Evaluation of Orbicularis Oculi Muscle Stripping on the Cosmetic Outcome of Upper Lid Blepharoplasty: A Randomized, Controlled Study


  • The authors have indicated no significant interest with commercial supporters.

Address correspondence and reprint requests to: David J. Kouba, MD, PhD, Toledo Clinic Dermasurgery and Laser Center, 4235 Secor Road, Toledo, OH 43623, or e-mail: dkouba@toledoclinic.com



Many variations in the surgical treatment of upper eyelid blepharoplasty have been described, including orbicularis oculi muscle stripping. There is no evidence in the literature to support the efficacy of this technique in improving the aesthetic results of the procedure.


To conduct a single-blind, randomized, controlled, split-face pilot study to evaluate the effects of orbicularis oculi muscle stripping on upper lid blepharoplasty.


Ten subjects were randomized to receive upper lid blepharoplasty with orbicularis oculi muscle stripping on one side and skin-only blepharoplasty on the other. Patients and two blinded physicians evaluated the aesthetics of the eyelids at 1-, 3-, and 17-month follow-up visits.


Blinded physician evaluation failed to show a difference in the overall cosmetic appearance of the eyelids between the control and treatment sides at any time point. Analysis of the composite of all patient scores showed a trend favoring the control side at 3 months (p = .28) and the treatment side at 17 months (p = .50), but neither difference was significant.


Based on the data from this pilot study, orbicularis oculi muscle stripping appears to have no affect on the aesthetic outcome of upper lid blepharoplasty.