Revision of Unfavorable Double Eyelid Operation by Repositioning of Preaponeurotic Fat

ABSTRACT

Oriental blepharoplasty or the commonly called "double eyelid" operation is the most common cosmetic procedure among Orientals because the Orientals tend to be conscious of the fold due to the influx of Caucasians and social westernimtion. Anatomically, the upper eyelids of the Orientals are considerably digerent from those of Caucasians, and nearly half of them have single eyelids. Considering the anatomic characteristics of the Koreans, an appropriate design and operative technique must be selected carefully to obtain an aesthetically satisfactory result. However, the incidence of complications occurs frequently. Patients who are faced with unsatisfactory results are perplexed by the fact that such a commonly performed procedures yield such a high dissatisfaction rate, and that secondary revisions can not be easily done. An unfavorable result does not necessarily imply a postoperative complication. Equally important is the unsatisfaction of the patient, whose goal may not be based on good aesthetic principles. The most common source of dissatisfaction in patients who underwent double eyelid operation is postoperative asymmetry and high level of the lid fold. During the eight years from 1991 to 1997, a total 72 patients underwent the secondary blepharoplasty either by transversely slitting and removing multilaminated septal structures exposed to the previous operative scar and or by spreading the preaponeurotic fat, that was extruded into a thin layer. The average age of the patients was 26.5 years and average follow up period was 2 years. No remarkable complications were encountered after operarion by our method and desired aesthetic improvements were acquired in the majority of the patients.