Double Eyelid Blepharoplasty With Palpebral Margin Incision in Asian Eyelids

Background: Double eyelid surgery is the most common plastic surgery in Asian women. The traditional full-incision method is widely used but leaves scars in the upper eyelid creases that are obvious when the eyes are closed, especially in Asians. Although the buried-suture method leaves no scars on the eyelids, it cannot be used to remove excess tissues or correct ptosis, which are common in Asian eyelids. Therefore, a palpebral margin incision technique has been developed. The aims of this study are to popularize this technology by presenting our clinical results of the palpebral margin incision technique and sharing our experience in details. Methods: This technique consists of 3 distinctive aspects: (1) The incision is made at a location 0.5 to 1 mm above the lash line; (2) For patients with redundant skin, the palpebral crease line is moved up at a distance corresponding to the amount of redundant skin; and (3) The dermis of the palpebral crease line and its corresponding tarsal plate are sutured. Results: This technique was performed in 112 Asian female patients, including 101 with a skin excision and 11 with no skin excision. The follow-up period was 1 year. Most (98.2%) of the patients gave good evaluations, reporting perfect curves of the upper eyelid folds and bilateral symmetry. No significant complications or apparent scarring occurred in any patients. Conclusions: The palpebral margin incision technique has even broader indications than the traditional full-incision method and overcomes the disadvantages of traditional full-incision methods such as visible scars when the eyes are closed and damage to the vasoganglion and lymphatic capillary net, resulting in severe swelling. This method is suitable for patients of any age with any type of eyelid and can achieve a natural and stably lasting double eyelid and more desired cosmetic effect.