Using Conjunctiva-Tarsus-Dermis Suture Method to Create Double Eyelid Fold with Help of a Syringe Needle in Facial Palsy Patients

Abstract

Purpose:

Double eyelid fold creation is a very common procedure in upper eyelid blepharoplasty. There were a lot of debates between open and suture blepharoplasty for double eyelid fold creation. This article will deal with a simple suture method, called outside tarsus-dermis suture method with help of a #25 syringe needle. Different situations have different approaches.

Materials and Methods:

Sixteen patients underwent double eyelid fold creation surgery between 2007 and

2012.Three small incisions over the designed fold line (usually 6mm from the cilia line) were made. A #25 syringe needle with multiple bending curves was used as thread passer. A 6-O prolene (clear) was used for outside tarsus-dermis sutures. 16 patients (6male and 10 female) with 32 upper eyelids were enrolled. The average age at operation was 25.3±9.1 years. There were 4 types of surgical procedure involved based on patient’s different eyelid conditions: Type A, suture method only, 9 patients; Type B, skin excision plus suture method, 1 patient; Type C, ptosis correction plus inside tarsus-dermis suture method, 4 patients; Type D, open septum fat removal or graft plus inside tarsus-dermis suture  method, 2 patients. They all had at least 6 months postoperative follow-up

Results:

There are 7 patients initially had asymmetrical eyes. After operation, there was no relapse after post-surgery evaluation. 15 patients were satisfied with the blepharoplasty and only 1 patient dissatisfied. The dis-satisfied patient was a man who complained about asymmetry of both upper eye-lid. He asked for a re-intervention to reduce the orbital fat pads and skin and was satisfied with the final result achieved.

Conclusion:

Good double eyelid fold creation is based on pulling force of the levator muscle and

adhesion force between tarsus and skin. Ptosis correction is always prior to double

eyelid fold creation, if patient has ptosis. With help of a syringe needle, double eyelid

fold creation will become simple, easy and effective.