Oriental double eyelid: a limited-incision technique.

Although there are many procedures reported in the literature regarding the double-eyelid operation, they can be categorized basically into two groups: nonincision and incision. 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. As an alternative option, the author developed a limited-incision single-stitch technique that minimizes tissue injury and provides adequate adhesion for fold formation. With this method, a small single incision (3-4 mm) is made in the upper eyelid. Through the incision, the orbital fat can be removed, when indicated. Under direct vision, a levator aponeurosis or tarsus is attached to the muscle and the dermis of the pretarsal margin by a single stitch. This technique gives a durable, natural fold; has a short recovery time; and can be applied to patients with fatty eyelids. This method has the merits of both the incision and the nonincision techniques, and avoids the disadvantages of both procedures.