eMedicine Specialties > Plastic Surgery > Eyelids

Blepharoplasty, Asian: Multimedia

Author: Charles S Lee, MD, Consulting Surgeon, Department of Plastic Surgery, Olympia Medical Center
Contributor Information and Disclosures

Updated: Feb 13, 2008

Multimedia

Measure the desired height of the fold. Typically...Media file 1: Measure the desired height of the fold. Typically, an 8-mm fold yields a medium-sized fold in young patients. If one brow lies lower, then mark the fold 1 mm higher on that side to compensate for the increased overhang of skin.
Measure the desired height of the fold. Typically...

Measure the desired height of the fold. Typically, an 8-mm fold yields a medium-sized fold in young patients. If one brow lies lower, then mark the fold 1 mm higher on that side to compensate for the increased overhang of skin.

Perform the medial epicanthoplasty first. Mark th...Media file 2: Perform the medial epicanthoplasty first. Mark the V-W plasty; each limb measures approximately 2 mm. Mark the W portion on the surface of the epicanthal fold. The tip of the central flap of the W sits at the edge of the epicanthal fold, and the V component lies on the undersurface of the epicanthal fold. The markings represent skin that will be resected.
Perform the medial epicanthoplasty first. Mark th...

Perform the medial epicanthoplasty first. Mark the V-W plasty; each limb measures approximately 2 mm. Mark the W portion on the surface of the epicanthal fold. The tip of the central flap of the W sits at the edge of the epicanthal fold, and the V component lies on the undersurface of the epicanthal fold. The markings represent skin that will be resected.

Use 6-0 nylon to suture the apex of each flap, as...Media file 3: Use 6-0 nylon to suture the apex of each flap, as well as one in between them, for a total of 7 sutures.
Use 6-0 nylon to suture the apex of each flap, as...

Use 6-0 nylon to suture the apex of each flap, as well as one in between them, for a total of 7 sutures.

Remove thin slivers of tissue, going through orbi...Media file 4: Remove thin slivers of tissue, going through orbicularis muscle, retro-orbicularis fat, and septum until reaching prelevator fat. Do not confuse the proper fat layer. Verify prelevator fat by the glistening levator aponeurosis underneath, which moves when the patient opens his or her eyelid.
Remove thin slivers of tissue, going through orbi...

Remove thin slivers of tissue, going through orbicularis muscle, retro-orbicularis fat, and septum until reaching prelevator fat. Do not confuse the proper fat layer. Verify prelevator fat by the glistening levator aponeurosis underneath, which moves when the patient opens his or her eyelid.

Pass 6-0 nylon through the conjunctiva along the ...Media file 5: Pass 6-0 nylon through the conjunctiva along the upper border of the tarsal plate.
Pass 6-0 nylon through the conjunctiva along the ...

Pass 6-0 nylon through the conjunctiva along the upper border of the tarsal plate.

Pass one arm of the needle through the full thick...Media file 6: Pass one arm of the needle through the full thickness of the eyelid.
Pass one arm of the needle through the full thick...

Pass one arm of the needle through the full thickness of the eyelid.

Arm the free end of the suture with a free needle...Media file 7: Arm the free end of the suture with a free needle, and then pass it through to the other side of the eyelid using the same needle hole as the initial conjunctival bite.
Arm the free end of the suture with a free needle...

Arm the free end of the suture with a free needle, and then pass it through to the other side of the eyelid using the same needle hole as the initial conjunctival bite.

Tie the suture and sink the knot deeply into the ...Media file 8: Tie the suture and sink the knot deeply into the space previously created to accommodate it.
Tie the suture and sink the knot deeply into the ...

Tie the suture and sink the knot deeply into the space previously created to accommodate it.

Close the skin and place a light compression dres...Media file 9: Close the skin and place a light compression dressing.
Close the skin and place a light compression dres...

Close the skin and place a light compression dressing.

Preoperative (top) and 2-wk postoperative (bottom...Media file 10: Preoperative (top) and 2-wk postoperative (bottom) photos of a patient who underwent semiopen procedure (without medial epicanthoplasty).
Preoperative (top) and 2-wk postoperative (bottom...

Preoperative (top) and 2-wk postoperative (bottom) photos of a patient who underwent semiopen procedure (without medial epicanthoplasty).

After the skin markings and incision, a sliver of...Media file 11: After the skin markings and incision, a sliver of orbicularis muscle is excised to expose the underlying orbital septum.
After the skin markings and incision, a sliver of...

After the skin markings and incision, a sliver of orbicularis muscle is excised to expose the underlying orbital septum.

The prelevator fat is identified and used as an a...Media file 12: The prelevator fat is identified and used as an anatomical guide to open the entire septoaponeurotic sling.
The prelevator fat is identified and used as an a...

The prelevator fat is identified and used as an anatomical guide to open the entire septoaponeurotic sling.

After the lateral portion of the fat is excised, ...Media file 13: After the lateral portion of the fat is excised, the pretarsal soft tissue "bursa" is cleared, exposing the relevant anatomy. The skin flap has been everted; the tarsal plate fully exposed; and the levator aponeurosis lies just cephalad to the tarsal plate, under the forceps.
After the lateral portion of the fat is excised, ...

After the lateral portion of the fat is excised, the pretarsal soft tissue "bursa" is cleared, exposing the relevant anatomy. The skin flap has been everted; the tarsal plate fully exposed; and the levator aponeurosis lies just cephalad to the tarsal plate, under the forceps.

Use 6-0 Vicryl to secure the dermis to the tarsal...Media file 14: Use 6-0 Vicryl to secure the dermis to the tarsal plate and levator aponeurosis.
Use 6-0 Vicryl to secure the dermis to the tarsal...

Use 6-0 Vicryl to secure the dermis to the tarsal plate and levator aponeurosis.

The suture has been tied.Media file 15: The suture has been tied.
The suture has been tied.

The suture has been tied.

The sutures have been placed in 6 positions along...Media file 16: The sutures have been placed in 6 positions along the incision. Closure is with 6-0 Prolene.
The sutures have been placed in 6 positions along...

The sutures have been placed in 6 positions along the incision. Closure is with 6-0 Prolene.

Preoperative (top) and postoperative (bottom) pho...Media file 17: Preoperative (top) and postoperative (bottom) photos of a 22-year-old patient after anchor blepharoplasty and medial epicanthoplasty.
Preoperative (top) and postoperative (bottom) pho...

Preoperative (top) and postoperative (bottom) photos of a 22-year-old patient after anchor blepharoplasty and medial epicanthoplasty.

More on Blepharoplasty, Asian

Overview: Blepharoplasty, Asian
Treatment: Blepharoplasty, Asian
Follow-up: Blepharoplasty, Asian
Multimedia: Blepharoplasty, Asian
References

References

  1. Sayoc BT. Plastic construction of the superior palpebral fold in slit eyes. Bull Phil Ophthal Otolaryngol Soc. 1953;1:2.

  2. Millard DR Jr. Oriental peregrinations. Plast Reconstr Surg. Nov 1955;16(5):319-36. [Medline].

  3. Fernandez LR. Double eyelid operation in the Oriental in Hawaii. Plast Reconstr Surg. Mar 1960;25:257-64. [Medline].

  4. Flowers RS. Upper blepharoplasty by eyelid invagination. Anchor blepharoplasty. Clin Plast Surg. Apr 1993;20(2):193-207. [Medline].

  5. Chen SH, Mardini S, Chen HC, et al. Strategies for a successful corrective Asian blepharoplasty after previously failed revisions. Plast Reconstr Surg. Oct 2004;114(5):1270-7; discussion 1278-9. [Medline].

  6. Flowers RS. Surgical treatment of the epicanthal fold (invited essay). Plast Reconstr Surg. 1983;73:571.

  7. McCurdy JA. Upper blepharoplasty in the Asian patient: the "double eyelid" operation. Facial Plast Surg Clin North Am. Feb 2005;13(1):47-64. [Medline].

  8. Mikamo KA. Method of palpebral plasty. J Chugaishinpo. 1986;396:9.

  9. Ohmori K. Esthetic surgery in the Asian patient. In: McCarthy JG, ed. Plastic Surgery. Vol 3. Philadelphia, Pa: WB Saunders Company; 1990:2415-35.

Further Reading

Keywords

Asian blepharoplasty, Oriental blepharoplasty, double-eyelid surgery, medial epicanthoplasty, Flowers anchor blepharoplasty, Asian eyelid surgery, Asian eye surgery, epicanthal fold, epicanthic fold, eyelid surgery, pretarsal crease

Contributor Information and Disclosures

Author

Charles S Lee, MD, Consulting Surgeon, Department of Plastic Surgery, Olympia Medical Center
Charles S Lee, MD is a member of the following medical societies: American College of Surgeons and American Society of Plastic Surgeons
Disclosure: Nothing to disclose.

Medical Editor

Neal R Reisman, MD, JD, Associate Chief, Department of Plastic Surgery, Clinical Associate Professor, St Luke's Episcopal Hospital, Baylor College of Medicine
Neal R Reisman, MD, JD is a member of the following medical societies: American Association of Plastic Surgeons, American College of Medical Quality, American College of Surgeons, American Society for Aesthetic Plastic Surgery, American Society for Surgery of the Hand, Lipoplasty Society of North America, Texas Medical Association, and Texas Society of Plastic Surgeons
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Jorge I de la Torre, MD, FACS, Professor of Surgery and Physical Medicine and Rehabilitation, Residency Program Director, Division of Plastic Surgery, University of Alabama at Birmingham; Director, Center for Advanced Surgical Aesthetics
Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Association of Plastic Surgeons, American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society for Reconstructive Microsurgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Association for Academic Surgery, and Medical Association of the State of Alabama
Disclosure: Nothing to disclose.

CME Editor

Nicolas (Nick) G Slenkovich, MD, Practice Director, Colorado Plastic Surgery Center at Swedish Medical Center
Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, American Society of Plastic Surgeons, and Colorado Medical Society
Disclosure: Nothing to disclose.

Chief Editor

Lars M Vistnes, MD, FRCSC, FACS, Professor of Surgery, Emeritus, Stanford University Medical Center
Lars M Vistnes, MD, FRCSC, FACS is a member of the following medical societies: Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.