A double eyelid plasty is performed by an incision technique or a nonincision technique, the latter comprising a stitch method and a buried suture method. With this surgery, an appropriate design and operative technique must be selected into careful consideration of patient's desire and eyelid condition. Patients were classified into four groups according to age and upper eyelid condition and got double eyelid plasty, modified techniques based on the Shirakabe's bead stitch method by each group. From above mentioned techniques, authors obtained a relatively successful result, so authors would like to report the outcome of the modified surgery methods. In this study, bead stitch method was performed in 405 patients(402 females, 3 males, average 31.2 years) from January to December of 2001. The follow up period ranged from one month to four years. Preoperatively, considering the patient's age, skin laxity of the upper eyelid and quantity of periorbital fat, patients was divided into four groups. For the bead stitch method, the eyelid is everted by raising the eyelash, and No. 2 braided white silk suture 16 cm in length is thrust from the two third of upper tarsal rim on the conjunctival side to the anticipated point on the skin side by using No. 5 round needle. The other end of the suture is guided out at a 4 to 5 mm distance from that point in a similar manner, such a procedure is usually carried out six to seven times for each eye. Simultaneously, if necessary, defattimg, skin undermining and upper blepharoplasty was also performed. Most of our patients were satisfied except thirteen cases with minor complications(mild asymmetry: 7 cases, sunken eye: 3 cases and high fold: 3 cases). But, the post operative palpabral swelling is comparatively strong. In conclusion, Some of the positive aspects were the followings: Lowering the chance getting an infection from stitches, the prevention of loosening by the scars forming double eyelids, and the development of natural double eyelids coming from the even pressure on the upper eyelids by the glass beads. Moreover, the new method improves, by combining the bead stitch method with the blepharoplasty, the prior incision method, which was difficult to apply to eyelids with excessive skin, therefore being able to expect more successful results from all age groups.
Blepharoplasty ; Cicatrix ; Eyelids ; Female ; Follow-Up Studies ; Glass ; Humans ; Male ; Needles ; Silk ; Skin ; Sutures

Double eyelidplasty is one of the most common esthetic surgical procedures in Asia. However the incidence of complications is not rare, even by the hands of much experienced plastic surgeons. The most common serious complication is high fold, deep fold or ectropion, triple fold, ptosis and retraction. These occur single or complexed. The proper time of secondary revision is usually accepted at least 6 months after primary operation. It means that revision should be delayed until wound maturation. However when the complications are too severe for patient to manage his or her normal life, early revision should be taken into consideration. Moreover early revision can get better result in certain cases especially such as ptosis and retraction. A total 23 patients were treated early revisions between December 2004 and June 2006. All of the patients had their initial surgery done at another hospital or clinic. Early revsion was performed differently according to the various problems. Dissection was carried out with two forceps traction each other. Metzem was not used. Previous adhesion was detached also with two forceps and high fixation was lowed. And in ptosis and retracction cases, levator advancement was adjusted according to the eye fissue size. The successful early correction of complicated double eyelidplasty could be accomplished by accurate identification of the problem based on established surgical principles.
Asia ; Blepharoplasty* ; Ectropion ; Hand ; Humans ; Incidence ; Surgical Instruments ; Traction ; Wounds and Injuries

The authors found that the results of severe epicanthal fold were excellent after repairing the transposition of the flap and transnasal wiring of the medial canthal tendon. Instead of using the flap transposition and transnasal wiring, we made a 4mm horizontal incision at the epicanthal region and shortened the medial canthal tendon in conjunction with double fold operation of 9 females aging from 16 to 29 (average, 20.6). Ten minutes after the injection of 1% lidocaine-1 : 100,000 epinephrine, an incision was made. Dissection of the medial canthal tendon was made in a careful and intensive manner in order to avoid injuring the angular artery. After full skeletonization of the tendon, an average of 4-6 mm of the tendon was resected and sutured with 4-0 clear nylon. Skin was sewed with two layers of 6-0 nylon. Steri-strips were applied to the wounds for a period of three months. Photogrammetric analysis of three proportional indices was carried out 6-19 months (average 6.04 months) after the surgery with the use of Photoshop. The proportional indices had intercanthal distance x 100/palpebral fissure width, and upper and lower interepicanthal distance x 100/palpebral fissure width. Postoperative proportional indices of the three levels were decreased statistically: from 159 to 150 at the medial canthus; from 168 to 164 at lower epicanthus; and from 195 to 181 at upper epicanthus. However, these indices increased slightly with time: from 143 to 150 at the medial canthus; from 152 to 164 at lower epicanthus; and from 160 to 181 at upper epicanthus. The resultant scar was short and inconspicuous except for one case which had revealed a white color. A short horizontal incision and shortening of the medial canthal tendon are supposed to be effective techniques to reduce the epicanthal fold, but not a way to completely eliminate the fold with minimal scar. The reason to why the results appeared to worsen with time was probably due to the relapse at the tendon repair. Therefore, over-resection and rigid fixation of the tendon would overcome the relaps
Aging ; Arteries ; Cicatrix ; Epinephrine ; Female ; Humans ; Nylons ; Recurrence ; Skeleton ; Skin ; Tendons* ; Wounds and Injuries

Epicanthoplasty with or without double-eyelid operation is one of the most commonly performed aesthetic procedure in Korea. Although many techniques have been described for the elimination of epicanthal folds, scarring and complexity in design are still barriers for surgeons to overcome. Epicanthoplasty using Hiraga's method was used to minimize these problems. From September of 1996 to July of 2002, the authors performed epicanthoplasty using Hiraga's method on the eyelids of 117 Asian patients to correct epicanthal folds. Results were satisfactory in almost all patients, with no significant complications. Scarring was acceptable. Mean reduction of intercanthal distance was 3.7 mm and mean operation time was within 10 minutes. Hiraga's method is most effective in patients with mild to moderate epicanthal fold. The advantages of this procedure are simplicity in design and short operation time. Most of all, it's technically simple and easy to perform.
Asian Continental Ancestry Group ; Cicatrix ; Eyelids ; Humans ; Korea

The medical epicanthal folds on eyelids is one of the unique features of Asians. Epicanthoplasty enhances the aesthetic results of eyelid surgery by lengthening the palpebral fissure and producing the image of a larger, more open eye. Many authors described surgical procedures for correction of epicanthal folds. But most of them leave additional scars. We used to use Hiraga's method for correcting the epicanthal folds. Hiraga's epicanthoplasty is simple and practicable method. However, Hiraga's method has the disadvantage of making vertical scar on the nasal side of the lower eyelid. To overcome this disadvantage, we transposed the incision line to be paralleled with the margin of lower eyelid. We presented here a simple epicanthoplasty with minimal scar based on modified Hiraga's method with 24 cases performed during the past 3 years. A double fold operation and ptosis correction was performed along with epicanthoplasty in 18 cases and a epicanthoplasty without a double fold operation was performed in the remaining 6 cases. The follow-up period ranged from six months to two years. The results, with the exception of one case of hypertrophic scarring and one case of undercorrection, were all satisfactory. The advantages of our procedure are simplicity in design and the minimal scarring produced in the medial canthal area compared with a Hiraga's method or complex W-plasty, Z-plasty, or half Z-plasty requiring multiple incisions and often creating unsightly scarring on the medial side of lower lid. This method can be one of the effective procedures for correcting the Asian epicanthal fold because of avoiding potential visible scar on the lower lid.
Asian Continental Ancestry Group ; Cicatrix ; Cicatrix, Hypertrophic ; Eyelids ; Follow-Up Studies ; Humans

No Abstracts Available.

Visible scar is the most annoying problem in the surgical procedure to eliminate the medial epicanthal fold, which is a predominant feature among the Asian population. Many surgical techniques have been introduced since the early decades of the 20th century, but the scar problem still has been remained unsolved. If all the skin incision lines were located along the muco-cutaneous junctions and just below the eyelashes, resulting scars could be nearly invisible after 3 or 6 months postoperatively. I think periciliary epicanthoplasty will be the appropriate method to realize this concept perfectlly. From January 2002 to August 2006, 427 patients with medial epicanthal folds underwent epicanthoplasty using a periciliary Y-V advancement procedure in my office and most results have been proved scar free and natural. Surgical design of this procedure is very simple and acceptable to any type of epicanthal folds. Based on my own experiences I would like to offer some tip offs in performing this procedure together with surgical techniques and guidelines.
Asian Continental Ancestry Group ; Cicatrix ; Eyelashes ; Humans ; Skin

Non incisional blepharoplasty, so called buried double fold operation in Asia, although a common procedure, has a some complications such as inclusion cyst or granuloma or loss of crease. To obviate this problem, we tried to modify existing suture method. Three sutures(medial, middle, lateral) were located on the skin crease site as superficial as possible to anchor the dermis for secure fixation, and we've located suture knot on the orbicularis oculi muscle as deep as possible. Between January 2001 and February 2004, 162 patients were operated with these procedure by one surgeon, we could trace 63 patients for postoperative follow-up, there were no postoperative findings of inclusion cyst or granuloma or loss of fold crease except 1 case of short crease. This simple suture operation could be one of useful non-incisional methods for Asian blepharoplasty.
Asia ; Asian Continental Ancestry Group ; Blepharoplasty ; Dermis ; Follow-Up Studies ; Granuloma ; Humans ; Skin ; Sutures

The amount of the soft tissue of upper eyelids is aesthetically important. The soft tissue of thick eyelids need to be removed, whereas the sunken eyelids need to be augmented. The sunken eyelids make someone look older and more tired. The aesthetical use of the autologous fat has been advocated for tissue augmentation for over a century and microfat graft is a popular procedure to augment the soft tissue. We had corrected the sunken eyelids of 11 patients without any history of aesthetical surgery or trauma of upper eyelids using autologous microfat graft. The fat had been harvested from periumbilical area, centrifuged at 3000rpm for 3 minutes. The middle fat tissue layer was obtained using 1cc syringe and injected in the upper eyelids. All procedures were performed under local anesthesia. There were no major complications except undercorrection in two cases. Though survival rate of injected microfat is variable, it is predictable in upper eyelid compare to other areas. As a result, autologous microfat graft should be considered as a good choice for correction of sunken eyelids.
Anesthesia, Local ; Eyelids* ; Humans ; Survival Rate ; Syringes ; Transplants*

Beauty make up in order to stimulate the appearance and express the identity has become a commonly performed cosmetic procedure. Recently developed permanent make up is the introduction of micropigment into the dermis. The pigmenting procedure is achieved by a single or triple needle coated with pigment, moving rapidly in a reciprocating fashion. It maintains cosmetic effect about 5 years. Contrary to old fashioned tattooing, micropigmentation produces various color and gradually the color is faded. So, after several years when the pigmentation color is faded, a patient can cope with new fashion. We introduce micropigmentation method in eyebrow and eyelashes. From september 2002 to 2005, a total 132 patients(4 men and 128 women) had been treated with micropigmentation. We have had 132 cases of scanty eyebrows, 68 cases of thin eyelashes. After 24 months follow-up period, we achieved satisfactory results.
Beauty ; Dermis ; Eyebrows ; Eyelashes ; Follow-Up Studies ; Humans ; Male ; Needles ; Pigmentation ; Tattooing