Double eyelid plasty, also known as double eyelid surgery, is widely used in the field of cosmetic surgery in China. Especially among young women, girls with single eyelids gradually seek the help of this technology to change their eye shape. By 2024, as people's awareness of plastic surgery continues to improve, more and more high school students and college students will choose this surgery.
The creation of double eyelid mainly adopts two methods: incision and embedding. The incision method involves cutting the upper eyelid skin according to the design line, removing part of the orbicularis oculi muscle and orbital septum fat in front of the tarsal plate, and then suturing again. The double eyelid formed by this method is stable and in good shape, but the upper eyelid edema is obvious after surgery, and the scar on the incision line is easy to be detected. The embedding principle is different. It embeds the suture under the skin of the upper eyelid, and uses the fixation of the suture and the resulting tissue reaction to make the upper eyelid skin adhere to the levator aponeurosis, thus forming the double eyelid. After this method, the upper eyelid is detumescent quickly without leaving scars, but the double eyelid formed is not lasting.
Nowadays, young women, especially students, expect that the double eyelid plasty can recover to its natural state in a short time after surgery, and the double eyelid is not easy to be detected. They tend to choose the embedding method. However, it is worth noting that the catgut embedding method is more suitable for those with thin eyelid skin and large eyelids. The eyelid skin and orbicularis oculi muscle in front of tarsal plate of most single eyelid patients in China are relatively hypertrophic, and there is also the problem of orbital septum fat prolapse. This leads to the double eyelid formed by burying thread method may be thick, lacking sense of hierarchy, and the double eyelid line is shallow and easy to disappear. After catgut embedding in beauty salons, many people will lose double eyelids or become dissatisfied with the shape after a certain period of time, and then need another operation.
In view of this situation, we innovatively adopted a small incision on the outer canthus for minimally invasive eyelid plasty by combining the advantages of incision method and catgut embedding method in practice. This method not only shortened the postoperative edema period and accelerated the recovery rate, but also formed a natural and lasting double eyelid effect. During the operation, we pay special attention to the treatment of the hypertrophic tissue of the lateral canthus, because this is the key to the formation of a stable eyelid. The specific operation is to cut a skin of about 0.5 cm at the outer canthus of the double eyelid design line, and remove the orbicularis oculi anterior tarsus muscle under the incision with ophthalmic scissors. For the anterior tarsal muscles in the inner canthus area, we used the method of sneaking separation to partially remove them. At the same time, open the orbital septum at the upper edge of the incision, remove the prolapsed fat, and then suture the incision. During the suture process, we pay special attention to hanging and fixing with the front fascia of the tarsal plate, and rely on the fixation of the outer canthal incision skin to form the fold line of the double eyelid.
One of the advantages of this method is that it can effectively avoid the generation of incision scar in the formation of lasting double fold lines. Since the operation uses a small incision in the lateral canthus, the healing is almost undetected. Since the upper eyelid skin is not completely cut, it does not affect the local tissue fluid return, and the postoperative edema is not obvious, it usually only takes 3 days to return to normal life. The extra muscle and fat in front of the tarsal plate were removed during the operation, and the shape of the formed double eyelids was natural and smooth, and the effect was lasting.
In general, this kind of lateral canthus small incision minimally invasive double eyelid plasty is suitable for young single eyelid patients with mild to moderate upper eyelid hypertrophy and no skin laxity. For those who need to remove the skin and upper eyelid with severe tissue hypertrophy of the single eyelid, the incision method of double eyelid plasty is still a more appropriate choice. No matter which method is selected, the key lies in the professional skills of doctors and the reasonable expectations of patients.
