From the Department of Plastic and Reconstructive Surgery, Shanghai Eighth People's Hospital, Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; and the Department of Dermatology, West China Hospital.
Plast Reconstr Surg. 2020 Oct;146(4):756-765. doi: 10.1097/PRS.0000000000007185.
Double-eyelid blepharoplasty is the most frequently performed aesthetic surgery in the Asian population. However, the epicanthal fold has been a conundrum limiting the outcomes of Asian blepharoplasty. Furthermore, with the blending of Western and Asian cultures, patients have individual standards of beauty for the upper eyelids. Here, we developed a four-step technique to form infold or outfold double-eyelid creases to satisfy individual patient requirements.
The medical records of patients who simultaneously underwent double-eyelid blepharoplasty and epicanthoplasty using this four-step technique from January of 2017 to January of 2019 were reviewed. The results were grouped by preoperative patient requirements for eyelid crease shapes. The rate of meeting patient expectations in each group was evaluated by two independent observers. Preoperative and postoperative photographs were collected, complications were identified, and postoperative results were assessed.
In total, 285 consecutive patients were included in this study, with a mean follow-up period of 9 months. Of the 285 patients, 207 requested infold eyelid creases, and 190 (92 percent) procedures met patient expectations; and 78 patients requested outfold eyelid creases, and 69 (87 percent) procedures met patient expectations. A high rate of satisfaction with the final eyelid crease shape and resulting scarring was noted in both patient groups. The revision rate was 3 percent. No severe complications were observed.
The four-step technique is a simple, flexible, and effective method for creating infold or outfold double-eyelid creases according to individual patient requirements and should be considered a routine method for patients who request double eyelids.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
重睑术是亚洲人群中最常施行的美容手术。然而，内眦赘皮一直是限制亚洲重睑术效果的难题。此外，随着东西方文化的融合，患者对双眼皮的审美有了个体标准。在此，我们提出了一种四步技术来形成内折或外折重睑皱襞，以满足患者的个体需求。
回顾了 2017 年 1 月至 2019 年 1 月期间采用四步技术同时行重睑术和内眦成形术的患者的病历。根据术前患者对重睑形状的要求对结果进行分组。由两名独立观察者评估每组中满足患者期望的比率。收集术前和术后照片，确定并发症，并评估术后结果。
本研究共纳入 285 例连续患者，平均随访时间为 9 个月。在 285 例患者中，207 例要求内折重睑，207 例（92%）手术满足患者期望；78 例要求外折重睑，78 例（87%）手术满足患者期望。两组患者对最终重睑皱襞形状和由此产生的瘢痕均有很高的满意度。修复率为 3%。未观察到严重并发症。
四步技术是一种根据患者个体需求形成内折或外折重睑的简单、灵活且有效的方法，应被视为要求行重睑术患者的常规方法。
临床问题/证据水平：治疗性，IV。
