The New Method Using Hybrid Technique in Double Fold Upper Blepharoplasty

Introduction:

Double fold upper blepharoplasty is probably the most common aesthetic procedure performed in Asia. However as common as the procedure, secondary retouch procedures are also very common either due to unsatisfactory fold height or asymmetry. Conventional retouch operation generally entails upper eyelid excision and dissection followed by new double fold formation of the upper eyelid. Because formation of double fold is reserved at the end of the entire procedure, intraoperative swelling is unavoidable, which in turn makes accurate double fold formation very difficult in many instances. The authors of this journal report far superior and reliable results after performing modified Park's method that combines the conventional buried suture technique and excision technique for primary or secondary double fold upper blepharoplasty.

Methods:

A total of nine among twelve subjects feasible for patient follow-up were enrolled in this prosepective study. They all had undergone Park's method for secondary double fold upper blepharoplasty. All subjects were female and reasons for the secondary operation was high fold for eight subjects and indefinite double fold for one patient. Asymmetry was evident in all patients. Most desirable new double fold height was determined and designed beforehand during patient consultation. Surgery was done under sedative anesthesia and minimal amount of local anesthetic was infiltrated through 5-6 different needle passage points of the skin and conjunctiva as in the standard buried suture technique for double fold upper blepharoplasty. After securing the new double fold line with the buried suture technique, excess skin or postoperative scar from previous surgery was resected. Then layer by layer dissection of the upper eyelid was done allowing correction of all soft tissue malposition and adjunct procedures such as upper eyelid fat removal was done if necessary. Repair of the skin was done as usual manners. Total operation time was on average one hour and follow up period was 3 weeks.

Results:

Among these nine patients, postoperative result was satisfactory in seven patients and satisfactory after retouch operation (to achieve full symmetry) in two patients. No postoperative complications were noted such as loosening of the double fold, or prominence of old double fold.

Conclusions:

We experienced excellent and superior postoperative results by employing Park's new novel method in secondary double fold eyelid plasty patients. This new method enabled us to achieve far better symmetry of the upper eyelid when compared with the conventional method. Park's method modified and rearranged the sequence of conventional surgery technique by making new double fold prior to upper eyelid excision and dissection rendering the entire procedure much more simple and reliable by preventing any unwanted asymmetry. In addition, postoperative recovery is faster. This new method is especially useful in secondary double fold operation cases where asymmetry needs to be corrected.