A practical technique of reverse orbicularis oculi muscle resection with preserved subcutaneous capillary network for double eyelid blepharoplasty

Background

Traditional full-incision double eyelid blepharoplasty has several significant disadvantages, including slow recovery and bilateral asymmetry, which results in high rates of patient dissatisfaction. These problems can be minimized using improved surgical techniques aimed at reducing tissue damage and bleeding, decreasing operation time, and especially at protecting the subcutaneous capillary network during the operation. We therefore aimed to guard the capillary network and reduce intraoperative bleeding using the practical technique of reverse orbicularis oculi muscle resection.

Methods

Fifty cases of double eyelid blepharoplasty with traditional full-incision (group A) and 61 cases of reverse double eyelid blepharoplasty with a preserved capillary network (group B) were divided into two groups from October 1 to December 31, 2021 and from March 1 to May 31, 2022, respectively. The orbicularis oculi muscle was removed reversely from the front of the tarsal plate using double eyelid blepharoplasty, and the muscular membrane and subcutaneous capillary network were preserved. The operation time recorded in previous medical records was checked and compared with that of our novel technique. The recovery of double eyelid blepharoplasty was determined at 1, 4, and 12 weeks after the operation and patient satisfaction was also compared with that in previous medical records of patients in group A.

Results

The reverse double eyelid blepharoplasty procedure was less complicated and easier to control than the traditional full-incision double eyelid blepharoplasty methodology. The average operation time of the double eyelid blepharoplasty cases with traditional full-incision was significantly greater than that of the cases of reverse double eyelid blepharoplasty with the capillary network preserved (45.68 ​± ​5.27 ​min and 31.11 ​± ​5.58 ​min, respectively; t=14.018 9, P=0.000 0). Patient satisfaction was 42% and 78.69%, respectively, at 1 week post-operation (χ²=15.724 8, P=0.000 1), 62% and 90.16% at 4 weeks post-operation (χ²=12.490 2, P=0.000 4), and 90% and 95.08%, at 12 weeks post-operation (χ²=1.061 1, P=0.303 0).

Conclusion

Reverse double eyelid blepharoplasty with preserved subcutaneous capillary network effectively decreases the operation time and improves post-operative patient satisfaction. It is a double eyelid blepharoplasty method worthy of popularization.