Oriental Upper Blepharoplasty

ABSTRACT

Aesthetic surgery of the upper eyelids is a very common procedure performed in cosmetic practices around the world. The word blepharoplasty, however, has a different meaning in Asia than it does elsewhere. Orientals have different periorbital anatomic characteristics, their motivations for seeking eyelid treatment are different, and operative techniques have been adapted consequently. There are also many eyelid shapes among Orientals, mostly with regard to the presence and location of the supratarsal fold and/or presence of an epicanthal fold. The surgeon must therefore master a range of surgical procedures to treat these variations adequately. It is critical to know the indications for each blepharoplasty technique as well as their complications to select the right surgery and avoid unfavorable results. Epicanthoplasty performed on the right patient can greatly improve aesthetic results while retaining ethnic characteristics. This article will discuss Oriental eyelid characteristics, preoperative patient assessment, commonly used corrective techniques for the “double-eyelid” creation, and complications and how to avoid them.

Asian blepharoplasty - double-eyelid surgery - anatomy - epicanthal fold - supratarsal fixation - aesthetic surgery - Asian - Oriental eye

REFERENCES

• 1 Gradinger G P. Cosmetic upper blepharoplasty.  Clin Plast Surg. 1988;  15 289-297
• 2 Guyuron B. Blepharoplasty and ancillary procedures. In: Achauer BM, Erikssom E, Guyuron B, et al Plastic Surgery: Indications, Operations and Outcomes. St. Louis, MO; Mosby 2000: 2537-2547
• 3 Hiraga Y. The double eyelid operation in the Asian patient. In: Gonzalez-Ulloa M, Meyer R, Smith W, et al Aesthetic Plastic Surgery. St. Louis, MO; Mosby 1988: 151-164
• 4 Rees T D, Aston S J, Thorne C. Blepharoplasty and facialplasty. In: McCarthy JG Plastic Surgery. Philadelphia, PA; Sauders 1990: 2320-2358
• 5 Zide B M. Anatomy of the eyelid.  Clin Plast Surg. 1981;  8 623-634
• 6 Doxanas M T, Anderson R L. Oriental eyelids: an anatomic study.  Arch Ophthalmol. 1984;  102 1232-1235
• 7 Liu D, Hsu W M. Oriental eyelids: anatomic difference and surgical consideration.  Ophthal Plast Reconstr Surg. 1986;  2 59-64
• 8 Chen W P. Asian blepharoplasty.  Ophthal Plast Reconstr Surg. 1987;  3 135-140
• 9 Fernandez L R. Double eyelid operation in the Oriental in Hawaii.  Plast Reconstr Surg Transplant Bull. 1960;  25 257-264
• 10 Hwang K, Kim D J, Chung R S, Lee S I, Hiraga Y. An anatomical study of the junction of the orbital septum and the levator aponeurosis in Orientals.  Br J Plast Surg. 1998;  51 594-598
• 11 Boo-Chai K. Plastic construction of the superior palpebral fold.  Plast Reconstr Surg. 1963;  31 74-78
• 12 Mutou Y, Mutou H. Intradermal double eyelid operation and its follow-up results.  Br J Plast Surg. 1972;  25 285-291
• 13 Uchida J. A surgical procedure for blepharoptosis Vera and for seudo-blepharoptosis Orientals.  Br J Plast Surg. 1962;  15 271-276
• 14 Homma K, Mutou Y, Mutou H, Ezoe K, Fujita T. Intradermal stitch blepharoplasty for Orientals: does it disappear?.  Aesthetic Plast Surg. 2000;  24 289-291
• 15 Weng C J, Noordhoff M S. Complications of Oriental blepharoplasty.  Plast Reconstr Surg. 1989;  83 622-628
• 16 Sayoc B T. Surgery of the Oriental eyelid.  Clin Plast Surg. 1974;  1 157-171
• 17 Del Campo A F. Surgical treatment of the epicanthal fold.  Plast Reconstr Surg. 1984;  73 566-571
• 18 Chen S H, Mardini S, Chen H C et al.. Strategies for a successful corrective Asian blepharoplasty after previously failed revisions.  Plast Reconstr Surg. 2004;  114 1270-1277
• 19 Hin L C. Oriental blepharoplasty: a critical review of technique and potential hazards.  Ann Plast Surg. 1981;  7 362-372
• 20 Chen W P. The concept of a glide zone as it relates to upper lid crease, lid fold, and application in upper blepharoplasty.  Plast Reconstr Surg. 2007;  119 379-386