ABSTRACT
There are numerous noninvasive buried suture methods available to make a double eyelid, such as, fixation with skin and pretarsal tissue, fixation with skin and conjunctiva through the tarsal plate and the sling technique, which goes between the levator and Muller muscle and subdermal tissue. But these methods have some shortcomings and many operators are concerned for preventing the double fold to lower and to fade away in puffy eyelid. Because, in puffy eyelid, the excessive orbital fat may migrate to the area of fixation and it jeopardizes the effect of suturing. So, We tried to change the thick and puffy eyelid to the slim eyelid by selectively removing soft tissue(pretarsal fat, muscle, orbital fat) through the three tiny incisions. Ninety-five patients underwent operation for creation of a double fold between January of 1996 and February of 1999. All were female. The patients' age ranged from 16 to 31 years, with the mean of 22 years. Most of our patients were satisfied except 5 cases with minor complication(mild asymmetry: 4 cases, foreign body granulation: 1 case). Our method is very similar to various nonincisional methods, however, we removed a portion of pretarsal tissue, muscle, and/or orbital fat around three small incision sites to facilitate tissue adhesion. A continued modification in nonincisional method and improvement in results for double eyelid operation can be expected.