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The Individualized Facelift Technique in Improving Facial Asymmetry for Asian Patients

Zhang, Pan, M.D.; Sui, Bing, M.M.; Ren, Lihong, M.D.; Yang, Jenny, M.D.; Ma, Xu, M.D.; Li, Qingchun, M.D.; Yang, Daping, M.D.

Ophthalmic Plastic & Reconstructive Surgery: November/December 2018 - Volume 34 - Issue 6 - p 516–521
doi: 10.1097/IOP.0000000000001072
Original Investigations

Purpose: Among multiple influential factors affecting facial symmetry, the role of soft tissue is often overlooked. Skin and skeletal differences between Asian and Caucasian people also require the adaptation of current techniques for Asian patients. This article aimed to explore the ability of individual facelift techniques to improve facial symmetry and reset youthful eye in Asian people, while a new method, called the grid method, was tried to evaluate the improvement in facial symmetry.

Methods: The authors conducted a review of 58 consecutive facelifts, which were all performed by a single surgeon between April 2009 and December 2016 following institutional review board approval. Among them, 21 patients underwent lower eyelid blepharoplasty. The original frontal photograph of each patient was evaluated by the grid method. Five independent plastic surgeons reviewed the facial asymmetry of the images before and after the operations using a visual analog scale to analyze the facial asymmetry of the patients.

Results: In the preoperative group evaluated by the grid, the mean facial asymmetry score was 4.11, while in the postoperative group, the mean score was 1.07, which was significantly lower than the mean score before the operation (p < 0.001). The change in mean scores illustrated that the technique was effective in improving facial symmetry in Asian people. A total of 8 patients experienced hematomas and recovered well without obvious sequelae.

Conclusions: The individual facelift technique was effective for improving facial symmetry and reshaping youthful eye in Asian people.

The method of individual facelift techniques could improve facial symmetry in Asian people by individually suspending superficial musculoaponeurotic system. Meanwhile, the youthful eye could be reset by simultaneously suspending the outer edge of the orbicularis oculi muscle.

Division of Plastic Surgery, The Second Hospital of Harbin Medical University, Harbin, Heilongjiang, People’s Republic of China

Accepted for publication December 16, 2017.

The authors have no financial or conflicts of interest to disclose.

Address correspondence and reprint requests to Daping Yang, M.D., Division of Plastic Surgery, The Second Hospital of Harbin Medical University, Harbin, People’s Republic of China. E-mail:

© 2018 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.