Paik Ji Sun, Lee Ji Hyeong, Uppal Sandeep, Choi Woong Chul
Department of Ophthalmology, Catholic University of Korea Yeouido Saint Mary's Hospital, Yeongdeungpo-gu, Seoul, Republic of Korea.
Cosmetic Plastic Surgery, Cosmetic Surgical Clinic Lauren, Seoul, Republic of Korea.
Facial Plast Surg. 2020 Oct;36(5):563-574. doi: 10.1055/s-0040-1718391. Epub 2020 Dec 24.
Differences between Oriental and Caucasian eyelids have been explained in great detail in several reports in the past. The purpose of this article is to discuss the functional aspects of Asian double fold upper blepharoplasty and to present techniques that help to improve both the functional and cosmetic outcomes and satisfaction after surgery. The eyes of Asians are relatively small with thick skin in the eyelids and periorbital area. They typically lack the upper eyelid crease (creating the so-called double eyelid) due to burden factors like thick skin, hypertrophied orbicularis oculi muscle (OOM), submuscular fibroadipose tissue, thick orbital septum, abundant preaponeurotic fat, and lower positioned transverse ligament. Asian eyes may also have a superior visual field defect due to skin overriding the upper lid margin (skin-OOM-fat complex slide down). These burden factors result in the eyelashes appearing short and becoming misdirected and pressed toward the globe, causing functional discomfort. As a compensatory mechanism, Asian people tend to engage the frontalis muscle to lift the eyebrow to help them open their eyes. Along with aesthetic enhancement, double-eyelid surgery in Asian burden lids can improve the functional deficiencies helping the patients to open the eyes more easily. In addition, treatment of the Mongolian fold (medial epicanthal fold), caused by medial hypertrophy of preseptal OOM, augments the surgical results. In this report, we present the appropriate preoperative assessment, surgical technique, and postoperative care that should be employed to achieve consistently good functional and aesthetic outcomes in these patients.
过去已有多篇报道详细解释了东方人眼睑与高加索人眼睑之间的差异。本文旨在探讨亚洲人双眼皮上睑成形术的功能方面，并介绍有助于改善手术功能和美容效果以及患者满意度的技术。亚洲人的眼睛相对较小，眼睑和眶周区域皮肤较厚。由于皮肤厚、眼轮匝肌（OOM）肥厚、肌下纤维脂肪组织、眶隔厚、眶隔前脂肪丰富以及横韧带位置较低等负担因素，他们通常缺乏上睑皱襞（形成所谓的双眼皮）。亚洲人的眼睛还可能因皮肤覆盖上睑缘（皮肤 - OOM - 脂肪复合体下滑）而出现视野缺损。这些负担因素导致睫毛看起来短且方向错误并被压向眼球，引起功能不适。作为一种代偿机制，亚洲人倾向于动用额肌抬起眉毛以帮助睁开眼睛。除了美容提升外，亚洲人负担较重的眼睑进行双眼皮手术可以改善功能缺陷，帮助患者更轻松地睁开眼睛。此外，治疗由眶隔前OOM内侧肥厚引起的蒙古褶（内眦赘皮褶）可增强手术效果。在本报告中，我们介绍了为这些患者持续实现良好功能和美学效果应采用的适当术前评估、手术技术和术后护理。
