• Korean Journal of Psychosomatic Medicine
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• v.2 no.1
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• pp.80-87
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• 1994

Objective : Cosmetic surgery, as a psychosocial intervention, is unique in that its foundation rests solely on the individual motivations, internal or external, of the patient We investigated the ego-identity in women who seek double eyelid operation, to understand one aspect of internal motivation for cosmetic surgery. Methods : Subjects of this study were 47 young women, visited to plastic surgery clinics in Kwangju from June 1993 to October 1993, and 58 women who did not want double eyelid operation were chosen as controls. Each subject's ego-identity was scored using Dignan's ego-identity scale. Results : The total and stability subscale's scores of ego-identity of double eyelid operation group were significantly lower than those of control group. Conclusion : More psychosocial research on the ego-identify of patients seeking double eyelid operation is required to understand the psychological motives for requesting surgery.

• Archives of Plastic Surgery
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• v.35 no.2
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• pp.187-192
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• 2008

Purpose: Generally speaking, most of Korean have smaller eyes than those of Caucasian and they have epicanthus with narrow palpebral fissure. It makes external appearance looking dull because the length of the palpebral fissure is short and there is a epicanthus. In case the function of the levator muscle is weak, their eyes look much smaller. Epicanthus and weak levator muscle function make the eyes look dull. The above mentioned, authors want to introduce double eyelid operation, epicanthoplasty, levator plication to extend and lengthen the palpebral fissure. Methods: From August 2001 to August 2004, there were 138 cases that had double eyelid operation with epicanthoplasty or levator plication. the 69 cases of them had double eyelid operation and epicanthoplasty, the 33 cases of them had double eyelid operation and levator plication and the 36 cases of them had double eyelid operation and epicanthoplasty and levator plication. Results: After the operation, the length and height of the eyelid are improved remarkably, and most of the patients were satisfied. The length of the eyelid is improved 3 to 5mm($3.4{\pm}0.5mm$) in case of the epicanthoplasty, the width of the eyelid is improved 3 to 4mm($3.1{\pm}0.3mm$) by the levator plication. The length of the eyelid is improved 3 to 5($3.4{\pm}0.4mm$) and the width is improved 2 to 4mm($2.9{\pm}0.5mm$) by the epicanthoplasty used levator plication. Conclusion: The improvement of the eyelid length is almost the same as epicanthoplasty and levator plication are done simultaneously. But the improvement of the eyelid width is less shorter when epicanthoplasty and levator plication are done simultaneously than the case of levator plication alone. This is because there is a tension influencing on the limitation of widening palpebral fissure to fix the epicanthal tendon. This method is recommendable for the patients who want to have much bigger eyes.

• Archives of Plastic Surgery
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• v.36 no.5
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• pp.649-653
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• 2009

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.

• Archives of Plastic Surgery
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• v.33 no.4
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• pp.449-453
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• 2006

Purpose: Perceiving the experience that $MRD_1$ is increased after small-incision double-eyelid operation, it has been statistically verified the improvement of $MRD_1$ retrospectively. Therefore, we suggest new interpretation for Korean-specific small eye and more definite classification for ptosis. Methods: In operation, we made 3 small incisions according to the line designed on upper eyelid and removed some soft tissues including connective tissues. Then, figure-of-8 continuous buried ligation was performed through the incision windows. This study is a retrospective study, measures $MRD_1$ changes and excursion distance change of eyelid margine and eyebrow using pre-and post-operative photos of 14 patients. Results: Postoperative photos were taken on the 4th day and all of 14 patients had an improvement in $MRD_1$ statistically. The excursion distance of upper eyelid was improved in half of patients, though not in the range of statistical verification. It was statistically confirmed that the movement of eyebrow was reduced after operation. Conclusion: It is thought that $MRD_1$ improvement without any operation on levator complex means that soft tissue including connective tissue eliminated in operation restricts the movement of upper eyelid. It is defined such factors as burden factors and such phenomenon as burdened eyelid. It is thougt that Korean's small eye is mainly burdened eyelid and cosmetic improvement may be obtaind even by removing such burden factors.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.2
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• pp.157-161
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• 2004

The eyes, the saying goes, are the windows of the soul. It's the first thing you notice about a person. Therefore, many people want to possess beautiful eyelids. Surgical formation of a palpebral fold and sulcus divides the lid into two well-defined segments (palpebral and pretarsal), producing the double eyelid desired by many Oriental women as well as an increasing number of man recently. Upper lid blepharoplasty is the Oriental eye is one of the variations of standard upper lid blepharoplasty. In Oriental double eyelid surgery, there have been two approaches to form a superior palpebral fold: the buried suture(nonincision) method and the full external incision method. Conventionally, the nonincision technique has been shown to produce little postoperative edema. However, the probability of the fold disappearing is high, and this technique cannot be performed in patients with fatty eyelids. Conversely, the incision technique has contrary characteristics. Recently, partial incision(or semi-open) technique which is combination of mentioned methods is used, this technique is removal of pretarsal tissue, muscle, and/or orbital fat around 2 or 3 incision site to facilitate tarsus-dermal adhesion. Our method is on the basis of this technique, furthermore, compared with conventional semi-open method, Y(Yang's) needle assisted double eyelid operation is more easy, convenient, saving-time method and provide satisfactory results.

• Archives of Plastic Surgery
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• v.32 no.3
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• pp.299-303
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• 2005

The epicanthal fold is common natural finding in Asian eyes. It is very common that patients, who look for oriental blephaloplasty for double eye lid, request correction epicanthal fold. It is very often difficult to achieve satisfactory results if the correction of the epicanthal fold is not corrected concomitantly. Many authors described surgical procedures for correction of epicanthal folds. But most of them leave additional scars which tend to be hypertrophic and noriceable. We achieved satisfactory result in epicanthoplasty with invisible scar, using combination of procedures, such as upward incision, double eyelid operation, anchoring suture of the medial upper lid skin to the medial canthal tendon, trans-nasal root subcutaneous mattress suture of the epicanthal fold itself and combined rhinoplasty. For past six years (1998 to 2003) 17 patients have been operated with one of these mentioned procedures. The mean follow up was 4months (2weeks to 6months). All patients were satisfied and no major complication was noted. This method can be one of the effective procedures for correcting the Asian epicanthal fold for avoiding potential visible scar and ancillary procedure in double eye lid blephaloplasty.

• Archives of Plastic Surgery
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• v.36 no.2
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• pp.200-204
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• 2009

Purpose: The epicanthal fold is a unique finding in the medial canthal area of many Asians. Various methods have been developed to eliminate this fold. However, excessive and prominent scarring in the medial canthal and nasal area and recurrence restricted application of epicanthoplasty. The authors performed a epicanthoplasty using Y-V advancement flap method in order to obliterate the epicanthal fold without making incisions in the nasal area and as a result, to avoid postoperative scarring. Methods: Sixty one patients underwent epicanthal fold correction using Y-V advancement flap method from July 1999 to February 2005. There were 4 males and 57 females with ages ranging from 9 to 60 years. The epicanthoplasty was performed combined with double eyelid operation, ptosis correction, augmentation rhinoplasty, nasal alar reduction, and nasal tip-plasty. Results: There were few complications in our studies, and most of the patients were satisfied with the results. Conclusion: Remarkable advantages of our Y-V advancement flap epicanthoplasty are as follows: 1) minimal postoperative scarring in the medial canthal area, 2) application of modified double eyelid operation, 3) wider opening of the medial palpebral fissure, 4 the correction of entropion or epiblepharon, 5) no recurrence.

• Archives of Plastic Surgery
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• v.34 no.6
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• pp.807-812
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• 2007

Purpose: The presence of epicanthal fold and the absence of supratarsal fold are characteristics of Korean eyelids. There has been many surgical procedures to eliminate medial epicanthal fold but those procedures focus on the lengthening of horizontal palpebral fissure and the shortening of intercanthal distance so that the shape of eye had tendency to be sharp. The authors suggest that the supermedial shifting of epicanthal fold enhance the aesthetic result. Methods: From Sep 2006 to May 2007, total 17 women(mean age 22) with Type III epicanthal fold underwent epicanthoplasty using author's modified Uchida method. The design for epicanthoplasty was drawn superolaterally along epicanthal fold and split V-W plasty was done to shift the epicanthal fold superomedially. Also non-incisional double-eyelid operation was underwent. Results: The epicanthal fold was shifted in superomedially, intercanthal distance was shortened and double-eyelid was achieved. The patients were satisfied with the result and no major complication was noted. Conclusion: This method can be effective in correcting the epicanthal fold of Korean eyelid by shifting the epicanthal fold superomedially to make the shape of eye aesthetically without noticeable scar.

• Archives of Plastic Surgery
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• v.41 no.4
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• pp.398-402
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• 2014

Background Non-incisional blepharoplasty is a simple, less invasive method for creating a more natural-appearing double eyelid than classical incisional blepharoplasty. However, in aging patients, non-incisional blepharoplasty is not effective due to more severe blepharochalasis. Traditionally, incisional blepharoplasty is a common surgical method used for older patients, but blepharoplasty in elderly patients typically results in prolonged recovery times, and final blepharoplasty lines may be located in unintended or asymmetrical positions. Here, we introduce a new modified combination technique for geriatric blepharoplasty. Methods A total of ten patients were treated from July 2010 through July 2012 using the combination method. First, we performed non-incisional blepharoplasty using tarsodermal fixation. Then, incisional blepharoplasty with additional elliptical excision of the upper eyelid skin was performed. We removed pretarsal tissue, fat, the orbicularis oculi muscle, and orbital fat. Telephone surveys were administered to all patients for follow-up. The questionnaire was composed of eight questions that addressed recurrence and satisfaction with aesthetics and the procedure. Results A total of nine patients (90%) responded to the telephone survey. All cases of moderate to severe blepharochalasia were corrected and there were no major complications. Patients who underwent blepharoplasty had higher satisfaction scores. All patients were satisfied with the postoperative shapes of their eyelids. Conclusions The advantages of the proposed technique include: ease of obtaining a natural-looking fold with symmetry at the desired point; reproducible methods that require short operation times; fast postoperative recovery that results in a natural-appearing double-eyelid line; and high patient satisfaction.

• Archives of Plastic Surgery
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• v.32 no.5
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• pp.582-588
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• 2005

Digital imaging is emerging as a standard method for patient documentation in clinical setting. Managing patient expectations before aesthetic surgery can greatly improve patient satisfaction after surgery. The patient who visited for plastic surgery wants a predicted figure after the operation. A virtual plastic surgery software is necessary in order to satisfy the desire of patients. Adobe $Photoshop^{(R)}$ is the professional standard in desktop digital imaging, offers indispensable new features for graphic and web design, photography, and video. Using imaging technology, it takes just minutes to realistically simulate the results of double eyelid operation, liposuction, rhinoplasty or any other aesthetic procedure. The aim of this study is to analyze the significance of the digital image processing and to introduce the virtual plastic surgery using Adobe $Photoshop^{(R)}$.