomized controlled studies (RCT). Three of which, were double blinded. Those RCTs were assigned level 2 evidence due to small size and methodological limitations. The sample size of included was studies 407 in the two retrospective studies and 57 in the four RCTs. The outcomes showed that resection of OOM along with skin in upper blepharoplasty showed no difference in long-term aesthetic outcome when skin only procedure is performed. Muscle strip resection was associated with initially higher ophthalmological morbidity (edema, bruising, pain, dry eye, sluggish eye closure and lagopthalmos). Those resolved a few weeks later with conservative treatment.

Conclusion

The resection of OOM along with skin in upper blepharoplasty showed no difference in long-term aesthetic outcome and was associated with initially higher ophthalmological morbidity compared to skin only procedure. While we are not suggesting that OOM resection is never required, the evidence strongly support its preservation during standard upper blepharoplasty.

Level of Evidence III

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266.

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Authors and Affiliations

  1. Division of Plastic Surgery, Faculty of Medicine, Dalhousie University, Room 4447, Halifax Infirmary, 4th Floor, Plastic Surgery, 1796 Summer Street, Halifax, NS, B3H 3A7, Canada

    Osama A. Samargandi & Jason Williams

  2. Division of Plastic Surgery, Department of Surgery, King Abdulaziz University, Jeddah, Saudi Arabia

    Osama A. Samargandi

  3. Faculty of Medicine, Dalhousie University, Halifax, NS, Canada

    Neetin Prabhu & Colton Boudreau

Authors
  1. Osama A. Samargandi
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  2. Neetin Prabhu
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  3. Colton Boudreau
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  4. Jason Williams
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Correspondence to Osama A. Samargandi.

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Samargandi, O.A., Prabhu, N., Boudreau, C. et al. Is Orbicularis Oculi Muscle Resection Necessary in Upper Blepharoplasty? A Systematic Review. Aesth Plast Surg 45, 2190–2198 (2021). https://doi.org/10.1007/s00266-021-02131-8

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  • DOI: https://doi.org/10.1007/s00266-021-02131-8

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