Aesthetic Plastic Surgery

, Volume 43, Issue 6, pp 1561–1563 | Cite as

Invited Discussion on: Orbicularis–White Line Fixation in Asian Blepharoplasty—Kiss Technique

  • Chin-Ho WongEmail author
  • Michael Ku Hung Hsieh
Editor’s Invited Commentary

Level of Evidence V 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 Table of Contents or the online Instructions to Authors


This is an interesting article on a surgical technique for Asian upper eyelid blepharoplasty. The authors’ technique leaves the orbital septum intact, mobilizing the inferior flap in the retro-orbicularis oculi plane, lifting the pretarsal orbicularis oculi off the anterior tarsus and fixating the pretarsal orbicularis oculi to the lower edge of the levator aponeurosis at the fusion point of the levator with the orbital septum. This conjoined area has a distinct whitish appearance and accordingly is called the ‘white line.’ The key difference with the incision Asian upper blepharoplasty used by most surgeons is that the orbital septum was left intact. The authors reasoned that because the technique involves lesser...


Compliance with Ethical Standards

Conflict of interest

The authors declare no conflict of interest in this present work. None of the authors has a financial interest in any of the products, devices or drugs mentioned in this manuscript.

Ethical Statement

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.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2019

Authors and Affiliations

  1. 1.W Aesthetic Plastic SurgerySingaporeSingapore
  2. 2.Department of Plastic Reconstructive and Aesthetic SurgerySingapore General HospitalSingaporeSingapore

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