Many single eyelid MM are eager to have a pair of big eyes with double eyelids and watery eyes. As you may know, double eyelids are made by cutting the upper lid of the eye and then stitching out the crease to make double eyelids. How does it actually look like? Do you know how the structure of the eye is like? The eyelids are located at the front of the orbit and cover the surface of the eye, divided into the upper and lower eyelids. The fissure between the upper and lower lid margins is called the palpebral fissure, and its inner and outer joints are called the medial and lateral canthus, respectively. The upper lid covers the upper cornea by 1 mm to 2 mm. There is a small fleshy elevation at the inner canthus called the lacrimal fissure, which is a metaplastic skin tissue. The lid margin has an anterior lip and a posterior lip. The anterior lip is bluntly rounded and has two to three rows of neatly arranged eyelashes, with sebaceous glands (Zeis glands) and metaplastic sweat glands (Moll glands) opening around the hair follicles. The posterior lip is at a right angle and is in close contact with the surface of the eye. There is a gray line between the two lips, which is the junction between the skin and the conjunctiva. Between the gray line and the posterior lip is a row of fine holes that serve as openings for the lid glands. The upper and lower lid margins each have a papillary projection at the medial end of the lid with a small hole called a tear point. Did you know that the eyelids are divided into five layers from the outside in? 1) Skin layer: This is one of the thinnest and softest layers of skin in the body and is easily wrinkled. 2) Subcutaneous layer: This is loose connective tissue and a small amount of fat. It is prone to edema in case of kidney disease and local inflammation; 3. Muscle layer: including orbicularis oculi and levator muscle. The orbicularis oculi muscle is a transverse muscle with fibers that travel in a circular pattern parallel to the lid fissure and is innervated by the facial nerve, which closes the eyelid. The levator aponeurosis is innervated by the ophthalmic nerve and lifts the upper lid to open the lid fissure. The muscle starts from the general tendon ring around the orbital aponeurosis, fans out along the superior orbital wall to the orbital rim, and divides into anterior, middle, and posterior parts: the anterior part is a thin, wide tendon membrane that crosses the orbital septum and ends in front of the lid plate, with some fibers crossing the orbicularis oris muscle and ending under the skin of the upper lid to form the lid; the middle part is a layer of smooth muscle fibers (Müller muscle) that is innervated by the sympathetic nerve and attaches to the upper edge of the lid plate (lower lid Müller muscle starts from the inferior The lid fissure opens particularly wide during sympathetic excitation; the posterior part is also a tendon membrane that ends at the conjunctiva of the fornix. 4. The lid plate: a semilunar structure formed by dense connective tissue, the ends of which are fixed to the medial and lateral orbital margins by the medial and lateral canthal ligaments. The lid is lined with several Meibom glands (Meibom glands), the largest sebaceous glands in the body, which open at the lid margin, secrete lipids, participate in the composition of the tear film, and lubricate the ocular surface. 5. Conjunctival layer: The clear mucous membrane immediately behind the lid plate is called the lid conjunctiva. What is the levator aponeurosis? Did you know? The levator aponeurosis is located above the superior rectus muscle and begins just above the optic nerve canal and ends forward at the upper lid via a broad tendon membrane. The posterior portion of the linea alba consists of smooth muscle that attaches to the upper edge of the upper lid plate and is called the superior levator muscle or Milller’s muscle. The superior levator muscle is innervated by the sympathetic nerve and can cause ptosis when there is a disorder. The levator muscle functions to lift the upper lid and is innervated by the motoneurotic nerve. Why do I bleed a lot when I have eyelid surgery? The blood supply to the eyelid: there are two arterial plexuses, superficial and deep, from the facial branch of the external carotid artery and the ophthalmic branch of the internal carotid artery, respectively. A marginal arterial arch forms about 3 mm from the lid margin, and a smaller peripheral arterial arch forms at the superior margin of the lid. The superficial (prelid) veins return to the internal and external jugular veins, and the deep veins eventually converge into the cavernous sinus. Because the eyelid veins do not have venous valves, there is a risk of septic inflammation spreading to the cavernous sinus, with serious consequences. Lymph of the eyelid: parallel to the venous return, the lateral eyelid drains to the preauricular and parotid lymph nodes; the medial eyelid drains to the submandibular lymph nodes. How is the double eyelid made? With this anatomical knowledge and a full understanding of the anatomy of the eye, let’s see how the double eyelids are formed. Principle: In the simplest terms, it is to form a firm adhesion between the skin and the levator muscle. Traditional method: Both buried or incisional methods can form a heavy eyelid. The former uses the force of the thread to connect the skin to the levator muscle, with the advantage of no incision, no post-operative stitching, and a quicker recovery with less damage. The disadvantages are: the thread knot tends to loosen, and over time the blepharoplasty is poorly formed and needs to be repaired again. In contrast, the incision method involves removing some of the skin and muscle and some of the fat, allowing the skin to form a fibrous connection directly with the levator muscle, which is actually what we call a scar, and this connection is more secure, which is why the incision is permanent. The Park method of blepharoplasty also belongs to the incision method, but differs from the traditional incision method in that the park method of blepharoplasty preserves the muscle tissue under the eyelids and uses the adhesions between the levator muscle and the muscle to form the eyelids. Second, there is a muscular lining between the skin and the levator muscle that does not create a deeper incision depression when the eyes are closed. The first thing you need to do is to have a good idea of what you’re doing. The swelling before the removal of the stitches is necessary after the double eyelid surgery, but strict compliance with medical advice will shorten the swelling period: for example, cold compresses within 48 hours; do not continue to play with the phone after the surgery; keep the diet light, pay attention to rest, etc.