Upper lid blepharoplasty is the most common cosmetic surgery for Asians. Excellent blepharoplasty requires surgeons to be familiar with upper eyelid anatomy and skilled in techniques. The formation mechanism of double eyelid folds has undergone many changes. With the deepening of research on biomimetic double eyelid surgery, various innovative and improved blepharoplasty techniques have emerged one after another. This article retrospectively analyzes various double eyelid incision techniques used by domestic scholars to study the theoretical basis and surgical methods of biomimetic double eyelid formation. It also provides a summary of upper eyelid anatomy, double eyelid aesthetic evaluation, double eyelid formation theory, and surgical methods.

Upper lid blepharoplasty is the most common cosmetic surgery for Asians. Excellent blepharoplasty requires surgeons to be familiar with upper eyelid anatomy and skilled in techniques. The formation mechanism of double eyelid folds has undergone many changes. With the deepening of research on biomimetic double eyelid surgery, various innovative and improved blepharoplasty techniques have emerged one after another. This article retrospectively analyzes various double eyelid incision techniques used by domestic scholars to study the theoretical basis and surgical methods of biomimetic double eyelid formation. It also provides a summary of upper eyelid anatomy, double eyelid aesthetic evaluation, double eyelid formation theory, and surgical methods.

Objective:To investigate the modified application of orbicularis oculi muscle-levator aponeurosis composite tissue flap fixation technique (modified Park method) in double-eyelid surgery.Methods:From June 2019 to March 2021, 823 patients included 92 males and 731 females, aged from 18 to 45 years with mean (31.4±7.9) years, in which 142 patients with slightly ptosis were selected to receive the treatment in the Department of Plastic Surgery of the Affiliated Hospital of Nangjing University of TCM. The symmetry of bilateral double eyelids after operation was evaluated by the third party. The marginal reflex distance (MRD1) was measured before and 6 months after operation, and the difference between preoperative and postoperative MRD1 (ΔMRD1) was calculated. And the postoperative complications were counted. The patients were followed up from 6 to 12 months after surgery to evaluate the long-term results.Results:The patients were followed up for 4-22 months (mean 10 months) after operation. And the incisions of all the 823 cases had primary healling. Most patients had smooth upper eyelid crease, upturned lashes and dynamic fold. The skin tended to spread evenly without dimple. The symmetry evaluation by the third party showed that there were 764 patients with symmetry and basic symmetry after operation, the symmetry rate was 92.8%; 59 patients with asymmetry, the asymmetry rate was 7.2%. The data of MRD1 increased significantly 6 months after operation, from (3.25±0.72) mm to (3.64±0.61) mm, and the ΔMRD1 was (0.38±0.76) mm ( t=-20.41, P<0.05). The difference between the two groups was statistically significant. The double eyelid line became shallow in 8 cases and disappeared completely in 3 cases. The double eyelid curve of the patients was natural and smooth after the operation. And there was no obvious sunken scar and pretarsal fullness. Conclusions:The " modified Park technique" blepharoplasty can obtain a more firm, symmetrical and natural appearance. And the mild ptosis could be corrected by this method. The anatomical structure can be identified clearly, and the surgical results are highly repeatable. It is worth promoting.

Objective:To investigate the cosmetic effect of biplane fixed technique for double-eyelid plasty.Methods:From September 2019 to June 2021, 80 patients, including 6 males and 74 females, aged 18-45 years with an average age of 31 years, were treated with single eyelid cosmetic surgery at the Medical Aesthetics Department of Northern Jiangsu People′s Hospital Affiliated to Yangzhou University. All the cases were performed by the " biplane fixed technique", and the key point of the surgery was to fix the orbicularis labii muscle in biplane (hard fixation plus soft suspension). A questionnaire survey was conducted and preoperative and postoperative photos were collected for statistical analysis to evaluate postoperative outcomes. The patients were follow up for 6-12 months after surgery, and the incidence of postoperative complications were calculated.Results:The incisions of 80 patients all healed by first intention. 79 patients were satisfied, accounting for 98.75%. Physicians evaluated 78 cases as satisfactory, accounting for 97.50%. The Vancouver Scar Scale score was 2.31±1.80, and the Edema and Eczema Visual Simulation Scale score was 3.58±2.15. After surgery, there were no significant abnormalities when eyes opening or closing, and the shape of the double eyelid remained intact without shedding. The scar on the closed eye incision was mild and there was no obvious depression.Conclusions:The " biplane fixed technique" blepharoplasty can form a firm double eyelid line, which is not easy to fall off and has slight scars. The postoperative effect is stable and worthy of clinical application.

Objective:To observe the efficacy of cosmetic suturing techniques combined with topical recombinant human basic fibroblast growth factor (rh-bFGF) in repairing facial trauma.Methods:A prospective study was conducted on 140 patients with facial trauma admitted to the Department of Burn and Plastic Surgery, Northern Jiangsu People＇s Hospital from January to December 2022. Patients were divided into two groups based on different treatment methods using a random number table method: treatment group (70 cases), including 38 males and 32 females aged 3 to 54 (23.1±8.2) years, received cosmetic suturing techniques combined with topical rh-bFGF for wound repair; control group (70 cases), including 36 males and 34 females aged 2 to 49 (22.3±7.5) years, only received cosmetic suturing techniques for wound repair. Patients were followed up 2 weeks post-surgery to evaluate wound healing quality. Patient satisfaction was assessed using the visual analogue scale (VAS). Six months post-surgery, scar conditions were evaluated using the Vancouver scar scale (VSS).Results:In the treatment group, 65 cases were directly sutured, and 5 cases were repaired with skin flaps, with a first-class healing rate of 100% (70/70). In the control group, 66 cases were directly sutured, and 4 cases were repaired with skin flaps, with a first-class healing rate of 91.4% (64/70). The first-class healing rate in the treatment group was higher than that in the control group, with a statistically significant difference ( P=0.037). Two weeks post-surgery, the VAS score for surgical satisfaction in the treatment group was (1.13±0.52) scores, which was lower than that in the control group (2.56±1.32) scores, with a statistically significant difference ( P<0.001). Six months post-surgery, the VSS score for the treatment group was (2.49±1.27) scores, which was lower than that in the control group (4.67±1.93) scores, with a statistically significant difference ( P<0.001). Conclusions:In repairing facial trauma, the combination of cosmetic suturing techniques and topical rh-bFGF can improve wound healing quality, reduce wound scarring, and enhance patient satisfaction with surgery.