Correction of High Fold without Skin Excision

피부 제거 없이 시행한 높은 쌍꺼풀의 교정

  • Oh, Heung Chan (Department of Plastic and Reconstructive Surgery, School of Medicine, Pusan National University) ;
  • Yoon, Dong Ju (Yoon's Plastic Surgery Clinic) ;
  • Kang, Cheol Uk (Department of Plastic and Reconstructive Surgery, School of Medicine, Pusan National University) ;
  • Choi, Chi Won (Department of Plastic and Reconstructive Surgery, School of Medicine, Pusan National University) ;
  • Choi, Soo Jong (Department of Plastic and Reconstructive Surgery, School of Medicine, Pusan National University) ;
  • Bae, Yong Chan (Department of Plastic and Reconstructive Surgery, School of Medicine, Pusan National University)
  • 오흥찬 (부산대학교 의학전문대학원 성형외과학교실) ;
  • 윤동주 (윤동주 성형외과) ;
  • 강철욱 (부산대학교 의학전문대학원 성형외과학교실) ;
  • 최치원 (부산대학교 의학전문대학원 성형외과학교실) ;
  • 최수종 (부산대학교 의학전문대학원 성형외과학교실) ;
  • 배용찬 (부산대학교 의학전문대학원 성형외과학교실)
  • Published : 2009.09.15

Abstract

Purpose: Double - eyelid operation is one of the most common cosmetic operations among Korean patients. In such operations, however, the complexity of and individual differences in the patients' anatomical structures may cause various complications, such as asymmetry, retraction of the eyelid, and the occurrence of a high fold. A high fold occurs frequently, and its correction is not very simple. Many methods have been developed to correct it, and among these, the operation involving the excision of the skin between the previous double - eyelid line and the new double - eyelid line is usually selected by plastic surgeons. In many cases, however, patients have insufficient eyelid skins for this operation. In this study, the authors introduce an operation procedure for high - fold correction that does not involve skin excision Methods: From June 2005 to June 2009, 246 cases were treated with this procedure. After the incision of the new double - eyelid line, dissection was done between the previous scar tissue and the levator aponeurosis. Then the orbital septum, orbital fat or the retro - orbicularis oculi fat was slid down and sutured with a tarsal plate. Such sutures were repeated at four to five points, including the lateral and medial limbus, to prevent the reattachment of the previous scar and to create a new double - eyelid line at the end of the orbital septum. Results: Most of the high - fold patients were satisfied with the procedure described above. Their previous scar was hidden under the new double - eyelid line after the operation. In the six cases, the scar was visible in the patients who had a very high and deep inner line. As such, scar revision was undertaken three months after the operation. It is known that scar revision is also required after an operation involving skin excision in the case of a very high inner - eyelid line. Conclusion: This method is an appropriative procedure for high - fold correction for patients who have insufficient upper - eyelid skin.

Keywords

References

  1. Weng CJ, Noordhoff MS: Complications of oriental blepharoplasty. Plast Reconstr Surg 83: 622, 1989 https://doi.org/10.1097/00006534-198904000-00005
  2. Seo MS, Hwang K: Double fold found in portraits of Korean women: analysis of 2001, 1990, 1982 grand art exhibitions of Korea. J Korean Soc Aesth Plast Surg 8: 13, 2002
  3. Cho IC: Early revision of unfavorable upper blepharoplasty. J Korean Soc Aesth Plast Surg 12: 119, 2006
  4. Kim YW, Park HJ, Kim S: Secondary correction of unsatisfactory blepharoplasty: removing multilaminated septal structures and grafting of preaponeurotic fat. Plast Reconstr Surg 106: 1399, 2000 https://doi.org/10.1097/00006534-200011000-00030
  5. Lee Y, Kwon S, Hwang K: Correction of sunken and/or multiply folded upper eyelid by fascia-fat graft. Plast Reconstr Surg 107: 15, 2001 https://doi.org/10.1097/00006534-200101000-00003
  6. Kim BG, Youn DY: Management of adhesion using a pretarsal fibromuscular flap or graft in secondary blepharoplasty. Plast Reconstr Surg 117: 782, 2006 https://doi.org/10.1097/01.prs.0000200064.40520.0b
  7. Kim YW, Park HJ, Kim S: Revision of unfavorable double eyelid operation by repositioning of preaponeurotic fat. J Korean Soc Plast Reconstr Surg 27: 99, 2000
  8. Chen WP: The concept of a glide zone as it relates to upper lid crease, lid fold, and application in upper blepharoplasty. Plast Reconstr Surg 119: 379, 2007 https://doi.org/10.1097/01.prs.0000244908.04694.32