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Published in: Aesthetic Plastic Surgery 1/2022

01-02-2022 | Eyelid Blepharoplasty | Original Article

Full-Incision Double-Eyelid Blepharoplasty with Selective Neurovascular Preservation Method

Author: Xiao Shen

Published in: Aesthetic Plastic Surgery | Issue 1/2022

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Abstract

Backgrounds

Double-eyelid blepharoplasty remains popular in east Asia. To avoid rigid eyelids and sinking scar after double-eyelid blepharoplasty, a new surgical approach with selective neurovascular preservation (SNVP) method is proposed to crease more physiological and dynamic double-eyelid crease.

Methods

During the full-incision double-eyelid surgery, a strip of preseptal orbicularis oculi muscle was resected. The longitudinally spreading upper eyelid nerves and vessels were preserved carefully. Four to five anchoring points between these neurovascular branches were made to reach the pretarsal fascia. Skin- orbicularis oculi muscle–pretarsal fascia sutures were placed on the anchoring points.

Results

From May 2018 to April 2020, 385 patients received double-eyelid surgery with SNVP method. Eyelid edema resolved quickly within a week and generally disappeared in 4 weeks. In total, 259 (67.27%) patients scored very satisfied, and 109 (28.31%) patients scored satisfied on six-month follow-up.

Conclusions

The SNVP approach can produce reliable and dynamic palpebral crease with inconspicuous scar. Vital neurovascular branches of upper eyelid could be saved, thus reducing postoperative complications and 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.
Literature
1.
go back to reference McCurdy JA Jr (2005) Upper blepharoplasty in the Asian patient: the double eyelid operation. Facial Plast Surg Clin North Am 13(1):47–64CrossRef McCurdy JA Jr (2005) Upper blepharoplasty in the Asian patient: the double eyelid operation. Facial Plast Surg Clin North Am 13(1):47–64CrossRef
2.
go back to reference Kiranantawat K, Suhk JH, Nguyen AH (2015) The Asian eyelid: relevant anatomy. Semin Plast Surg 29(3):158–164CrossRef Kiranantawat K, Suhk JH, Nguyen AH (2015) The Asian eyelid: relevant anatomy. Semin Plast Surg 29(3):158–164CrossRef
3.
go back to reference Sayoc BT (1956) Absence of superior palpebral fold in slit eyes; an anatomic and physiologic explanation. Am J Ophthalmol 42:298–300CrossRef Sayoc BT (1956) Absence of superior palpebral fold in slit eyes; an anatomic and physiologic explanation. Am J Ophthalmol 42:298–300CrossRef
4.
go back to reference Hirohiko K, Raman M, Dinesh S (2009) Upper eyelid anatomy: an update. Ann Plast Surg 63(3):336–343 Hirohiko K, Raman M, Dinesh S (2009) Upper eyelid anatomy: an update. Ann Plast Surg 63(3):336–343
5.
go back to reference Kakizaki H, Takahashi Y, Nakano T, Asamoto K, Ikeda H, Iwaki M, Selva D, Leibovitch I (2012) The causative factors or characteristics of the Asian double eyelid: an anatomic study. Ophthal Plast Reconstr Surg 28:376–381CrossRef Kakizaki H, Takahashi Y, Nakano T, Asamoto K, Ikeda H, Iwaki M, Selva D, Leibovitch I (2012) The causative factors or characteristics of the Asian double eyelid: an anatomic study. Ophthal Plast Reconstr Surg 28:376–381CrossRef
6.
go back to reference Saonanon P, Thongtong P, Wongwuticomjon T (2016) Differences between single and double eyelid anatomy in Asians using ultrasound biomicroscopy. Observational Study Asia Pac J Ophthalmol Phila 5(5):335–338CrossRef Saonanon P, Thongtong P, Wongwuticomjon T (2016) Differences between single and double eyelid anatomy in Asians using ultrasound biomicroscopy. Observational Study Asia Pac J Ophthalmol Phila 5(5):335–338CrossRef
7.
go back to reference Saonanon P (2014) Update on Asian eyelid anatomy and clinical relevance. Curr Opin Ophthalmol 25(5):436–442CrossRef Saonanon P (2014) Update on Asian eyelid anatomy and clinical relevance. Curr Opin Ophthalmol 25(5):436–442CrossRef
8.
go back to reference Park JI (1999) Orbicularis-levator fixation in double-eyelid operation. Arch Facial Plast Surg Apr-Jun 1(2):90–95CrossRef Park JI (1999) Orbicularis-levator fixation in double-eyelid operation. Arch Facial Plast Surg Apr-Jun 1(2):90–95CrossRef
9.
go back to reference Kim HS, Hwang K, Kim CK, Kim KK (2013) Double-eyelid surgery using septoaponeurosis junctional thickening results in dynamic fold in Asians. Plast Reconstr Surg Glob Open 1(2):1–9CrossRef Kim HS, Hwang K, Kim CK, Kim KK (2013) Double-eyelid surgery using septoaponeurosis junctional thickening results in dynamic fold in Asians. Plast Reconstr Surg Glob Open 1(2):1–9CrossRef
10.
go back to reference Pan L, Sun Y, Yan S, Shi H, Jin T, Li J, Zhang L, Wu SF (2019) A flexible suspension technique of blepharoplasty: clinical application and comparison with traditional technique. Aesthetic Plast Surg 43(2):404–411CrossRef Pan L, Sun Y, Yan S, Shi H, Jin T, Li J, Zhang L, Wu SF (2019) A flexible suspension technique of blepharoplasty: clinical application and comparison with traditional technique. Aesthetic Plast Surg 43(2):404–411CrossRef
11.
go back to reference Li GF, Ding W, Tan J, Zhang B, Chen X, He B (2018) A new method for double-eyelid blepharoplasty using orbital septum. Ann Plast Surg 81(6):633–636CrossRef Li GF, Ding W, Tan J, Zhang B, Chen X, He B (2018) A new method for double-eyelid blepharoplasty using orbital septum. Ann Plast Surg 81(6):633–636CrossRef
12.
go back to reference Vestal KP, Rathbun JE, Seiff SR (1994) Anatomy of the terminal nerves in the upper eyelid. Ophthalmic Plast Reconstr Surg 10(1):1–5CrossRef Vestal KP, Rathbun JE, Seiff SR (1994) Anatomy of the terminal nerves in the upper eyelid. Ophthalmic Plast Reconstr Surg 10(1):1–5CrossRef
13.
go back to reference Higashino T, Okazaki M, Mori H, Yamaguchi K, Akita K (2018) Microanatomy of sensory nerves in the upper eyelid: a cadaveric anatomical study. Plast Reconstr Surg 142(2):345–353CrossRef Higashino T, Okazaki M, Mori H, Yamaguchi K, Akita K (2018) Microanatomy of sensory nerves in the upper eyelid: a cadaveric anatomical study. Plast Reconstr Surg 142(2):345–353CrossRef
14.
go back to reference Lopez R, Lauwers F, Paoli JR, Boutault F, Guitard J (2008) The vascular system of the upper eyelid. Anatomical study and clinical interest. Surg Radiol Anat 30(3):265–269CrossRef Lopez R, Lauwers F, Paoli JR, Boutault F, Guitard J (2008) The vascular system of the upper eyelid. Anatomical study and clinical interest. Surg Radiol Anat 30(3):265–269CrossRef
Metadata
Title
Full-Incision Double-Eyelid Blepharoplasty with Selective Neurovascular Preservation Method
Author
Xiao Shen
Publication date
01-02-2022
Publisher
Springer US
Published in
Aesthetic Plastic Surgery / Issue 1/2022
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-021-02418-w

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