By William P. Chen MD FACS
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Extra info for Asian Blepharoplasty and the Eyelid Crease 2nd Edition
The eyelid is ﬁrst anesthetized by local inﬁltration of lidocaine hydrochloride. The upper eyelid is everted, and three double-armed sutures are placed from the conjunctival side (transconjunctival) in a subconjunctival fashion above the superior tarsal border (Step 1). One of the following three alternative steps may be performed to complete this procedure. Variation 1: Full-Thickness Suture Technique Both ends of the suture pass through to the skin surface (Step 2); one end is then passed subcutaneously again to exit through the exit site of the second needle on the skin (Step 3).
15. Uchida J. A surgical procedure for blepharoptosis vera and for pseudo-blepharoptosis orientalis. Br J Plast Surg 1962;15:271–276. 16. Miyake I, Tange I, Hirage Y. MRI ﬁndings of the upper eyelid and their relationship with single and double-eyelid formation. Aesth Plast Surg 1994;88:183–187. 17. Yoo HB. The double eyelid operation without supratarsal ﬁxation. Plast Reconstruct Surg 1991;88:12–17. 18. Johnson CC. Epicanthus. Am J Ophthalmol 1968;66:939–946. 19. Boo-Chai K. The Mongolian fold (plica Mongolia).
5-3 Variation 2. Full-thickness suturing technique with stab incisions. Chapter 5 Suture Ligation Methods 45 Strategic placement of intramuscular sutures creates infolding of crease Indentation of skin Skin Orbicularis muscle Exit 1 2 Entry for both needles of double-armed sutures Levator aponeurosis .. Muller's muscle Conjunctiva Fig. 5-4 Variation 3. Transconjunctival intramuscular suturing technique. Note the absence of passage through the skin. Asian Blepharoplasty and the Eyelid Crease 46 2 1 First stab incision 1 2 Skin 1 Orbicularis muscle Levator aponeurosis ..