Blepharoplasty through palpebral margin incision with preservation of the pretarsal orbicularis oculi muscle
10.3760/cma.j.cn114453-20231222-00272
- VernacularTitle:保留睑板前眼轮匝肌睑缘切口内固定法重睑术的临床应用
- Author:
Huiling MA
1
;
Xiuxiu CAI
;
Jiaojiao ZHANG
Author Information
1. 长沙爱思特医疗美容医院整形美容外科，长沙 410000
- Keywords:
Blepharoplasty;
Pretarsal orbicularis oculi muscle;
Double eyelid plasty;
Palpebral margin incision
- From:
Chinese Journal of Plastic Surgery
2024;40(5):537-544
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To modify the blepharoplasty through palpebral margin incision with preservaton of the pretarsal orbicularis oculi muscle, and to discuss the clinical application effects.Methods:The clinical data of patients who underwent double-eyelid blepharoplasty through palpebral margin incision with preservation of the pretarsal orbicularis oculi muscle were retrospectively analyzed from August 2021 to August 2023 in Changsha Aist Medical Cosmetology Hospital. After the skin peeling rang was designed, the skin was removed, tissue was separated under the orbicularis oculi muscle. The pretarsal orbicularis oculi muscle was thinned-shaped at the upper edge of tarsus as wedge-shaped, and was detached from the upper edge of tarsus. The pretarsal fascia or levator aponeurosis was fixed internally with the orbicularis oculi muscle at the position of the double-eyelid crease. After confirming the shape and symmetry of the double-eyelid, the skin was sutured. Incision healing, eyelid swelling and complications were observed, and double-eyelid morphology was followed up. Six months after surgery, the patients’ satisfaction with the surgical effect (satisfied, somewhat satisfied, dissatisfied) was investigated, and the upper eyelid scar status (including pigmentation, thickness, vascularity, and pliability) was scored using the Vancouver scar scale (VSS). The higher the score, the more serious the scar was.Results:A total of 78 patients with single eyelid or subtle double eyelid were included, including 6 males and 72 females, aged 18-40 years old. All the patients underwent modified double-eyelid blepharoplasty through palpebral margin incision with preservation of the pretarsal orbicularis oculi muscle, 29 patients underwent ptosis correction simultaneously, and 47 patients underwent epicanthus correction simultaneously. The incision healed by first intention after the operation. 78 cases were followed up for 1 to 6 months, and slight upper eyelid swelling was eliminated in 71 cases at 10-15 days and in 7 cases at 25-30 days. Among them, 61 cases were followed up for 6 months, the creases of double-eyelid was natural and smooth, bilateral basic symmetry, and there were no adverse manifestations such as double-eyelid shallowing and pretarsal tissue pilling, and no complications such as incompleted eye-closure. 57 cases were satisfied with the results and 4 cases were somewhat satisfied. The incision scar was not obvious when the eyes were closed in 61 patients. The VSS score was close to 0, and the average score of pigmentation, thickness, vascularity, and pliability were 0.29, 0, 0.31 and 0 points, respectively.Conclusion:This operation method preserves almost all the pretarsal orbicularis oculi muscle to promote the healling of lymph circulation. After the orbicularis oculi muscle is choosed for internal fixation, this more simple operation method can not only guarantee the efficacy of double-eyelid blepharoplasty through palpebral margin incision, but also accelerate the healling of the eyelid after surgery and reduce the incidence of incompleted eye-closure.
