A new approach: resection and suture of orbicularis oculi muscle to define the upper eyelid fold and correct asymmetries

Correction of Asymmetry of Palpebral Folds by Adopting Interrupted and Continuous Buried Suture Techniques Respectively on Different Eyelid

People with an obvious palpebral fold on 1 eye and a narrow or no palpebral fold on the other eye are usually more satisfied with the shape of the obvious palpebral fold and want to acquire symmetry by minimally invasive surgical methods that preserve the shape of the original folds they are more satisfied with. This study introduced a minimally invasive approach using 2 different buried suture techniques on different eyelids to acquire symmetry. The continuous suture method aimed to build palpebral folds, whereas the 3-point interrupted suture method aimed to enhance naturally formed palpebral folds. The 3-point interrupted buried suture method was used on the eye with an obvious palpebral fold, and the continuous buried suture method was performed on the eye with a narrow or no palpebral fold. Twenty patients underwent this procedure to correct the asymmetry between June 2010 and July 2022. The mean follow-up period was 18.12 months. The average swelling period was 7 days on the side using the interrupted buried suture technique and 10 days on the side using the continuous suture method. It took ~3 weeks to recover a relatively natural appearance. According to postoperative follow-up data, all patients were satisfied with the results. Our surgical approach of adopting 2 different buried suture techniques on different eyelids allowed the building of the palpebral fold on one eyelid while enhancing the original fold on the other eyelid, leading to satisfactory results of palpebral fold symmetry.

Evaluation of upper blepharoplasty outcome-objective measurements and patients` satisfaction

Background/Aim. Upper blepharoplasty is one of the most often performed aesthetic operations and is indicated for periorbital rejuvenation or correction of some functional problems. The aim of the study was to evaluate the outcome of this procedure and to assess patients? satisfaction and possibilities of objective measurement of operative results. Methods. A two-year prospective observational study was conducted among female patients who had upper blepharoplasty done by the same surgeon. Data were collected from medical documentation, questionnaire, and objective measurements conducted via standardized digital photographs taken before and two months after surgery. Tarsal platform show (TPS) and brow fat span (BFS) were measured at three points (P1, P2, P3) before and two months after the surgery. A questionnaire conducted before surgery and two months after it included general complaints considering upper eyelids (visual field narrowing, fallen eyelids, the sensation of heavy eyelids, raising head backward in order to enhance vision, headache), patients? assessment of eyelid asymmetry and an additional questionnaire after surgery included questions for the surgeon and patients concerning satisfaction with treatment outcome. Results. This study involved 50 female patients aged be-tween 33 and 67 years (49.98 ? 8.6 years). There was a statistically significant difference in all points for TPS and BFS measurements before and after the operation. No significant asymmetries were noticed between eyes neither before nor after surgery. There was a statistically significant difference in operation success among 3 age categories in TPS-P1 (?2 = 13.089, df = 2, p = 0.001) and TPS-P2 (?2 = 8.386, df = 2, p = 0.015) with best results achieved in older patients (> 55 years). There was strong positive, statistically significant correlation between patient?s and surgeon?s satisfaction (r= 0.704, p = 0.002), as well as between patients? satisfaction and their age (r = 0.704, p = 0.002). Conclusion. Realistic expectations, adequate information about the surgery and possible complications, are essential to satisfied patients. Objective measurements correlate with patients? satisfaction and together with photographs can be a useful tool in communication with them.