Modified double-eyelid blepharoplasty with the combined partial- And minimal-incision method

Minimally invasive blepharoplasty and it's complementary role for failed buried-suture-blepharoplasty

OBJECTIVE

To investigate the effects of the minimally invasive blepharoplasty in recreation of double eyelid for the patients of single eyelid or failed buried-suture-blepharoplasty.

METHOD

From September 2012 to January 2022, 392 female patients were involved in the study. They had primarily single eyelid or failed buried-suture-blepharoplasty. For the patients whose double eyelid partially or totally disappeared due to breakdown of the buried sutures, the minimally invasive blepharoplasty was performed to recreate double eyelid more than 6 months after primary operation. During the surgical procedure, four minimal incisions were made on the upper eyelid. After excision of some oculli muscles and orbital fat, the incisions were technically sutured to form double eyelid. The primarily buried sutures were also extracted through the minimal incisions in the failed buried-suture-blepharoplasty. The results were evaluated by the patients. The adverse effects were analyzed.

RESULTS

The follow-up period ranged from 6 to 48 months. The newly created creases were consistent and natural. The scarring was inconspicuous after recovery. 93 % of the patients were satisfied with the results. The most common complication was swelling within first week and it subsided spontaneously after 1 month. Bleeding was found and treated by immediate pressing in a few patients. Asymmetry occurred in a few patients and was corrected after 6 months. No other severe complication was found.

CONCLUSION

Minimally invasive blepharoplasty is reliable for the young people who have single-eyelid or failed buried-suture-blepharoplasty. The newly created crease is natural-looking and long-lasting.

Clinical Results of Asymmetric Blepharoplasty Plastic Repair

OBJECTIVE

To investigate plastic surgery repair's effects and adverse reactions in the clinical therapy of asymmetric double eyelids.

METHODS

All 126 sufferers who came to the hospital for asymmetric double eyelid plastic repair from January 2022 to October 2022 were selected as the research objects, and they were divided into a control group and an observation group using the random number method, with 63 cases in each group, in which sufferers in the control group underwent full incision blepharoplasty and sufferers in the observation group underwent small incision liposuction with submerged sutures. The general data, treatment results, treatment satisfaction, related surgical indicators, and frequency of adverse reactions of the 2 groups of sufferers with asymmetric double eyelid plastic repair were compared.

RESULTS

It had no statistically obvious distinction between the control group and the observation group of sufferers in terms of general data such as sex, age, weight, and height ( P> 0.05); the total therapy efficiency of the sufferers in the observation group (95.24%) was greater than the control group (74.60%), with P value <0.05; the total treatment satisfaction of the patients in the observation group (96.83%) was significantly higher than that in the control group (76.19%), with P value <0.05; compared with the control group, patients in the observation group had shorter operative time and healing time and less intraoperative bleeding, with P value < 0.05; the total frequency of adverse reactions of sufferers in the observation group (4.76%) was less than the control group (17.46%), with P value < 0.05.

CONCLUSION

Small incision liposuction with submerged sutures for plastic repair has significant efficacy, relatively high patient satisfaction, and low incidence of adverse reactions, in line with patient esthetic review, which has a broad clinical application prospect.

The small incisions combined with interrupted buried suture blepharoplasty: flexible-rigid fixation

Background

The traditional full incision blepharoplasty is the most commonly used in Asia. However, it has significant drawbacks like long recovery period, excessive surgical marks etc. We offer a new suture idea and combine it with interrupted suture buried blepharoplasty to improve these disadvantages.

Methods

In our procedure, the orbital septum is opened and separating the levator aponeurosis-the retro-orbital septum complex under this 3-5 millimeters small incision, a flexible-rigid fixation would be made: suture fixation was made to the tarsus-the complex-lower lip orbicularis oculi muscle. We interrupted bury the sutures in the uncut skin between the two small incisions.

Results

This paper included 333 patients divided into small incision groups using flexible-rigid fixation (n = 244, 73.3%) and full incision groups using rigid fixation (n = 89, 26.7%). Both at 6-month and at 5-year postoperative follow-up, the satisfaction of small incision group was statistically higher than the full incision group. The overall postoperative complication rate was statistically significantly less in the small incision. The permanence was not statistically different. For Assignment of Postoperative Effort Score (PES) results, at 6 months postoperatively, the mean score was 8.29 ± 1.32 in the small incision group, 7.86 ± 1.54 in the full incision group. At 5 years postoperatively, the mean score was 7.48 ± 1.45 in the small incision group, 7.51 ± 1.73 in the full incision group. None were statistically different.

Conclusion

The small incisions group achieves a higher level of patient satisfaction and more mild trauma in the surgical area, has a low complication rate, and a decent degree of durability.

Less Is Better: Full-Incision Double-Eyelid Blepharoplasty with Rapid Recovery

SUMMARY

Full-incision double-eyelid blepharoplasty is effective, but postoperative complications, such as local trauma and persistent tissue swelling, are major concerns. Because tissue swelling is caused by the obstruction of blood and lymphatic flow, the authors modified the conventional full-incision method to minimize the trauma as much as possible. Twenty-five patients underwent the modified procedure. There was minor swelling immediately after the surgery, which subsided 1 to 5 days after the surgery. No patient reported loss of the double eyelid crease. Only 2 patients underwent a second operation because of a low crease. Satisfactory results were obtained in 92% of patients (23 of 25). According to our understanding of this technique, less trauma is the key to obtaining better results under certain conditions.

Single Mini-incisional Blepharoplasty with the Orbicularis-Orbital Septum Fixation Technique for the Creation of a Natural Double Eyelid

BACKGROUND

Mini-incisional double-eyelid blepharoplasty has increasingly gained popularity in oriental populations. Moreover, many related studies have made a detailed technical introduction to this topic. This study aims to introduce a simple single mini-incisional blepharoplasty procedure with orbicularis-orbital septum fixation technique to create a physiologically natural double eyelid with no visible scar and a short postoperative recovery time.

METHODS

A single mini-incisional blepharoplasty with orbicularis-orbital septum fixation technique is described in detail and is illustrated with pictures. Patients who underwent this procedure in our department from November 2020 to May 2023 were retrospectively reviewed RESULTS: This study included 159 patients who underwent a single mini-incisional blepharoplasty with the orbicularis-orbital septum fixation technique. Surgery duration ranged from 16 to 42 minutes (mean 27 minutes). The majority of the swelling was reduced in 5 days and completely disappeared in 2 weeks for most patients. The follow-up period ranged from 2 to 31 months. All the double eyelids were natural and dynamic, and the creases were stable with no visible scar. Asymmetries occurred in 1.2% (2 of 159), and crease disappeared in 0.6% (1 of 159) of patients; during the follow-up period, no other complications were reported. Of the 159 patients, 99.4% (158) were satisfied with the surgical outcomes CONCLUSIONS: The single mini-incisional blepharoplasty with the orbicularis-orbital septum fixation technique offers a simple, safe, and effective approach to creating double eyelids. It provides natural, stable, scarless, and rapid recovery results with a low risk of complication.

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 www.springer.com/00266 .

Small-Incisional Double Eyelid Blepharoplasty: A Retrospective Study of Our Minimally Invasive Technique with Three Mini Incisions

BACKGROUND

Small-incisional double eyelid surgery has been increasingly performed these years and achieved good aesthetic results, but the techniques vary greatly between literatures. The authors reviewed the cases of three-small-incisional double eyelid surgery performed in the past three years and introduced their surgical technique in detail.

METHODS

A total of 87 patients receiving bilateral three-small-incisional double eyelid surgery were included in this retrospective study. The pretarsal folds were designed meticulously, along which three evenly distributed 2 mm-long incisions were made. A minimal amount of orbicularis oculi muscle and pretarsal soft tissue were removed to expose the pretarsal fascia for further fixation. An appropriate amount of orbital septal fat was removed through the lateral incision if required. The superficial orbicularis oculi muscle and dermis on the lower margin of the incision were fixed onto the pretarsal fascia with some underlying tarsus on the upper margin of the tarsus. The skin was closed by one stitch for each incision.

RESULTS

The average follow-up was 9.9 ± 5.2 months (range: 6-27 months). All the patients were satisfied with the result. None of them experienced loss of the pretarsal fold, bilateral asymmetry, scar hyperplasia, or persistent swelling after surgery.

CONCLUSIONS

Our three-small-incisional technique with minor soft tissue debulking offers a simple, safe, and reproducible approach to double eyelids. It can create a stable and natural-looking pretarsal fold with a short recovery period.

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 www.springer.com/00266 .

Correction of Primary Multiple Upper Eyelid Folds by Three Mini-Incision Upper Blepharoplasty and Simultaneous Orbital Fat Pad Repositioning in East Asians

BACKGROUND

This study aims to assess the feasibility and efficacy of a three mini-incision upper blepharoplasty combined with simultaneous orbital fat pad repositioning for correcting primary multiple upper eyelid folds in East Asians.

METHODS

A retrospective analysis of 75 patients who underwent three mini-incision double-eyelid blepharoplasty in conjunction with orbital fat pad repositioning for the correction of multiple upper eyelid folds between January 2018 and January 2022 was conducted. During the surgery, the lateral extension of the central upper eyelid fat mass was anchored medially to the upper medial eyelid via three small skin incisions. Postoperative follow-up was carried out to evaluate the improvement in multiple upper eyelid folds, and patient satisfaction was measured.

RESULTS

The follow-up period ranged from 6 to 36 months, with an average of 12 months. Post-surgery, the multiple fold lines were completely resolved in 71 patients (95%), while relapse occurred in 4 patients (5%). The overall satisfaction rate was 88%.

CONCLUSIONS

The three mini-incision double-eyelid blepharoplasty combined with simultaneous orbital fat repositioning is an effective method for correcting primary multiple upper eyelid folds. This technique presents a novel alternative for patients with primary multiple eyelid folds, particularly those who are hesitant to undergo a full-incision double-eyelid procedure.

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 www.springer.com/00266 .

Photo-Assisted Anthropometric Analysis of Double Eyelid Blepharoplasty in Young Chinese

BACKGROUND

Double eyelid blepharoplasty has gained popularity over decades among Asians. Quantitative assessment of the morphologic changes after double eyelid blepharoplasty remains obscure. A photo-assisted digital method was introduced to measure the outcomes of double eyelid surgery in young Chinese.

METHODS

A total of 168 Chinese patients who underwent esthetic upper blepharoplasty were recruited from October 2018 to October 2020. The participants were divided into mini-incision, full-incision, and full-incision double with epicanthoplasty (FIDE) groups. Changes in the eyeball exposure area (EEA), brow eyelid margin distance [brow eyelid distance (BED)], and palpebral crease height after surgery were analyzed using ImageJ software.

RESULTS

There was an overall increase in EEA in the 3 groups after upper blepharoplasty surgery. The FIDE group showed the most increase in EEA among these groups. Furthermore, BED was significantly decreased in each group after upper eyelid blepharoplasty; however, the mini-incision double group showed the least BED reduction. The palpebral crease height at 90 days was significantly lower than that at 7 days after surgery.

CONCLUSIONS

The photo-assisted anthropometric analysis offers a simple and objective measurement for double eyelid blepharoplasty. The eyes appear larger because of the increase in EEA and decrease in BED after double eyelid blepharoplasty. Distinct results were produced by different surgical techniques. The FIDE group showed the maximum increase in EEA and a decrease in BED. These findings provide important references for preoperative planning and postoperative measurement.

Ropivacaine and Lidocaine in Double Eyelid Blepharoplasty: A Comparative Analysis

Double eyelid blepharoplasty is an operation of changing the structure of the eyelid and reshaping the eyelid to form a new upper eyelid fold. This prospective randomized controlled study aimed to compare and evaluate the effect of ropivacaine and lidocaine in double eyelid blepharoplasty. A total of 120 patients who underwent double eyelid blepharoplasty in the beauty department of our hospital from January 2019 to July 2021 were enrolled and randomized (1 : 1) into the control group (1% lidocaine-epinephrine mixture) and the study group (0.75% ropivacaine-epinephrine mixture) via the random number table method. The 0.75% ropivacaine-epinephrine mixture led to lower Wong-Baker FACES Pain Rating visual analog scale score from 2 h to 1 d after surgery versus 1% lidocaine-epinephrine mixture (all P < 0.05). The operation time, intraoperative anesthetic drug dosage, and intraoperative blood loss were similar in the two groups (all P < 0.05). The 0.75% ropivacaine-epinephrine mixture resulted in a lower postoperative swelling score, but a higher patient satisfaction score versus 1% lidocaine-epinephrine mixture (all P < 0.05). The safety profiles of the two groups were similar (all P < 0.05). Both lidocaine and ropivacaine produce desirable anesthesia effects in double eyelid blepharoplasty. Ropivacaine can significantly reduce postoperative pain and mitigate postoperative swelling, with better satisfaction, and is thus worthy of further promotion.