Individualized small-incision orbicularis-levator fixation blepharoplasty for unilateral single-eyelid Asians

Unilateral double-eyelid blepharoplasty is often required by people with unilateral single eyelid. The full incisional method may cause permanent skin scar formation, and the buried suture method may lead to early eyelid fold loosening, which could not reduce the soft tissue thickness of eyelid. A total of 85 patients (8 males and 77 females) with unilateral single eyelids were studied between January 2015 and January 2016, with a mean age of 25.57 ± 6.5 years. Small-incision orbicularis-levator fixation blepharoplasty was performed on all patients on the single eyelid side. During surgery, the orbicularis oculi (OO) muscle and the orbital fat (OF) were selectively removed through the small skin incisions. The thicknesses of upper eyelid were measured preoperatively and at 6 months postoperatively. The position and tension of the eyelid creases, eyelids symmetry, and satisfaction status were also evaluated. Eighty patients (10 left eyes and 70 right eyes) were followed up for 19 ± 3.4 months. Before surgery, the average thickness of OO muscle is 0.895 ± 0.199 mm (left) and 0.970 ± 0.185 mm (right) (P = 0.0127), the thickness of OF is 0.717 ± 0.154 mm (left) and 0.867 ± 0.143 mm (right) (P = 0.0187). Six months postsurgery, the average thickness of OO muscle is 0.894 ± 0.199 mm (left) and 0.907 ± 0.188 mm (right) (P = 0.293), the thickness of OF is 0.703 ± 0.143 mm (left) and 0.747 ± 0.0957 mm (right) (P = 0.534). In conclusion, small-incision orbicularis-levator fixation blepharoplasty can produce a desired aesthetic effect for unilateral single-eyelid patients as its personalized designing, symmetrical eyelid thickness, and slight skin scar formation.