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基于活体解剖学研究的保守性可调节皱襞高度亚洲双眼皮手术技术

A Conservative Crease-Height-Adjustable Asian Double-Eyelid Surgery Technique Based on Live Anatomical Studies.

作者信息

Yu Arthur Y, Yu Abigail A, Boonipat Thanapoom, Pu Lee L Q

机构信息

From Premier Cosmetic Surgery & MedSpa.

Westridge School.

出版信息

Plast Reconstr Surg. 2025 Jul 1;156(1):29-40. doi: 10.1097/PRS.0000000000011948. Epub 2025 Jan 3.

DOI:10.1097/PRS.0000000000011948
PMID:39761004
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12184984/
Abstract

BACKGROUND

Ideal methods for double-eyelid crease creation in Asian upper eyelids remain controversial because of the complexity of the Asian upper eyelid anatomy. Key issues include the underestimation of tarsal height and the septum/aponeurosis fusion point height (FPH), which may underlie the unnaturally high creases in many classic double-eyelid procedures.

METHODS

A total of 1272 patients had tarsal heights measured. Among 386 patients with orbital septa opened, FPHs and other anatomic findings were documented. Based on the anatomic findings, a novel method for double-eyelid crease formation was designed. This method involves preserving the pretarsal fibrofatty tissue and using horizontal mattress sutures to connect the orbicularis oculi muscle, through the pretarsal fibrofatty tissue and levator aponeurosis, to the pretarsal membrane (MAP method) as the linkage mechanism.

RESULTS

Tarsal height levels were higher than reported in many previous studies. In the supine position, all FPHs were higher than the tarsi. Eyelid creases using the MAP method are created below the superior tarsal edges at varying heights, accommodating individual patient requests while achieving well-formed creases and improved eyelid mechanics. The recovery was brief, and the results were long-lasting with a minimal failure rate.

CONCLUSIONS

Tarsal heights and FPHs are not as low as previously thought, which could explain why many classic surgical procedures have various issues. The proposed MAP method for Asian double-eyelid blepharoplasty allows for conservative crease-height adjustability with results that are dynamic, natural, and durable.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

摘要

背景

由于亚洲人上睑解剖结构复杂，亚洲人上睑形成双眼皮皱襞的理想方法仍存在争议。关键问题包括对睑板高度和眶隔/腱膜融合点高度（FPH）的低估，这可能是许多经典双眼皮手术中出现不自然高皱襞的原因。

方法

共测量了1272例患者的睑板高度。在386例打开眶隔的患者中，记录了FPH及其他解剖学发现。基于这些解剖学发现，设计了一种新的双眼皮皱襞形成方法。该方法包括保留睑前纤维脂肪组织，并使用水平褥式缝线将眼轮匝肌通过睑前纤维脂肪组织和提上睑肌腱膜连接至睑前膜（MAP法）作为连接机制。

结果

睑板高度水平高于许多先前研究报道。仰卧位时，所有FPH均高于睑板。使用MAP法形成的眼睑皱襞在不同高度的上睑缘下方形成，既能满足患者的个性化需求，又能形成良好的皱襞并改善眼睑力学。恢复时间短，效果持久，失败率极低。

结论

睑板高度和FPH并不像之前认为的那么低，这可以解释为什么许多经典手术会出现各种问题。所提出的亚洲人双眼皮成形术的MAP法允许进行保守的皱襞高度调整，结果动态、自然且持久。

临床问题/证据水平：治疗性，IV级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d1d/12184984/166a4345c63f/prs-156-0029-g011.jpg
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