Orbicularis-White Line Fixation in Asian Blepharoplasty: Kiss Technique

In recent years, because the formation mechanism of double eyelids in Asians is still controversial, many techniques for double-eyelid plasty have been developed. However, the removal of large amounts of pretarsal tissue and the obvious scars in those techniques make patients dissatisfied with the appearance. Thus, we have devised a novel surgical approach named the kiss technique. The method is to create a physiological double-eyelid fold on the basis of the formation mechanism of double-eyelid creases.

From January 2017 to March 2019, the novel blepharoplasty was performed on 386 Chinese patients (769 eyes) in our department. Patients were evaluated at 3-24 months after surgery. Instead of dividing the orbital septum all the way to the orbital margin both medially and laterally, all that is required is to dissect the pretarsal orbicularis oculi muscle inferiorly to the lower border of the tarsus and to incise the pretarsal extension of the aponeurosis to expose the white line. Then, the white line is sutured to the orbicularis oculi muscle. Finally, the skin incisions are sutured interruptedly, and a vivid fold is created.

The general satisfaction rate was 97.5%. The edema period for most patients ended within 2 weeks. The scars became unnoticeable after 3-6 months. Disappearance of the fold was not found in any case.

The kiss technique is a simple and effective method, which can not only create a natural double crease but also reduce the complications of double-eyelid surgery.

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