Practice Patterns in Blepharoplasty: A 15-Year Review of Continuous Certification Tracer Data from the American Board of Plastic Surgery.

Background: The American Board of Plastic Surgery (ABPS) continuous certification tracer data on blepharoplasty offer valuable information on national trends in clinical practice. The current study was performed to analyze evolving trends in blepharoplasty and compare practice patterns with evidence-based medicine (EBM) publications within the same timeframe.

Methods: Tracer data for blepharoplasty procedures performed by ABPS-certified surgeons between 2005 and 2020 were analyzed. Data between 2 timeframes-2005 through 2014 (early cohort [EC]) and 2015 through 2020 (recent cohort [RC])-were compared to identify evolving trends in blepharoplasty over time. Results were then compared with EBM-based publications.

Results: Of 3050 blepharoplasties (1510 EC; 1540 RC), 82% were performed in female patients, and the average age was 56 years. Blepharoplasty was most frequently performed in an ambulatory setting (56%) compared with in hospital (25%); significantly more cases are being performed in the office ( P < 0.001) in the RC compared with the EC. Mean surgical duration has decreased by 13 minutes ( P < 0.001), and fewer surgical procedures are being performed with concomitant procedures ( P < 0.001). Fewer surgeons use antibiotics ( P < 0.001), and fewer surgeons use deep vein thrombosis prophylaxis in the form of sequential compression devices after anesthesia ( P < 0.001). More skin resections were performed for upper blepharoplasties ( P = 0.016), whereas fewer cases of lower lid blepharoplasty involved either skin-muscle flaps ( P = 0.038) or transcutaneous fat removal ( P = 0.004). Most surgeons did not perform canthal tightening during blepharoplasty (82%).

Conclusions: This review of more than 15 years of ABPS blepharoplasty tracer data allows surgeons to compare their practice with national trends and EBM. The tracer data illustrate a shift in technique toward shorter and simpler procedures in the office setting.