A new crease fixation technique for double eyelidplasty using mini-flaps derived from pretarsal levator tissues

Area of Science:

• Oculoplastic Surgery
• Aesthetic Surgery

Background:

• Traditional double eyelid surgery often involves levator insertion, leading to adhesion and potential scarring or depressions.
• Incision methods create supratarsal folds but can result in visible scars or depressions during downward gaze.

Purpose of the Study:

• To introduce a modified double eyelidplasty technique using eyelid mini-flaps.
• To evaluate the efficacy and aesthetic outcomes of this novel approach, focusing on scar reduction and natural fold creation.

Main Methods:

• Elevation of multiple comblike mini-flaps from upper eyelid pretarsal levator tissues.
• Anchoring flap bases to the tarsus and interposing distal flap portions into the orbicularis muscle for layer-by-layer repair.

Main Results:

• 522 double eyelidplasties performed with a mean follow-up of 26 months.
• Low rates of complications: 7 fold failures and 12 asymmetries (all revised).
• High patient satisfaction with natural palpebral folds and no visible scarring during downward gaze at 2 years.

Conclusions:

• A modified double eyelidplasty technique using pretarsal levator mini-flaps is presented.
• This method facilitates clean eyelid repair without disrupting tissue continuity.
• The procedure achieves double eyelid creation with minimal scar formation and improved aesthetic outcomes.