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Double-Eyelid Blepharoplasty: Dermis–Outer Orbicularis Fascia–Orbicularis–Levator Fixation Technique with Preorbicular Venous Network Preservation

  • Original Article
  • Oculoplastic
  • Published:
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Abstract

Background

This article presents a new method using a dermis–outer orbicularis fascia–orbicularis–levator (DOOL) fixation technique for double-eyelid blepharoplasty.

Methods

Our surgical technique preserves the preorbicular venous network (POVN) and uses mattress sutures to fix the dermis, outer fascia of the orbicularis oculi muscle, and orbicularis oculi muscle with pretarsal levator aponeurosis (DOOL). Between January 2016 and July 2018, 335 patients were treated with this POVN-preserving DOOL technique (321 women and 14 men; mean age, 29.6 y). The patients were followed up for 6–30 months. The complications were documented, and the overall outcomes of the upper eyelid folds were evaluated by both surgeons and patients as good, fair, or poor.

Results

Among 335 patients, 307 (91.6%) had good results, 17 (5.1%) had fair results, and 11 (3.3%) had poor results. Postoperative complications included partial (n=4) or complete (n=3) loss of the double-eyelid line and asymmetric folds (n=4). Hypertrophic/depressed scars did not occur.

Conclusions

With less invasiveness and secure internal fixation, the DOOL fixation technique with POVN preservation can achieve a stable and natural double-eyelid appearance.

Level of evidence IV

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Funding

This manuscript is funded by the Key Project of the Strategic International Science and Technology Innovation Cooperation, Ministry of Science and Technology, grant No.: 2019YFE020215.

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Author notes

  1. Jiuzuo Huang, Yong Feng authors contributed equally to this work and are considered to be co-first authors.

Authors and Affiliations

  1. Division of Plastic Surgery, Department of Surgery, Peking Union Medical College & Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, Shuaifuyuan No. 1, Dongcheng District, Beijing, 100730, China

    Jiuzuo Huang, Zhujun Li, Ruijia Dong & Xiao Long

  2. AID BeauCare Clinic, Huanghe Street# 16, Shahekou District, Dalian, Liaoning, China

    Yong Feng, Hefei Wang & Zhigang Liu

Authors
  1. Jiuzuo Huang
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  2. Yong Feng
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  3. Zhujun Li
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  4. Hefei Wang
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  5. Ruijia Dong
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  6. Xiao Long
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  7. Zhigang Liu
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Corresponding authors

Correspondence to Xiao Long or Zhigang Liu.

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Conflict of interest

The authors have no financial or conflicts of interest to disclose.

Ethical approval

Our experiments were in accordance with the ethical standards formulated in the Declaration of Helsinki. This study was approved by the Research Ethics Board of our Hospital.

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Consent was obtained from the participants responding to the follow-up surveys.

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Supplementary Information

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266_2021_2627_MOESM1_ESM.jpg

Supplementary Figure A patient before the operation and 6 months postoperatively, with no visible scar when the eyes are closed. A series of pictures indicated the patient opening eyes and closing eyes before operation (a1, b1), 1 day (a2, b2), 5 days (a3, b3), 2 weeks (a4, b4), 1 month (a5, b5), 2 months (a6, b6), and 6 months (a7, b7) postoperatively. Swelling resolved quickly after operation, which was minimal 2 months postoperatively. (JPG 2631 kb)

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Huang, J., Feng, Y., Li, Z. et al. Double-Eyelid Blepharoplasty: Dermis–Outer Orbicularis Fascia–Orbicularis–Levator Fixation Technique with Preorbicular Venous Network Preservation. Aesth Plast Surg 46, 231–236 (2022). https://doi.org/10.1007/s00266-021-02627-3

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  • DOI: https://doi.org/10.1007/s00266-021-02627-3

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