Skip to main content
SpringerLink
Log in

Orbicularis-Tarsus Fixation Approach in Double-Eyelid Blepharoplasty: A Modification of Park’s Technique

  • Original Article
  • Oculoplastic
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Incisional double-eyelid blepharoplasty is widely applied because of its extensive indications and robust results. The orbicularis-levator fixation method is an incisional approach that provides stronger adhesion than traditional techniques. However, there remains the risk of postoperative relapse or suture spitting out.

Methods

The authors introduced a modified technique for supratarsal crease formation. When necessary soft tissue removal was completed, the orbicularis oculi muscle was anchored on the tarsus. Then the muscle edges near canthus were reattached to prevent muscle retraction. For skin closure, the skin-pretarsal fascia-skin maneuver was adopted to enhance cicatricial adhesion.

Results

Six hundred and fifty-nine patients underwent double eyelidplasty by the same surgeon using this modified technique. Patients were followed up from 2 to 38 months, with a mean period of 15 months. Short-term complications included mild edema, bruising or reddish change of the upper eyelid, yet all gradually relieved in 6–8 weeks. Fourteen cases of palpebral fold asymmetry and nine cases of unsatisfactory fold formation near the inner canthus were encountered, and all the defects had been well improved by revision surgeries. Ninety-five percent of the patients were satisfied with the long-term outcomes, which showed as natural and well-defined palpebral folds without scar hypertrophy, suture spitting out or crease depression. Besides, no supratarsal crease drooping or disappearing was observed 3 years postoperatively.

Conclusions

The authors introduced an orbicularis-tarsus fixation method for upper eyelid blepharoplasty. It is a reliable technique that enables high feasibility and long-lasting result, and with lower risk of suture spitting out.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13
Fig. 14

Similar content being viewed by others

References

  1. Hwang HS, Spiegel JH (2014) The effect of “single” vs “double” eyelids on the perceived attractiveness of Chinese women. Aesthet Surg J Am Soc Aesthet Plast Surg 34(3):374–382

    Article  Google Scholar 

  2. Zide BM (2006) Surgical anatomy around the orbit: the system of zone, 2nd edn. Lippincott Williams & Wilkins, Philadelphia

    Google Scholar 

  3. Mikamo M (1997) Mikamo’s double-eyelid operation: the advent of Japanese aesthetic surgery. Plast Reconstr Surg 99:662–667

    Article  Google Scholar 

  4. Song RY, Song YG (1985) Double eyelid operations. Aesthet Plast Surg 9:173–180

    Article  CAS  Google Scholar 

  5. Bang YH (1991) The double-eyelid operation without supratarsal fixation. Plast Reconstr Surg 88:12–17

    Article  CAS  Google Scholar 

  6. McCurdy JA Jr (2002) Upper blepharoplasty in the Asian patient: the “double eyelid” operation. Facial Plast Surg Clin N Am 10:351–368

    Article  Google Scholar 

  7. Choi Y, Eo S (2010) A new crease fixation technique for double eyelidplasty using mini-flaps derived from pretarsal levator tissues. Plast Reconstr Surg 126(3):1048–1057

    Article  CAS  Google Scholar 

  8. Moon KC, Yoon ES, Lee JM (2013) Modified double-eyelid blepharoplasty using the single-knot continuous buried non-incisional technique. Arch Plast Surg 40(4):409–413

    Article  Google Scholar 

  9. Li L, Ni B, Pan S, Lin Y (2014) Creating natural double eyelids with continuous buried suture and mini-incision technique using subcutaneous absorbable suture for patients with puffy eyelids. JAMA Facial Plast Surg 16(3):188–192

    Article  Google Scholar 

  10. Park JI (1999) Orbicularis-levator fixation in double-eyelid operation. Arch Facial Plast Surg 1(2):90–95

    Article  CAS  Google Scholar 

  11. Park JI, Park MS (2007) Double-eyelid operation: orbicularis oculi-levator aponeurosis fixation technique. Facial Plast Surg Clin N Am 15(3):315–326

    Article  Google Scholar 

  12. Nguyen MQ, Hsu PW, Dinh TA (2009) Asian blepharoplasty. Semin Plast Surg 23(3):185–197

    Article  Google Scholar 

  13. Pottier F, El-Shazly NZ, El-Shazly AE (2008) Aging of orbicularis oculi: anatomophysiologic consideration in upper blepharoplasty. Arch Facial Plast Surg 10(5):346–349

    Article  Google Scholar 

  14. Lee H, Park M, Lee J et al (2012) Histopathologic findings of the orbicularis oculi in upper eyelid aging. Arch Facial Plast Surg 14(4):253–257

    Article  Google Scholar 

  15. Lee JW, Baker SR (2013) Esthetic enhancements in upper blepharoplasty. Clin Plast Surg 40(1):139–146

    Article  Google Scholar 

  16. Gradinger GP (1988) Cosmetic upper blepharoplasty. Clin Plast Surg 15(2):289–297

    CAS  PubMed  Google Scholar 

  17. Rohrich RJ, Coberly DM, Fagien S et al (2004) Current concepts in aesthetic upper blepharoplasty. Plast Reconstr Surg 113(3):32e–42e

    Article  Google Scholar 

  18. Furnas DW (1981) The orbicularis oculi muscle. Management in blepharoplasty. Clin Plast Surg 8(4):687–715

    CAS  PubMed  Google Scholar 

  19. Presti P, Yalamanchili H, Honrado CP (2006) Rejuvenation of the aging upper third of the face. Facial Plast Surg 22(2):91–96

    Article  CAS  Google Scholar 

  20. Wu LW, Ye Z, Xu Y et al (2015) Orbicularis-levator-tarsus composite suture technique in double-eyelid operation. J Plast Reconstr Aesthet Surg 68(8):1079–1084

    Article  Google Scholar 

Download references

Funding

This work is supported by Teaching Reform Project of Peking Union Medical College (10023201504024).

Author information

Authors and Affiliations

  1. Plastic Surgery Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, No. 33 Ba-Da-Chu Road, Shi-Jing-Shan District, Beijing, 100144, China

    Weiyi Sun, Yongqian Wang, Tao Song, Di Wu, Haidong Li & Ningbei Yin

Authors
  1. Weiyi Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yongqian Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tao Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Di Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Haidong Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ningbei Yin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yongqian Wang.

Ethics declarations

Conflict of interest

The authors have no financial or conflicts of interest to disclose.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 2998 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sun, W., Wang, Y., Song, T. et al. Orbicularis-Tarsus Fixation Approach in Double-Eyelid Blepharoplasty: A Modification of Park’s Technique. Aesth Plast Surg 42, 1582–1590 (2018). https://doi.org/10.1007/s00266-018-1218-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00266-018-1218-7

Keywords

Search

Navigation