Double eyelid surgery is medically termed "blepharoplasty." The two most common surgical techniques are the suture method and the incision method.
1. Suture Method. This technique is generally suitable only for individuals with thin upper eyelid skin and no skin laxity or fat protrusion. It involves no skin incision; instead, sutures are used to ligate and bind the tarsal plate to the subcutaneous tissue, creating the double eyelid crease.Its advantages include quick recovery and no visible surgical scars. However, over time, the sutures may loosen or the tissue may be resorbed, potentially causing the crease to fade or disappear. Wu Sufan, Plastic Surgery Department, Zhejiang Provincial People's Hospital
2. Incision Method.The incision method is suitable for all types of monolids, particularly for patients with puffy upper eyelids and loose skin. It can also be used to correct unsatisfactory buried suture procedures. This technique involves making an incision in the skin, removing part of the orbicularis oculi muscle, eliminating puffy fat, and suturing the skin to the tarsal plate. Sutures are removed 5-7 days post-surgery.Its advantages include perfect and long-lasting results. Disadvantages include a necessary recovery period and visible scarring from the surgical incision.
3. Three-Point Technique. An improved version of the incision method is the "Three-Point" double eyelid surgery. It achieves double eyelid effects through three shorter incisions, offering the lasting results of the incision method without leaving noticeable scars.
4. Upper Eyelid Rejuvenation Surgery. As skin ages and sags, the outer corners of the eyes may droop downward, sometimes resulting in a pronounced "triangular eye" appearance. In such cases, double eyelid surgery can remove excess skin and lift sagging tissue to restore a more youthful look.
Epikanthoplasty
Epikanthus is a characteristic of Mongoloid eyes, appearing as a small crescent-shaped fold of skin extending from the upper to lower eyelid at the inner canthus.The standard facial proportion is "three stops and five eyes," meaning the face width equals five eye widths, and the distance between the eyes equals one eye width. Individuals with epicanthal folds have their inner eye corners obscured by the fold, making the eyes appear smaller and the eye distance wider. This creates an imbalance, giving the impression of a broad nasal bridge and widely spaced eyes.Therefore, correcting epicanthal folds during double eyelid surgery can make the eyes appear larger and more vibrant. It should be noted that epicanthal fold surgery may leave a slight scar at the inner canthus.
Eyelid Bag Correction Surgery
Eyelid bag correction surgery primarily involves two approaches: internal incision and external incision, each suited for different types of eyelid bags.
1. Internal incision surgery is suitable for younger patients with minimal skin laxity and minimal orbicularis oculi muscle relaxation. It involves removing orbital fat through a small incision in the conjunctiva, offering quick recovery and no visible scarring on the eyelid skin. Its advantage is the absence of external incisions and scarring. The disadvantage is its inability to remove excess skin or tighten the muscle.
2. External incision blepharoplasty involves making an incision 1–2mm below the lash line, parallel to the eyelid margin. This procedure removes protruding orbital fat, tightens lax orbicularis oculi muscle, and excises excess skin. Post-healing, the lower eyelid appears smoother with reduced wrinkles and minimal scarring.Its advantage lies in simultaneously addressing skin, muscle, and fat laxity. The disadvantage is that it leaves visible surgical marks on the skin.
Ptosis
Ptosis refers to an inability to fully open the eyes, where the upper eyelid's tarsal plate covers more than 3mm of the corneal upper margin. This gives a tired appearance and, in severe cases, impairs normal daily functioning.
Multiple surgical approaches exist for correcting ptosis, primarily categorized into three types: levator muscle shortening, tarsal plate suspension, and forehead muscle suspension.
1. Levator muscle shortening surgery aligns well with physiological and aesthetic requirements but is only suitable for patients with preserved levator function;
2. Suspension techniques involve anchoring the upper eyelid to the deep fascia or periosteum of the forehead using sutures, fascia, or PTFE strips to facilitate eye opening.
3. Frontalis muscle-based procedures involve transposing a segment of the frontalis muscle above the eye and fixing it to the tarsal plate. When the frontalis muscle contracts (raising the eyebrow), it pulls the tarsal plate upward, opening the eye. This method is suitable for patients with severe levator aponeurosis dysfunction.
The specific technique selected depends on individual circumstances. A thorough preoperative examination is essential to determine the appropriate surgical approach based on the degree of ptosis, levator muscle function, and the presence of conditions like myasthenia gravis.
What Preparations Are Needed Before Eye Surgery?
1. Preoperative blood tests: Complete blood count (CBC) and rapid hepatitis B surface antigen (HBsAg) screening. 2. Women should avoid scheduling surgery during menstruation. 3. Discontinue anticoagulants like aspirin or warfarin at least 2 weeks prior. 4. Bring sunglasses for postoperative eye protection.
How should I care for myself after eye surgery?
1. Keep the wound clean to prevent infection. If scabs or discharge form on the wound post-surgery, gently wipe with sterile saline or eye drops.
2. Avoid external impacts to the eyes, strenuous exercise, or forceful breath-holding that could cause bleeding or bruising at the wound site.
3. Take oral antibiotics for 3-5 days.
4. Apply cold compresses for the first 48 hours post-surgery, then switch to warm compresses thereafter to promote faster swelling and bruise reduction.
3. Take oral antibiotics for 3-5 days.
4. Apply cold compresses for the first 48 hours post-surgery, then switch to warm compresses thereafter. This helps reduce swelling and bruising more quickly. When resting in bed, elevate your head with pillows to prevent excessive swelling due to a low head position.
5. Avoid smoking, alcohol, and spicy or irritating foods post-surgery.
6. Sutures are removed one week post-surgery; the wound may be exposed to water 24 hours after suture removal.
7. Apply pressure dressing to the eye area for 48 hours after eyelid surgery. Avoid bending over, squatting, or holding your breath for one week to prevent orbital bleeding.