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Surgical Correction for Pediatric Epiblepharon and Trichiasis
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High Double Eyelid Fold Correction Using Wide Dual-Plane Dissection.

Kenneth K Kim1, Woo-Seok Kim, Se Kwang Oh

  • 1From the *Division of Plastic and Reconstructive Surgery, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA; †Department of Energy and Electrical Engineering, Korea Polytechnic University, Siheung; and ‡Ohkims Plastic Surgical Clinic, Ilsan, South Korea.

Annals of Plastic Surgery
|October 15, 2016
PubMed
Summary

This study presents a new surgical technique to lower high and deep double eyelid folds, even without excess upper eyelid skin. The procedure successfully corrected fold height and minimized visible scarring for improved aesthetic outcomes.

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Area of Science:

  • Ophthalmic Plastic Surgery
  • Aesthetic Surgery
  • Eyelid Surgery

Background:

  • Correcting high and deep double eyelid folds is challenging due to limited skin and prior scarring.
  • Existing methods often struggle with cases lacking redundant upper eyelid skin.

Purpose of the Study:

  • To evaluate a novel fold-lowering surgical procedure for correcting high and deep double eyelid folds.
  • To assess the efficacy of a wide double-layer dissection technique in improving eyelid aesthetics.

Main Methods:

  • A cohort of 256 patients with high/deep double eyelid folds underwent a two-layer dissection technique.
  • Dissection involved superficial and deep planes to release the prior fold.
  • The lower flap was secured to achieve normal skin tension and lower fold height.

Main Results:

  • The technique successfully converted unnatural high/deep folds to lower, nondepressed folds.
  • Postoperative scars were minimally visible upon close examination.
  • Complications included asymmetry (10 cases), persistent folds (5 cases), and need for further skin excision (25 cases).

Conclusions:

  • A wide double-layer dissection effectively lowers high double eyelid folds.
  • This method is successful even when redundant upper eyelid skin is absent.