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
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References
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
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
Reid RR, Said HK, Yu M et al (2006) Revisiting upper eyelid anatomy: introduction of the septal extension. Plast Reconstr Surg 117:65–70
John AM (2005) Upper blepharoplasty in the Asian patient: the “double eyelid” operation. J Fac Plast Clin N Am 13:47–64
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
Hirohiko K, Raman M, Dinesh S (2009) Upper eyelid anatomy: an update. Ann Plast Surg 63(3):336–343
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
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
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
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
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
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
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
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
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
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
Jung IP, Min SP (2007) Double-eyelid operation: orbicularis oculi-levator aponeurosis fixation technique. Fac Plast Surg Clin N Am 15:315–326
Funding
Funding was provided by the General Project Funds from the Health Department of Zhejiang Province (Grant No. 2016KYB022).
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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
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DOI: https://doi.org/10.1007/s00266-019-01317-5