A modified mini-incisional technique for double-eyelid blepharoplasty

Abstract

It is commonly accepted that double-eyelid surgery results in largerappearing eyes, a soft and womanly appearance, clear-cut features and a refreshed appearance to the face (1). Upper eyelid blepharoplasty is one of the most popular cosmetic surgeries in Asia because nearly one-half of the Asian population lacks a supratarsal fold (2). The first cutaneous suture technique was devised by Mikamo (reported by Lam [3]). Various methods have been described, broadly including the incisional, nonincisional and mini-incisional methods (4). The present article introduces a modified mini-incisional technique. METHODSA total of 372 patients (325 women and 47 men) were involved in the study between July 2008 and August 2014. Their age ranged from 16 to 34 years (mean 24 years of age), and all underwent the modified mini-incisional upper blepharoplasty. Bilateral surgeries were performed in 341 patients and unilateral procedures in 31 patients. The follow-up period was three to 12 months (mean nine months) to evaluate the effect. Patient satisfaction was evaluated three months postoperatively. Satisfactory results indicated no multiple eyelids, no shifting or disappearance of the fold, and symmetrical heights of the fold when the difference between the bilateral heights was <1 mm. Complications were recorded. Preoperative evaluationThe desires of the patients were understood during consultation and they were taken into consideration before the operative design. With the patient sitting, the height and shape of the desired double-eyelid line were simulated. A probe was used to push the upper eyelid upward to form a crease in front of a mirror. The crease position was confirmed when the patient was satisfied with the simulated crease, which was usually approximately 7 mm to 10 mm above the ciliary margin. The symmetry of the line on the bilateral upper eyelid was verified. The proposed double-eyelid line was marked using a marker pen. All patients were photographed pre-and postoperatively. Surgical procedureThe operation was performed under local anesthesia. 1% lidocaine (5 mL) containing 1:100,000 of epinephrine was injected into each eyelid. Four 2 mm incisions were made along the double-eyelid line. BACkGROUND: Double-eyelid blepharoplasty is one of the most popular cosmetic surgeries in Asia. OBjECTIVE: To introduce a modified mini-incisional technique to form a double eyelid. METHODS: A total of 372 patients (325 women, 47 men) were involved in the study between July 2008 and August 2014. Their age ranged from 16 to 34 years, with a mean age of 24 years. All patients underwent the modified mini-incisional upper blepharoplasty. In the technique, four 2 mm incisions were made along the designed fold. The orbicularis muscle overlying the levator aponeurosis was removed. The removal of the lateral fat pad was completed accordingly. The medial fat pad was also removed if necessary. Suture was used to fix the skin to pretarsal fascia along the double-eyelid line. The double-eyelid crease was formed after the operation. RESULTS:...

Ropivacaine and Lidocaine in Double Eyelid Blepharoplasty: A Comparative Analysis

“…Due to the merits of the long-lasting effect and wide-range indications, the incision method has been extensively recognized. However, double eyelid blepharoplasty is highly demanding regarding intraoperative local infiltration anesthesia and postoperative analgesia [ 8 ]. Excellent anesthesia and analgesia can reduce tension, anxiety, and fear caused by pain and contribute to good surgical results and satisfaction.…”

Review of complications in double eyelid surgery

“…Double eyelid surgery aims to make a stable and effective adhesion between the levator palpebrae superioris muscle and the upper eyelid skin, so that the upper eyelid can form a crease when opening the eye. [ 1 2 3 4 5 6 7 8 9 ] Double eyelid surgery is an extremely common plastic surgery worldwide. [ 9 10 ] It is named differently in different regions.…”

“…[ 1 2 3 4 5 6 7 8 9 ] Double eyelid surgery is an extremely common plastic surgery worldwide. [ 9 10 ] It is named differently in different regions. In Europe and the United States, it is called “upper blepharoplasty,” while in East Asia, it is often called “double eyelid surgery.” We believe that double eyelid surgery is popular for two reasons: (a) the periorbital region is an important cosmetic unit, and double eyelid surgery can make people look younger and more energetic;[ 11 12 ] and (b) Mongoloid eyes, more frequent in Asians than in Caucasians, are characterized by a single eyelid, shorter palpebral fissure, and epicanthus.…”