Full-incision double-eyelid blepharoplasty with selective sensory nerve preservation
10.3760/cma.j.cn114453-20230330-00069
- VernacularTitle:保留上睑感觉神经分支的切开重睑术
- Author:
Xiaodong CHEN
1
;
Jinlong HUANG
;
Gang CHEN
;
Jinming WANG
Author Information
1. 南京中医药大学附属医院 江苏省中医院整形外科，南京 210029
- Keywords:
Blepharoplasty;
Hypesthesia;
Upper eyelid sensory nerve;
Numb
- From:
Chinese Journal of Plastic Surgery
2023;39(10):1082-1087
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To introduce a new surgical method that retains the sensory nerve branches of the upper eyelid to achieve a more physiological double eyelid effect.Methods:Data of patients in the Department of Plastic Surgery of Jiangsu Province Hospital of Chinese Medicine from March 2021 to February 2022, who underwent full-incision double-eyelid blepharoplasty with selective sensory nerve preservation were retrospectively analyzed. During the procedure, the skin and orbicularis oculi muscle were incised along the design line, the orbicularis oculi muscle was separated, and the pretarsal fascia layer was exposed. One or two oblique inward nerve branches could be seen on the medial side of the midline of the pupil, which were carefully dissected and preserved. The deep orbital septum was separated and part of the orbital septum fat was removed. Orbicularis oculi muscle-pretarsal fascia sutures were placed to form a natural double eyelid. Suture the skin without tension. Complications were followed up after operation. After 3 to 12 months of surgery, the tactile sensation of the corresponding areas above and below the double eyelid line was examined using the Semmens-Weinstein monofilament with light touch method. The tactile loss of the skin below the double eyelid line was evaluated and divided into three levels: no difference, mild difference, and significant difference. The patient’s satisfaction with the surgical outcome was evaluated and divided into four levels: very satisfied, satisfied, average, and dissatisfied.Results:A total of 79 patients (158 eyes) with double eyelid blepharoplasty were enrolled in the study. The follow-up time was 3-12 months, with an average follow-up time of 9.4 months. The upper eyelid sensation of 89.9% (142/158) was evaluated as "no difference", and 10.1% (16/158) was evaluated as "mild difference". No patient reported discomfort symptoms such as upper eyelid numbness or sensory abnormalities. Two patients had slight asymmetry. One patient developed a hematoma, which was self-absorbed two weeks later with mild asymmetry of double eyelids. One patient had a hypertrophic scar, which was treated with an external application of silicone gel combined with laser therapy. The patients recovered 9 months after surgery.Conclusion:Full-incision double eyelid blepharoplasty with the preservation of the upper eyelid sensory nerve branch is a new operation with a natural effect, retaining the skin sensation below the double eyelid line, reducing postoperative complications and recovery period.
