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Plast Reconstr Surg 2022 Jun 28. Epub 2022 Jun 28.

Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine; Shanghai, China.

Background: Lower blepharoplasty continues to improve over time. With discovery of the numerous fat compartments of the face, surgeons noticed that the appearance of the lower eyelid area through aging could be improved through midface lifting. This study introduces a vertical "V-Y" advancement lifting technique, using the concept of fat compartments for lower lid and midcheek rejuvenation. Read More

Ann Plast Surg 2022 Jul 28;89(1):17-22. Epub 2022 May 28.

From the Ninth Department of Plastic Surgery, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Background: Traditional coronal Z-epicanthoplasty usually generates visible scars, and V-Y advancement or skin redraping can damage the normal shape of the lower eyelid. In addition, these methods usually lead to loss of the medial canthus depth, which is important for the natural appearance of East Asians. This report aims to describe a 3-dimensional Z-epicanthoplasty that can maintain the depth of the medial canthus with fewer visible scars. Read More

Aesthet Surg J 2022 Jun 9. Epub 2022 Jun 9.

Department of Plastic and Reconstructive Surgery, Shenzhen Nanxizi Medical Beauty Hospital, Shenzhen, Guangdong, China.

Background: Double-eyelid surgery is one of the most common cosmetic surgeries performed in Asians. The palpebral marginal incision technique (PMIT) conceals the incision scar and creates natural-looking double eyelids. However, the amount of eyelid skin removed by conventional PMIT is limited, which potentially results in an unnatural crease or swollen-like inferior skin below the palpebral crease. Read More

Aesthetic Plast Surg 2022 Jun 6. Epub 2022 Jun 6.

Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University, 127 Changle West Road, Xincheng District, Xi'an, Shaanxi, China.

Background: Supra-brow and sub-brow blepharoplasty are two types of upper eyelid blepharoplasties that are commonly performed in middle-aged Asian women to correct skin laxity of the upper eyelid; the postoperative scar formation of the two procedures may be different. Therefore, we designed this retrospective study to explore the differences in postoperative scarring between patients receiving supra- or sub-brow blepharoplasty.

Methods: We identified 52 patients who underwent supra-brow blepharoplasty and 54 patients who underwent sub-brow blepharoplasty. Read More

Aesthetic Plast Surg 2022 May 26. Epub 2022 May 26.

Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu City, 61000, Sichuan Province, People's Republic of China.

Background: Although many epicanthoplasty techniques have been proposed, prominent hypertrophic scarring in the medial canthal region remains a problem. The aim of this study was to develop a novel design that has a less prominent scar with minimal tension.

Methods: A total of 489 patients underwent thunderbolt Z-epicanthoplasty from July 2015 to April 2019, with or without blepharoplasty. Read More

Ann Plast Surg 2022 06 18;88(6):606-611. Epub 2022 Feb 18.

From the Department of Plastic and Reconstructive Surgery, Xijing Hospital, Forth Military Medical University, Xi'an, Shaanxi, China.

Background: Fifty percent of Asians are born without a supratarsal fold (also called single eyelid), and double eyelid blepharoplasty is one of the most commonly performed and most popular facial cosmetic surgeries in the Asian population. However, patients with single eyelid frequently present with concomitant mild blepharoptosis (degree of ptosis, ≤2 mm), which often fails to cause the attention of surgeons and misses correction.

Methods: A retrospective study of all patients who underwent double eyelid blepharoplasty and blepharoptosis correction simultaneously with the modified levator aponeurosis plication technique was performed from June of 2017 to June of 2020. Read More

Aesthetic Plast Surg 2022 Apr 22. Epub 2022 Apr 22.

Department of Plastic Surgery, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Shuaifuyuan No. 1, Dongcheng District, Beijing, 100730, China.

Background: Double eyelid blepharoplasty is a popular procedure among Asian population. Double eyelid shape is important to achieving high satisfaction rate. Currently, there lacks large sample survey and detailed analysis on preferred double eyelid shape. Read More

Aesthetic Plast Surg 2022 Apr 1. Epub 2022 Apr 1.

Department of Burn and Plastic Surgery, The First Affiliated Hospital of Chongqing Medical University, Yuzhong District, Chongqing, 400016, China.

The combination of epicanthoplasty and blepharoplasty is a popular choice in Asians to acquire a pair of charming big eyes. However, the obvious scarring in the medial canthal area may result in unsatisfactory aesthetic outcomes. Recently, various laser treatments have been used to deal with scars had achieved detectable improvement, but only a few studies investigating the efficacy of lasers used in post-epicanthoplasty scarring were developed. Read More

Aesthetic Plast Surg 2022 Mar 30. Epub 2022 Mar 30.

Department of Plastic Surgery, Medical College, Chang Gung University, Chang Gung Memorial Hospital, Taoyuan City, Taiwan.

Asian upper blepharoplasty is one of the most commonly requested procedures in Asian patients. Many incisional and suture methods have been described in the literature. While the suture method is advantageous for its simplicity and quick recovery, the incision method is more versatile and able to deliver predictable and reproducible results for Asian patients presenting with a diverse range of anatomy and requests. Read More

Dermatol Surg 2022 Jun 22;48(6):653-658. Epub 2022 Mar 22.

Department of Dermatology, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan.

Background: Lower eyelid aging is a complicated process, and for that reason, a comprehensive assessment of the lower eyelid is important before treatment.

Objective: This study was conducted to analyze and assess the lower eyelid aging process between different age groups of Asian women.

Methods And Materials: The authors developed the comprehensive lower eyelid age rating scale (CLEARS). Read More

Ann Plast Surg 2022 04;88(4):375-380

Department of Plastic and Reconstructive Surgery, Shinshu University School of Medicine and Graduate School of Medicine, Matsumoto, Japan.

Abstract: A puffy eyelid without a crease, also known as single eyelid, is a common characteristic in East Asians. Existence of a lid crease is generally considered an aesthetic concern for both patients and surgeons, and postoperative evaluations have mainly focused on the appearance of the eye. The aim of this study was to clarify the functionality of the superior visual field (SVF) with single eyelid. Read More

J Plast Reconstr Aesthet Surg 2022 Jun 31;75(6):1993-2000. Epub 2022 Jan 31.

Department of Ophthalmology, Shanghai Tongji Hospital, Tongji University School of Medicine, 389 Xin Cun Road, Putuo district, Shanghai 200065, China. Electronic address:

Background: In East Asians, a common method to ameliorate puffy eyelids is to resect the excess orbital fat and the orbicularis. However, in some patients, a satisfactory improvement cannot be achieved because of the thick submuscular fibroadipose tissue (SMFAT) and minimal orbital fat. The SMFAT lies between the orbicularis and the orbital septum and can also be found in the pretarsal area. Read More

J Craniofac Surg 2022 Feb 14. Epub 2022 Feb 14.

Department of Plastic and Reconstructive Surgery, Armed Forces Capital Hospital, Seongnam, Republic of Korea.

Abstract: Dermatochalasis is a consequence of aging and results in various problems, such as tired look, dry eye syndrome, or reduced vision. Although the demand for upper blepharoplasty is growing in the senescing world, the demand from male patients has been generally overlooked. Male patients prefer natural creases and fast recoveries, with minimal swelling. Read More

Aesthetic Plast Surg 2022 Jan 10. Epub 2022 Jan 10.

Charming Institute of Esthetic and Regenerative Surgery (CIARS), 2F.-1, No.172, Ziqiang 2nd Rd., Qianjin District, Kaohsiung City, 801, Taiwan.

J Plast Reconstr Aesthet Surg 2022 Apr 27;75(4):1431-1437. Epub 2021 Nov 27.

Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China. Electronic address:

Background: Many people are characterized by a swollen appearance and loose skin of upper eyelids, especially Asians. Retro-orbicularis oculus fat (ROOF) lying in the lateral canthus area is a critical factor of the bulkiness formation. Although several approaches have been reported, most of them intend to remove orbicularis muscle and preaponeurotic fat through a double-eyelid incision, leaving ROOF untreated. Read More

BMC Ophthalmol 2021 Dec 15;21(1):435. Epub 2021 Dec 15.

Joint Shantou International Eye Centre of Shantou University and The Chinese University of Hong Kong, North Dongxia Road, Shantou, 515041, Guangdong, China.

Background: To evaluate a modified technique for involutional entropion correction in a retrospective cohort study.

Methods: The patients with involutional entropion eyelid were corrected by tightening the pretarsal orbicularis oculi muscle and excising the excess skin of the lower eyelid. The patients received correction surgery from April 2013 to March 2019 were followed up for more than 6 months postoperatively. Read More

J Plast Reconstr Aesthet Surg 2022 03 14;75(3):1224-1229. Epub 2021 Nov 14.

Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100141 China.

Background: In buried suture methods, the levator aponeurosis is fixed to the subcutaneous tissue in the pretarsal region using a suture. However, loosening of the suture occurs frequently and causes regression or disappearance of the double-eyelid folds. To avoid potential loosening of the suture after surgery, we modified the horizontal suture technique commonly used in buried suture double-eyelid blepharoplasty. Read More

J Cosmet Dermatol 2022 Mar 21;21(3):1111-1119. Epub 2021 Nov 21.

No. 3 Department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Introduction: Double-eyelid blepharoplasty and epicanthoplasty is usually performed concurrently in Asian patients to achieve aesthetically pleasing eye appearance, but the epicanthal area is prone to scarring. This article introduces an integrated four-step technique that enlarges the eyes with minimal scarring risk.

Methods: One hundred and thirty-five patients who underwent Asian upper blepharoplasty and dual-plane epicanthoplasty between January 2019 and September 2020 were retrospectively reviewed. Read More

Aesthetic Plast Surg 2021 Nov 19. Epub 2021 Nov 19.

Department of Plastic and Reconstructive Surgery, College of Medicine, Chang Gung Memorial Hospital, Chang Gung University, Linkou, 5, Fu-Hsin StreetTaoyuan 333, Kwei-Shan, Taiwan, ROC.

Background: This study aimed to propose a novel four-type deformity and treatment-oriented classification of the lower eyelids that directs the therapeutic combination of three-step lower blepharoplasty for Asian populations.

Methods: We reviewed 183 patients who underwent a therapeutic combination of three steps of lower blepharoplasty after being diagnosed with four types of lower eyelid deformities between July 2018 and April 2021. The three-step lower blepharoplasty includes: (1) mid-face and lower eyelid augmentation, (2) transconjunctival eye bag removal, and (3) skin pinch removal. Read More

J Craniofac Surg 2021 Oct;32(7):2516-2520

Department of Plastic Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, China.

Asian J Surg 2021 Oct 19. Epub 2021 Oct 19.

College of Medicine, Chang Gung University, Kwei-shan, Taoyuan, Taiwan; Department of Plastic and Reconstruction Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan. Electronic address:

Background/objectives: In recent years, a modified levator muscle resection using Putterman ptosis clamp was developed. We used a retrospective case-control study to compare the effects of the modified and traditional levator muscle resection methods.

Methods: Patients with moderate-to-severe ptosis who underwent the traditional or modified method for levator muscle resection were divided into two groups: Group I received the traditional method in 2013 and Group II received the modified method using Putterman clamp in 2015. Read More

Facial Plast Surg Clin North Am 2021 Nov;29(4):523-532

Department of Ophthalmic Plastic and Reconstructive Surgery, Kim's Eye Hospital, 136 Yeongshin-ro, Yeongdeungpo-gu, Seoul 07301, Republic of Korea. Electronic address:

Various nonincisional techniques for double eyelid surgery have been introduced in the past. They are simple, noninvasive, and efficient techniques to create a double eyelid. The authors prefer the full-thickness single continuous method using the 7-0 nylon, round long needle. Read More

Facial Plast Surg Clin North Am 2021 Nov;29(4):511-522

Drsong4u Aesthetic Plastic Surgery Clinic, 2-3 Floors, Dosandaero 37gil 6, Gangnam-gu, Seoul 06026, Korea.

The goal of Asian blepharoplasty is to create a lid crease configuration that resembles the natural-appearing crease found in other Asians. Because the Asian upper eyelid contains more prominent preseptal fat resulting in greater lid fullness, soft tissue work in blepharoplasty of the Asian eye is even more diverse and essential than that of whites in order for there to be the sustainability of the eyelid crease. Hence, Asian blepharoplasty should be performed specifically following the orbital anatomy of Asians. Read More

Facial Plast Surg Clin North Am 2021 Nov;29(4):487-495

Labom plastic surgery clinic, Gangnam-daero 600, Dongshin B/D 3F, Seoul, Korea.

Asians have anatomic and clinical characteristics to be considered before forehead lift. Because of the anatomic characteristics of Asians, for the better outcomes of blepharoplasty or augmentation rhinoplasty, forehead lift as a combined surgery must be considered beforehand. Forehead lift is frequently indicated in young Asian patients. Read More

Ann Plast Surg 2021 10;87(4):389-395

Department of Plastic and Reconstructive Surgery, College of Medicine, Dongguk University, Gyeongju, Republic of Korea.

Background: The double eyelid operation is the most common cosmetic procedure conducted in Asians. However, the epicanthal fold presents a conundrum that limits the cosmetic results of double eyelid surgery. Despite not being a pathologic condition, numerous procedures have been developed and introduced to address this issue, but these techniques have potential disadvantages that include an unnatural ciliary position of the lower lids and prominent scarring. Read More

J Craniofac Surg 2022 Mar-Apr 01;33(2):624-627

Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Objective: Upper eyelid laxity affects facial aesthetics and the eyebrow arch in the East Asian population is generally low. The authors developed infraeyebrow blepharoplasty using a dynamic suspension technique between the dermis-fascia flap and frontalis for upper eyelid lifting and eyebrow augmentation.

Methods: A retrospective study was performed on 43 female patients with upper eyelid laxity from August 2015 to October 2019. Read More

J Craniofac Surg 2021 Sep;32(6):2024-2028

Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China.

Abstract: Fat repositioning is an effective way to treat tear trough deformity (TTD) in Asians. Recent techniques mainly focused on the fixation technique, whereas how to precisely shape and individually quantify the fat pedicle has been ignored. This article introduced an individualized, targeted, and tension-free technique to fabricate a fan-shaped thin septum fat pedicle for repositioning. Read More

Ann Plast Surg 2022 02;88(2):138-143

From the Department of Burn and Plastic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

Objective: Double blepharoplasty or double eyelid surgery is a common plastic surgery in Asians. Our study aimed to evaluate the advantages and disadvantages of the minimally invasive 3-point subcutaneous tunnel double eyelid surgical technique relative to other commonly used approaches.

Method: The study compared 852 single eyelid patients electing 1 of 3 double eyelid surgical options; minimally invasive 3-point subcutaneous tunnel, minimally invasive 3-point embedding, or incision double eyelid surgery. Read More

Indian J Plast Surg 2021 Apr 28;54(2):201-203. Epub 2021 Jun 28.

Handa Nursing Home, Raja Garden, New Delhi, India.

The upper eyelid crease is an indentation at the level where fibers from the levator aponeurosis insert into the skin. Typically, Asian eyes are described as creaseless and puffy and the aim of blepharoplasty is to achieve an eyelid crease, without losing the ethnicity of the individual. We aim to describe the most commonly performed technique as well as the peculiar points to be kept in mind from the Indian perspective. Read More

Aesthetic Plast Surg 2022 Feb 23;46(1):241-247. Epub 2021 Jun 23.

Department of Plastic and Burn Surgery, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Chongqing, People's Republic of China.

Backgrounds: Double-eyelid blepharoplasty remains popular in east Asia. To avoid rigid eyelids and sinking scar after double-eyelid blepharoplasty, a new surgical approach with selective neurovascular preservation (SNVP) method is proposed to crease more physiological and dynamic double-eyelid crease.

Methods: During the full-incision double-eyelid surgery, a strip of preseptal orbicularis oculi muscle was resected. Read More