Mini-Incision Eyelidplasty in Single Eye to Correct Congenital Upper Eyelid Crease Asymmetry

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.

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

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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.