1. Introduction
headaches, dermatochalasis, postoperative headache complaints, muscle fatigue, visual field obstruction
TENSION-TYPE HEADACHES, CONTRACTION, DERMATOCHALASIS
The aim of this study was to assess changes in headaches, eyebrow height, and electromyographic (EMG) outcomes of the frontalis and orbicularis oculi muscles, after an upper blepharoplasty with or without resecting a strip of orbicularis oculi muscle. In a randomized controlled trial, 54 patients received an upper blepharoplasty involving either only removing skin (group A) or removing skin with an additional strip of orbicularis muscle (group B). Preoperative, and 6 and 12 months postoperative headache complaints were assessed using the HIT-6 scores and eyebrow heights were measured on standardised photographs. Surface EMG measurements, i.e., electrical activity and muscle fatigue, were assessed for the frontalis and orbicularis oculi muscles preoperatively and 2, 6, and 12 months postoperatively. Significantly fewer headaches were reported following a blepharoplasty. The eyebrow height had decreased, but did not differ between groups. Regarding the surface EMG measurements, only group A’s frontalis muscle electrical activity had decreased significantly during maximal contraction 12 months after surgery (80 vs. 39 mV, Patients with dermatochalasis of the upper eyelids often elevate their eyebrows by recruiting the frontalis muscles in order to compensate for the visual field obstruction caused by sagging of the upper eyelid skin. This elevation may be associated with an increase in frontalis muscle electrical activity [An upper blepharoplasty can be a solution for dermatochalasis of the eyelids, providing general improvements in functional complaints [The literature is inconsistent regarding what happens to the eyebrow height after an upper blepharoplasty [The question arises whether a cosmetic upper blepharoplasty has an effect on the eyebrow position, frontalis muscle activation/fatigue, and possibly headaches experienced by patients, and whether there is a relationship between these variables. Thus, the aim of this RCT was to assess the electrical activity of the upper facial muscles, eyebrow position, and tension-type headaches after two surgical upper blepharoplasty techniques.