Lam Samuel M, Kim Young-Kyoon
Lam Facial Plastic Surgery Center, Dallas, TX, USA.
Aesthet Surg J. 2003 May;23(3):170-6. doi: 10.1067/maj.2003.42.
Three principal techniques exist with which to create the Asian double eyelid: the suture, partial-incision, and full-incision methods. The partial-incision method is reliable and long-lasting without many of the drawbacks of the full-incision method.
The surgical technique of the partial-incision method is reviewed in a stepwise fashion so that the reader can reproduce this method for double-eyelid creation.
Preoperative lid measurements were made with the patient in an upright sitting position to account for the effects of gravity on the lid. An incision was made through both the skin and orbicularis muscle to expose the underlying orbital septum. The lateral septum was lifted upward and a small wedge of elevated septum removed to permit entry into the preaponeurotic adipose tissue, which was then teased forward through the aperture in the orbital septum. Normally, only half of the exposed fat is removed, leaving a small adipose cuff on the hemostat. The remaining adipose cuff was cauterized and the wound inspected for hemostasis. Suture fixation was accomplished with a 7-0 nylon suture to tack the levator aponeurosis to the inferior skin edge along the incision line. The suture was passed through the epidermis to ensure permanence.
We have successfully used the partial-incision method of double-eyelid correction in 1500 cases. The 3 notable complications that can occur are loss of the lid crease, suture extrusion, and asymmetry. All of these complications occur in approximately 2% to 3% of cases but are easily corrected. The apparent elevated appearance of the lid height during the postoperative period is attributed to edema and diminishes by 1 to 2 mm to a more natural position after 3 to 12 months.
The partial-incision approach is a simple, safe, and straightforward approach to double-eyelid creation that can be performed even by surgeons with relatively little experience in the technique. (Aesthetic Surg J 2003;23:170-176.).
形成亚洲人双眼皮主要有三种技术：缝线法、部分切开法和全切法。部分切开法可靠且持久，没有全切法的诸多缺点。
逐步回顾部分切开法的手术技术，以便读者能够重现这种双眼皮成形方法。
让患者直立坐姿进行术前眼睑测量，以考虑重力对眼睑的影响。通过皮肤和眼轮匝肌做切口，暴露下方的眶隔。将外侧眶隔向上提起，切除一小片抬起的眶隔组织，以便进入眶隔前脂肪组织，然后将其通过眶隔上的小孔向前牵拉。通常，仅切除一半暴露的脂肪，在止血钳上留下一小圈脂肪组织。烧灼剩余的脂肪组织圈，检查伤口止血情况。用7-0尼龙缝线进行缝合固定，将提上睑肌腱膜沿着切口线固定于下睑缘皮肤。缝线穿过表皮以确保持久性。
我们已成功地将部分切开法用于1500例双眼皮矫正手术。可能出现的3种显著并发症为双眼皮消失、缝线外露和不对称。所有这些并发症在大约2%至3%的病例中出现，但很容易矫正。术后眼睑高度明显升高是由水肿引起的，3至12个月后会减轻1至2毫米，恢复到更自然的位置。
部分切开法是一种简单、安全且直接的双眼皮成形方法，即使是对该技术经验相对较少的外科医生也能实施。（《美容外科杂志》2003年；23:170 - 176。）
