Skip to main content
Log in

A Flexible Suspension Technique of Blepharoplasty: Clinical Application and Comparison with Traditional Technique

  • Original Article
  • Oculoplastic
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Double-eyelid blepharoplasty is one of the most popular aesthetic surgeries in China. But the traditional method produces a hidebound double eyelid due to its rigid suturing between the skin and the tarsus. The authors of this article concluded a novel technique of “flexible suspension technique” compared with traditional blepharoplasty which is considered as a “rigid fixation technique.”

Methods

This is a retrospective study of two groups of 100 Chinese Han females, on whom double-eyelid blepharoplasty was performed, 50 cases by “flexible suspension technique” and the other 50 by “rigid fixation technique.” The basic procedure of “flexible suspension technique” is suturing the orbicularis oculi muscle to the septal extension. Thus, the surgical connection between skin and tarsus is flexible. The surgical results were evaluated and compared using the Global Aesthetic Improvement Scale and Visual Analogue Scale/Score.

Results

The “very much improved” rate in the “flexible suspension technique” group was higher than that in the “rigid fixation technique” group (p < 0.05). Postoperative appearances of the “flexible suspension technique” group were also better than the “rigid fixation technique” group with less edema (p < 0.05) and slighter incision scars (p < 0.05). However, the incidences of asymmetry and fold loss were higher in the “flexible suspension technique” group (p < 0.05).

Conclusion

The flexible suspension technique blepharoplasty can obtain a more natural appearance and has less adverse effects and shorter recovery time.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Kim HS, Hwang K, Kim CK et al (2013) Double-eyelid surgery using septoaponeurosis junctional thickening results in dynamic fold in Asians. Plast Reconstr Surg Glob Open 1(2):1–9

    Article  PubMed  PubMed Central  Google Scholar 

  2. Dong WL, Inho B, Eul JC et al (2013) Eyelid dynamics and supratarsal crease appearance after double eyelid surgery. J Craniofac Surg 24(3):818–821

    Article  Google Scholar 

  3. Reid RR, Said HK, Yu M et al (2006) Revisiting upper eyelid anatomy: introduction of the septal extension. Plast Reconstr Surg 117:65–70

    Article  CAS  PubMed  Google Scholar 

  4. John AM (2005) Upper blepharoplasty in the Asian patient: the “double eyelid” operation. J Fac Plast Clin N Am 13:47–64

    Article  Google Scholar 

  5. Rhoda SN, Fredric B, James L et al (2003) A randomized, double-blind, multicenter comparison of the efficacy and tolerability of restylane versus zyplast for the correction of nasolabial folds. Dermatol Surg 29:588–595

    Google Scholar 

  6. Hirohiko K, Raman M, Dinesh S (2009) Upper eyelid anatomy: an update. Ann Plast Surg 63(3):336–343

    Article  CAS  Google Scholar 

  7. Sangki J, Bradley NL, Richard KD (1999) The Asian upper eyelid: an anatomical study with comparison to the Caucasian eyelid. Arch Ophthalmol 117(7):907–912

    Article  Google Scholar 

  8. Sufan Wu, Shi Hangyan, Yan Sheng et al (2010) Combined anchor suture with external upper eyelid blepharoplasty in Asian patients. Arch Fac Plast Surg 12(4):230–234

    Google Scholar 

  9. Yeop C, Hyun GK, Yong SN (2017) Three skin zones in the Asian upper eyelid pertaining to the Asian blepharoplasty. J Craniofac Surg 28:892–897

    Article  Google Scholar 

  10. Er P, Yun-Fei N, Zhen-Jun W et al (2016) Aponeurosis of the levator palpebrae superioris in Chinese subjects: a live gross anatomy and cadaveric histological study. Medicine (Baltimore) 95(31):e4469

    Article  Google Scholar 

  11. Hirohiko K, Igal L, Dinesh S et al (2009) Orbital septum attachment on the levator aponeurosis in Asians: in vivo and cadaver study. Ophthalmology 116(10):2031–2035

    Article  Google Scholar 

  12. Flowers RS (1975) Aesthetic surgery of the eyelids. In: Marchac D (ed) Transactions of the 6th international congress of plastic and reconstructive surgery. Masson, Paris

    Google Scholar 

  13. Woo CC, Yong OK, Young SK et al (2002) Refinement of double eyelid plasty in asian patients: attachment of the septoaponeurotic union to the pretarsal dermis. Aesth Surg J 22(2):154–161

    Article  Google Scholar 

  14. Kun H, Seong KY, Dae JK (2018) Location of the septoaponeurosis junction relative to the tarsal plate in upper eyelids. J Craniofac Surg 29(4):1051–1053

    Article  Google Scholar 

  15. Jae SL, Weon-Jin P, Myoung-Soo S et al (1997) Simplified anatomic method of double-eyelid operation: septodermal fixation technique. Plast Reconstr Surg 100(1):170–178

    Article  Google Scholar 

  16. Kakizaki H, Zako M, Nakano T et al (2005) The levator aponeurosis consists of two layers that include smooth muscle. Ophthal Plast Reconstr Surg 21:379–382

    Article  PubMed  Google Scholar 

  17. Jung IP, Min SP (2007) Double-eyelid operation: orbicularis oculi-levator aponeurosis fixation technique. Fac Plast Surg Clin N Am 15:315–326

    Article  Google Scholar 

Download references

Funding

Funding was provided by the General Project Funds from the Health Department of Zhejiang Province (Grant No. 2016KYB022).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sufan Wu.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest to disclose.

Human and Animal Rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

For this type of study informed consent is not required.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pan, L., Sun, Y., Yan, S. et al. A Flexible Suspension Technique of Blepharoplasty: Clinical Application and Comparison with Traditional Technique. Aesth Plast Surg 43, 404–411 (2019). https://doi.org/10.1007/s00266-019-01317-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00266-019-01317-5

Keywords

Navigation