Aesthetic Plastic Surgery

, Volume 42, Issue 6, pp 1582–1590 | Cite as

Orbicularis-Tarsus Fixation Approach in Double-Eyelid Blepharoplasty: A Modification of Park’s Technique

  • Weiyi Sun
  • Yongqian WangEmail author
  • Tao Song
  • Di Wu
  • Haidong Li
  • Ningbei Yin
Original Article Oculoplastic



Incisional double-eyelid blepharoplasty is widely applied because of its extensive indications and robust results. The orbicularis-levator fixation method is an incisional approach that provides stronger adhesion than traditional techniques. However, there remains the risk of postoperative relapse or suture spitting out.


The authors introduced a modified technique for supratarsal crease formation. When necessary soft tissue removal was completed, the orbicularis oculi muscle was anchored on the tarsus. Then the muscle edges near canthus were reattached to prevent muscle retraction. For skin closure, the skin-pretarsal fascia-skin maneuver was adopted to enhance cicatricial adhesion.


Six hundred and fifty-nine patients underwent double eyelidplasty by the same surgeon using this modified technique. Patients were followed up from 2 to 38 months, with a mean period of 15 months. Short-term complications included mild edema, bruising or reddish change of the upper eyelid, yet all gradually relieved in 6–8 weeks. Fourteen cases of palpebral fold asymmetry and nine cases of unsatisfactory fold formation near the inner canthus were encountered, and all the defects had been well improved by revision surgeries. Ninety-five percent of the patients were satisfied with the long-term outcomes, which showed as natural and well-defined palpebral folds without scar hypertrophy, suture spitting out or crease depression. Besides, no supratarsal crease drooping or disappearing was observed 3 years postoperatively.


The authors introduced an orbicularis-tarsus fixation method for upper eyelid blepharoplasty. It is a reliable technique that enables high feasibility and long-lasting result, and with lower risk of suture spitting out.

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


Blepharoplasty Orbicularis-tarsus fixation Technique modification 



This work is supported by Teaching Reform Project of Peking Union Medical College (10023201504024).

Compliance with Ethical Standards

Conflict of interest

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

Supplementary material

266_2018_1218_MOESM1_ESM.docx (2.9 mb)
Supplementary material 1 (DOCX 2998 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2018

Authors and Affiliations

  • Weiyi Sun
    • 1
  • Yongqian Wang
    • 1
    Email author
  • Tao Song
    • 1
  • Di Wu
    • 1
  • Haidong Li
    • 1
  • Ningbei Yin
    • 1
  1. 1.Plastic Surgery HospitalChinese Academy of Medical Sciences, Peking Union Medical CollegeBeijingChina

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