Double eyelid surgery by using palpebral marginal incision technique in Asians

Approximately 50% of Asians do not have upper eyelid creases. Full-incision methods may leave obvious scars and buried-suture methods cannot remove excess tissues to create a double eyelid. The new palpebral marginal incision technique masked the incision at the upper palpebral margin and removed the excess tissue, thereby achieving scarless and natural double eyelids.

The modified technique involved the incision site and positioning processes. The incision line is 1.0-1.5 mm above the palpebral margin. A strip of orbicularis muscle beneath the positioned double eyelid must be removed. The orbital septum is then exposed, and a certain amount of orbital fat is removed. Next, the dermis and tarsal plate are sutured in an orderly manner. Finally, a strip of the redundant skin located approximately 1-3 mm above the incision is excised to correct blepharochalasis before the skin is closed.

This new technique was performed in 212 patients including 56 patients with blepharochalasis who had their skin excised during the surgery. The follow-up period ranged from 6 months to 3 years. Ninety-five percent of the patients rated excellent and good and that they were satisfied with their surgery, and no significant complications occurred.

The following are the advantages of the authors' technique: (1) minimal or even no surgical scarring is discernible on the eyelids even when they are closed; (2) solves the problem of excessive tissue and correct blepharochalasis; and (3) the double eyelid fold is stable and natural for a long time.