Aesthetic Plastic Surgery

, Volume 37, Issue 1, pp 46–50 | Cite as

A New Approach: Resection and Suture of Orbicularis Oculi Muscle to Define the Upper Eyelid Fold and Correct Asymmetries

  • Claudio Thomas Bas
  • Joaquín Pérez-GuisadoEmail author
Multimedia Manuscript Aesthetic


Upper-eyelid blepharoplasty is a very common procedure in aesthetic plastic surgery. Among all the literature in favor of orbicularis muscle resection, there are no commentaries associated with orbicularis muscle suture and its convenience. This article discusses a new approach: independent resection of the orbicularis oculi muscle similar in size to the resected skin and the subsequent suture of the orbicularis muscle after its resection. This results in a fine reconstruction of the upper-eyelid crease, achieves a good definition of this anatomical structure, and allows correction of asymmetries with the contralateral upper eyelid. The results obtained (98 % of patients satisfied) and no complications with this procedure make it a safe alternative for upper blepharoplasty.

Level of Evidence IV

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Blepharochalasis Blepharoplasty Rejuvenate Upper eyelids Upper-eyelid crease 


Conflict of interest


Supplementary material

Supplementary material 1 (WMV 9,014 kb)


  1. 1.
    Van der Lei B, Timmerman IS, Cromheecke M, Hofer SO (2007) Bipolar coagulation-assisted orbital (BICO) septoblepharoplasty: a retrospective analysis of a new fat-saving upper-eyelid blepharoplasty technique. Ann Plast Surg 59:263–267PubMedCrossRefGoogle Scholar
  2. 2.
    Jacono AA, Moskowitz B (2011) Transconjunctival versus transcutaneous approach in upper and lower blepharoplasty. Facial Plast Surg 17:21–28CrossRefGoogle Scholar
  3. 3.
    Serra F (2004) Upper cosmetic blepharoplasty and the eye brow. J Fr Ophtalmol 27:644–650PubMedCrossRefGoogle Scholar
  4. 4.
    Gradinger GP (1988) Cosmetic upper blepharoplasty. Clin Plast Surg 15:289–297PubMedGoogle Scholar
  5. 5.
    Rohrich RJ, Coberly DM, Fagien S, Stuzin JM (2004) Current concepts in aesthetic upper blepharoplasty. Plast Reconstr Surg 113:32e–42ePubMedCrossRefGoogle Scholar
  6. 6.
    Flowers RS (1991) Periorbital aesthetic surgery for men. Eyelids and related structures. Clin Plast Surg 18:689–729PubMedGoogle Scholar
  7. 7.
    D’Assumpcao EA (1999) Blepharoplasty: a personal tactical approach. Aesthet Plast Surg 23:28–31CrossRefGoogle Scholar
  8. 8.
    Chen WP (1996) Concept of triangular, trapezoidal, and rectangular debulking of eyelid tissues: application in Asian blepharoplasty. Plast Reconstr Surg 97:212–218PubMedCrossRefGoogle Scholar
  9. 9.
    Fagien S (2002) Advanced rejuvenative upper blepharoplasty: enhancing aesthetics of the upper periorbita. Plast Reconstr Surg 110:278–291PubMedCrossRefGoogle Scholar
  10. 10.
    Fagien S (2010) The role of the orbicularis oculi muscle and the eyelid crease in optimizing results in aesthetic upper blepharoplasty: a new look at the surgical treatment of mild upper eyelid fissure and fold asymmetries. Plast Reconstr Surg 125:653–666PubMedCrossRefGoogle Scholar
  11. 11.
    Older JJ (1995) Ptosis repair and blepharoplasty in the adult. Ophthalmic Surg 26:304–308PubMedGoogle Scholar
  12. 12.
    Brown MS, Putterman AM (2000) The effect of upper blepharoplasty on eyelid position when performed concomitantly with Muller muscle-conjunctival resection. Ophthal Plast Reconstr Surg 16:94–100PubMedCrossRefGoogle Scholar
  13. 13.
    Baker TJ (1981) Upper blepharoplasty. Clin Plast Surg 8:635–641PubMedGoogle Scholar
  14. 14.
    Zide BM (1981) Anatomy of the eyelids. Clin Plast Surg 8:623–634PubMedGoogle Scholar
  15. 15.
    Tebbetts JB (1992) Blepharoplasty. A refined technique emphasizing accuracy and control. Clin Plast Surg 19:329–349PubMedGoogle Scholar
  16. 16.
    Damasceno RW, Cariello AJ, Cardoso EB, Viana GA, Osaki MH (2011) Upper blepharoplasty with or without resection of the orbicularis oculi muscle: a randomized double-blind left-right study. Ophthal Plast Reconstr Surg 27:195–197PubMedGoogle Scholar
  17. 17.
    Hoorntje LE, Lei B, Stollenwerck GA, Kon M (2010) Resecting orbicularis oculi muscle in upper eyelid blepharoplasty: a review of the literature. J Plast Reconstr Aesthet Surg 63:787–792PubMedCrossRefGoogle Scholar
  18. 18.
    Siegel RJ (1993) Essential anatomy for contemporary upper lid blepharoplasty. Clin Plast Surg 20:209–212PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2012

Authors and Affiliations

  1. 1.Sara Moncada ClinicSantiago de ChileChile
  2. 2.Service of Plastic, Aesthetic and Reconstructive SurgeryReina Sofía University HospitalCórdobaSpain

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