I. Blepharoplasty Blepharoplasty, also known as blepharoplasty, is one of the most common procedures in plastic and cosmetic surgery. The surgical approach varies for different blepharoplasty cases. There are two general categories: the incision method and the buried liner method. Each category has a variety of procedures, adding up to no less than 100, but the basic principles and methods are the same regardless of the procedure. The eyelid skin is connected to the levator muscle so that the upper lid skin can be depressed to form the lid furrow when the eyes are open. The common surgical procedures are 1) incision lid fixation; 2) buried suture method; 3) suture method; 4) Korean blepharoplasty, etc. Here’s a look at each of them. 1) Incisional lid fixation, including the PARK method and the conventional method Incisional lid fixation is a longer lasting blepharoplasty procedure because it regulates and changes the tissue structure of the upper lid at all levels and can solve many complex problems of the eyelid, such as upper lid skin laxity, eyelash entropion, upper lid bloating, orbital fat sagging, orbital septum laxity, and outer superior orbital rim bulge. The incisional lid fixation method creates a firm and long-lasting heavy lid with deep creases and a three-dimensional appearance. The disadvantage is that the procedure is complex, requiring familiarity with eyelid anatomy and a solid foundation in plastic surgery. After surgery, the incision line scars are visible for 3-6 months and gradually subside over time. Edema is often noticeable one month after surgery, but by 2 months or more after surgery, it already looks natural. The incision lid fixation method is suitable for all eye types, has a low probability of disappearing, and can be maintained for almost a lifetime. The buried wire method is suitable for young people with large lid fissures, thin eyelids, no bloating, no laxity of the eyelid skin, normal tension, and no canthus. The advantages are that it is simple to perform and easy to master. The ligature is fixed between the upper lid dermis and the anterior or superior lid margin of the levator aponeurosis, resulting in a natural-looking crease. There is no incision and the postoperative tissue reaction is minimal and does not interfere with work. It is easily accepted by the patient, and if the beginner does not master the technique properly, the original method or the incision method can be used to make up for the failure without sequelae. The disadvantage is that the upper lid crease can easily become shallow and narrow, and if the case is not chosen properly or the technique is not well mastered, the upper lid crease can easily disappear. The knot can be easily loosened, leading to surgical failure. The nodes are too shallow and can easily become exposed or form small cysts. Case selection is narrower than with the incision method. If the upper lid is mildly bloated and the patient is adamant about the buried wire procedure, a small incision can be made in the outer 1/3 of the upper lid crease to remove the orbital fat. (1) Buried blepharoplasty is suitable for those who have a single lid on one side. This is done on the single lid side in order to match the opposite side of the lid. 2) Buried blepharoplasty is suitable for young people with little orbital fat in the upper lid and thin, tight skin. 3) After blepharoplasty, a partial shallowing or disappearance of the blepharoplasty fold can be remedied by this method. (4) Buried blepharoplasty is suitable for those whose eyelids are hidden, clinically known as occult double eyelids. 5) Buried blepharoplasty is suitable for people with single eyelids who want to make double eyelids. 6) Buried blepharoplasty is suitable for people who use double eyelid tape to form lines. 7) A buried eyelid blepharoplasty is suitable for people with mild droopy eyelids. 8) Buried blepharoplasty is suitable for people who want to have double eyelids but are afraid to use the incision method. 3. Suture Method The suture method, also known as the penetrating suture method, is suitable for people with large lid fissures, thin eyelids, no bloating, and no laxity or mild laxity of the upper eyelid skin without medial canthus. The advantages are that it is simple to perform and easy for beginners to master. No incisions are made and there are no visible scars after surgery, making it easy for the patient to accept. The disadvantage is that because the entire eyelid tissue is ligated and lymphatic flow is impaired, postoperative reliance on the tissue’s response to the sutures results in an oblique fibrous adhesion between the levator aponeurosis and the skin at the upper edge of the lid, but the number of fibers formed often varies. Once the scar has relaxed, the crease becomes shallow or disappears. In many cases, the crease is often too high and difficult to lower. If the ligature is too high, it restricts the mobility of the levator and Muller muscles, which can lead to ptosis, eye fatigue, and difficulty in opening the eyes. The surgery cannot remove loose upper lid skin and orbital fat at the same time. 4. Three-point blepharoplasty Korean three-point blepharoplasty has better post-operative results than traditional blepharoplasty, and the overall result is a more vivid and beautiful face, which is why it is so sought after. Korean 3-dot blepharoplasty has excellent results compared to other surgeries, while the buried line method of surgery only creates 3 to 5 dotted wounds on the eyelids and is suitable for single eyelids with thin eyelids and little fat, or eyes with one double and one single, one large and one small. However, Korean 3-dot blepharoplasty is a very easy procedure to undergo because it takes only 2 to 3 days for the swelling to go down significantly, and the sutures are not removed after the surgery, making it a natural procedure for the average person. The Korean 3-dot blepharoplasty attracts women with a level of sophistication, care, and humanity that is unmatched by previous common double eyelid surgery, making the eyelids created by Korean 3-dot blepharoplasty look beautiful and agile. Korean 3-dot blepharoplasty is one of the most fashionable personalized eyelids with soft, natural lines that many women are looking for. The 6 advantages of Korean blepharoplasty: 1) With Korean blepharoplasty you can make your upper eyelid appearance thinner, appear flirtatious and give beautiful eyes. 2) Korean blepharoplasty also allows the lid margin to be fully exposed, which is equivalent to the effect of eyeliner. 3) The wide and long eye fissure after Korean blepharoplasty gives the eyes a visually enlarged effect is another feature of Korean blepharoplasty surgery. 4) Korean blepharoplasty is non-invasive and non-marking, and the eyelashes are naturally upturned and sexy, with the dual effect of fat removal and eyelash enhancement. 5) Korean blepharoplasty removes the stitches in three days after surgery, leaving the eyes natural and permanent. (6) Korean blepharoplasty is performed by experts with hundreds of thousands of successful cases, and the results are natural and beautiful, with almost no scars visible and natural and beautiful when the eyes are closed. Contraindications: 1) People who are mentally unstable or have psychological disorders, lack determination of their own conditions, and are obsessed with pursuing unrealistic blepharoplasty patterns. 2. Patients with bleeding disorders and hypertension, as well as active and progressive diseases of the heart, lungs, liver, kidneys and other vital organs, uncontrolled diabetes and those suffering from infectious diseases are not suitable for blepharoplasty. 3. Patients with congenital amblyopia, inner or outer eye, acute or chronic periocular infections that have not yet been controlled or healed are not candidates for blepharoplasty. 4. Blepharoplasty is not suitable for those with facial paralysis with incomplete lid closure. 5. Blepharoplasty is not suitable for people with various causes of ophthalmoplegia, hyperconcave or eyelid recession. 6. Blepharoplasty is not suitable for those whose family members strongly oppose it. 7. Ptosis is not suitable for blepharoplasty. Indications: 1. Single eyelids that are healthy, mentally normal, and actively request surgery without contraindications are suitable for blepharoplasty. 2. Single eyelids with bloated upper eyelids (commonly known as blister eyes) are suitable for blepharoplasty. 3. Single eyelids with medial canthus are suitable for blepharoplasty. 4. Mild upper eyelid entropion is suitable for blepharoplasty. 5. Mild ptosis (combined with levator muscle shortening) is suitable for blepharoplasty. 6. Upper lid skin laxity and ptosis that affects the visual field (mostly in the elderly) is suitable for blepharoplasty. 7. Single and double eyes, single lid side can be operated on or both eyes have different crease widths and lid fissures of different sizes are suitable for blepharoplasty. 8.Inner and hidden double eyelids that are not obvious when the eyes are open are suitable for blepharoplasty. 9. Adults over 18 years old, if underage, need to be accompanied by a guardian. 1) What kind of people are suitable for blepharoplasty? Anyone who is in good health, mentally normal, and has volunteered for surgery without contraindications with a single lid, or who has lax eyelid skin is suitable for surgery. 2) What kind of eyes are not suitable for blepharoplasty? Blepharoplasty is not suitable for those who have a wide eyelid, short round eyes, prominent eyes, strabismus, ptosis, post-implantation, patients with facial palsy, mental abnormalities, peculiar aesthetic views, unrealistic or unreasonable demands. 3) What are the aesthetic, morphological and anatomical differences between double eyelids and single eyelids? In people’s minds, the difference between double eyelids and single eyelids is obvious. In fact, there are aesthetic differences, morphological differences and anatomical differences between the two. 4) Is it better to have wider or narrower double eyelids? The decision depends on a person’s face shape, the width from the arch of the eyebrow to the lid margin (i.e. the width of the upper eyelid), the depth of the eye sockets, the thickness of the upper lid, and other factors. Oriental people have narrow upper lids, flat eye sockets, low eyebrow arches and thick upper lids, so double eyelids should not be made too wide, usually 5 to 7 mm is appropriate. 5) Can one single and one double eye be made into double eyelids? The answer is yes. If the natural double eyelid of this eye is ideal, then it will prevail and the single eyelid on the opposite side will be changed into a symmetrical double eyelid with it. If the natural eyelid is not ideal, or if it is very shallow, it is best to operate on both sides at the same time to obtain a more symmetrical and consistent eyelid. The dangers of blepharoplasty are simple and easy to perform, and can be avoided as long as you choose a professional cosmetic surgery clinic and communicate with your surgeon in detail before surgery! What we need to be aware of is that the dangers that may be caused by our own situation can be completely avoided through pre-operative examination and post-operative care. Therefore, it is important to have a detailed examination before blepharoplasty. If a candidate is found to have a systemic underlying disease such as coagulation disorder, hypertension, heart disease, or diabetes, blepharoplasty should not be performed at this time. In addition, it is important to abstain from smoking, alcohol, pregnancy and menstruation for two weeks prior to blepharoplasty, and to avoid oral medications such as aspirin or aspirin-containing medications, and Chinese herbal medicines that have blood-activating properties, as they can aggravate bleeding during blepharoplasty and may increase the risk of blepharoplasty. In conclusion, is blepharoplasty dangerous? It may come from your own objective reasons, or it may be related to the skill and experience level of the plastic surgeon. In order to avoid the risks associated with plastic surgeons, it is necessary to carefully choose a regular cosmetic medical institution when doing eyelid surgery, so that a trusted expert in medical ethics and skills can do the blepharoplasty for you. The first thing you need to do is to have your skin folded. The main surgical procedures are blepharoplasty plus dermaplaning, suprabrow skin excision, and brow cut. Suitable for: 1. Candidates who subjectively want to improve upper eyelid laxity. 2. Those who have a single upper eyelid and have significant skin laxity. 3. Those with bloated upper lids (commonly known as swollen eyeballs). 4.People who have flat eyelashes or inversion. 5. Those who have failed double eyelid surgery. For people with single eyelids who have simple upper eyelid skin laxity, a simple brow lift can be used if the upper eyelid is lax with a sagging brow, or a brow lift plus blepharoplasty if there is a requirement for heavy eyelids. For people with heavy eyelids who have simple upper lid laxity, a 1mm crescentic skin excision with intermittent sutures is used for heavy eyelids with wide eyebrow-eye spacing. Brow surgery: For people with upper lid laxity and sagging eyebrows. Eye bags, sagging lower lid skin Eye bags are puffy lower eyelids. The manifestation of sagging eye bags can be divided into four types: type I only skin laxity, subcutaneous fat atrophy; type II in addition to skin laxity, subcutaneous fat atrophy, the orbicularis oculi muscle is also lax; type III in addition to the above characteristics, there is orbital fat prolapse; type IV orbital fat bulging heavier, skin and orbicularis oculi muscle tension is still possible. Eye bag sagging correction is one of the most common procedures in cosmetic plastic surgery. During surgery, a professional cosmetic surgeon will cut the skin and lower orbicularis muscle along the curve of the lower lid margin 2-3 mm below the lower lid margin, lift the skin and muscle tissue, remove the fat globules that herniated by themselves, then fold and suture the loose orbicularis muscle for suspension, finally stretch the skin, remove the excess part, and close the incision with non-invasive hair-thin cosmetic sutures, and remove the sutures in three to five days. After surgery, you only need to rest for two or three days and take appropriate antibiotics to prevent infection, and it is important to do a good job of postoperative care and maintenance. The inner canthus is a vertical skin crease in front of the inner canthus, which hides the inner canthus, making the angle of the inner canthus smaller than without the inner canthus, it also blocks part of the field of vision, so that people with double faces can only form a “half double”, which affects the beauty of the eye. There are two types of canthus: congenital and acquired. Congenital canthus is mostly bilateral and has genetic characteristics, and in severe cases it is often associated with ptosis and small lid fissures. Acquired medial canthus is most often caused by trauma, burns, and scalds, and is mostly unilateral and often associated with damage to adjacent tissues, such as damage to the lacrimal duct and the medial canthal ligament. The purpose of canthus correction is to remove the skin folds in the inner corner of the eye to reveal the tear duct and increase the eye fissure. Treatment is only required if the canthus alone is still evident after puberty. In mild cases, the skin incision can be sutured directly after cutting the redundant skin, while in more severe cases, a “z” reshaping or other flap repair should be performed. Although the incision marks may be left on the inner canthus after surgery, the surgically enlarged eye canthus will add color to the eyes. Common corrective surgical methods are as follows: 1. The medial canthus skin excision method is suitable for patients with a small medial canthus type redundancy. The effect of this surgical method is not very satisfactory and is rarely used now. 2.The “Y-V” suture method is suitable for patients with light canthal redundancy. The method is to make a horizontal “Y” shaped incision in the medial canthus, the size of which is determined as needed, and the width of the upper and lower should generally be greater than the lid cleft. The suture will be traction sutured to the nasal side, and the wound will be transverse “V” shaped. Blair-Brown’s method is suitable for patients with larger canthal type redundancies. The method is to make an incision in the medial canthus, peel off two triangular flaps, deep to the medial canthal ligament, close the medial canthal ligament to the nasal side and suture the two flap tips to the nasal side, suture the top of the transverse incision, and finally suture the skin wound edges in a “∈” shape. 4.Ping He method is suitable for patients with medial canthus type redundancy. The method is to make a “>” shaped incision in the inner canthus, peel off the flap, fix a needle in the inner canthus, and loosen the redundant skin. The skin above and below the canthus is removed and then sutured into a “＜” shape. 5.”Z”-shaping method is suitable for patients with various kinds of canthus. The method is to make a “Z”-shaped incision in the medial canthus, peel the subcutaneous tissue around the incision, make two triangular flaps, exchange the two flaps, and then suture the skin edges. The two flaps are exchanged and the skin edges are sutured together. There are several specific surgical methods that are often used in clinical practice, and different “Z” shaped surgical methods are generally used depending on the patient’s condition. 6.Mustarde’s method (four flap method) This is a more common surgical method with better results. It is suitable for patients with inverted medial canthus and a combination of widened medial canthus, small lid fissure and ptosis. The method is to make four flaps in the medial canthus, exchange positions and suture them together. The Speath flap correction method is suitable for patients with canthal hypertrophy combined with mild lower lid ectropion. A tongue-shaped flap is made on the medial side of the upper eyelid in the medial canthus, which is peeled off and then rotated to the skin defect area of the lower eyelid and sutured to the wounded edge. V. External canthoplasty An external canthoplasty is a procedure to extend the horizontal length of the eye by cutting the outer corner of the eye when you want the eye to appear larger. This is a surgery to cut the mucous membrane on the outside of the eye to extend the length of the eye without leaving a scar. The same as canthoplasty is used when you want to increase the horizontal length of your eyes, or when you want to perform blepharoplasty to increase the size of your eyes if you do not have canthus and the distance between your eyes is not far. Indications: 1. Healthy, mentally normal people who want to have surgery and have no contraindications. 2. Those with small eyes who wish to have their eyes corrected by surgical plastic surgery. 3.Patients with congenital microphthalmia. External canthal suture eyelid shortening is a cosmetic and therapeutic procedure, which can be done to shorten the eyelid permanently for cosmetic reasons or temporarily for therapeutic reasons. Lid margin suturing of the external canthus is indicated for: 1. Asymmetrical lid fissures in both eyes and long deformity of one lid fissure. 2. Protrusion of the eye in thyroid-related eye disease. Shortening of the lid fissure protects the cornea and limits its progression. 3, Paralytic rabbit eyes. Shortening the lid fissure can help the lid to close, protect the cornea and slightly elevate the lower lid to reduce tear spillage. 4. Reshape the external canthus. Ptosis is the partial or complete drooping of the upper eyelid due to the incomplete or loss of function of the levator muscle and the Müller smooth muscle. In order to overcome the visual impairment, bilateral ptosis creates a special posture of tilting the head and wrinkling the forehead because of the need to look up. This can be classified as: 1. Paralytic ptosis is caused by paralysis of the oculomotor nerve. This is mostly unilateral and is often combined with paralysis of other extraocular or intraocular muscles innervated by the motor nerve. Sympathetic ptosis is caused by dysfunction of the Müller muscle or by damage to the cervical sympathetic nerve; in the latter case, it is accompanied by ipsilateral pupillary narrowing, sunken eyes, flushing and an absence of sweating, called Horner syndrome. 3. Myogenic ptosis is most often seen in myasthenia gravis and is often associated with generalized random muscle fatigue. This type of ptosis is characterized by improvement after rest, immediate aggravation during continuous transients, light in the morning and heavy in the afternoon, and temporary relief of symptoms after 15 to 30 minutes of subcutaneous or intramuscular injection of neostigmine. 4. Other (1) Traumatic injury to the motoneurotic nerve or levator muscle or Müller muscle can cause traumatic ptosis. (2) Diseases of the eyelid itself, such as severe trachoma and lid tumors, increase the weight of the eyelid and cause mechanical ptosis. (3) Anophthalmia, microphthalmia, ocular atrophy and various causes of reduced orbital fat or orbital contents can cause pseudopelvic ptosis. Congenital ptosis should be surgically corrected early if it interferes with vision development. If the ptosis is mild and does not affect visual development, surgery can be performed at a later date to improve the appearance. In cases of unilateral ptosis that obscures the pupil, early surgery should be sought, preferably before age 6, to prevent amblyopia from developing. For myogenic or paralytic ptosis, adenosine triphosphate, vitamin B1, or neostigmine may be used. Surgery should be carefully considered when prolonged treatment is ineffective. VII. Eyelid entropion Lid entropion refers to an abnormal position of the eyelid, especially the curl of the lid margin toward the eye. When the lid is turned inward to a certain degree, the eyelashes are also turned back toward the eyeball. Therefore, entropion and impingement often coexist. There are three types of entropion: congenital entropion; spastic entropion; and scarring entropion. Congenital entropion is often bilateral, while spastic and scarring entropion may be unilateral. Patients have photophobia, tearing, tingling, and eyelid spasm. Examination reveals curling of the lid, especially the lid margin, toward the eyeball. The corneal epithelium may be shed and fluorescein may be diffusely stained as the impingement rubs against the cornea. If the infection is secondary, it may develop into a corneal ulcer. If left untreated for a long time, the cornea has neovascularization and loses its transparency, causing vision loss. 1. Congenital lid entropion can disappear on its own as the nasal bridge develops with age, so there is no need to rush surgical treatment. If the child is 5 to 6 years old and the eyelashes are still turned inward and severely irritate the cornea, surgical treatment can be considered by performing a vaulted-eyelid skin threading procedure to correct the entropion by pulling the lid margin outward using the force of the suture pull. 2. Age-related lid entropion Botulinum toxin local injections can be performed. If this is not effective, the excess loose skin can be surgically removed and some of the orbicularis oculi fibers can be cut. For acute spastic entropion, inflammation should be actively controlled. To temporarily relieve irritation, the lower lid can be taped and pulled. A prosthetic eye can be fitted if there is no eyeball, and the bandage can be removed if it is caused by a bandage. 3. Scarring entropion must be treated surgically, either by lid wedge resection or lid dissection. 4. Entropion correction (1) Indications ① inward curl of the eyelid margin with lashes in rows backwards towards the cornea; ② eyelid entropion causing significant corneal injury or the patient complaining of foreign body sensation. The surgical results of entropion correction are common surgical procedures for the external eye. The common causes of entropion are scarring, skin laxity, and spasticity in the elderly, so the surgical methods vary, which means that there are many surgical methods for entropion correction. In some cases, there may be recurrence, and special attention should be paid to the fact that any obvious foreign body sensation should be followed up promptly. (2) Contraindications ① severe eyelid closure insufficiency; ② acute conjunctivitis, glaucoma attack; ③ chronic lacrimal sac inflammation with obvious pus overflow. Anesthesia method Mucosal surface anesthesia + local infiltration anesthesia. Anesthesia is contraindicated to be safe and effective. VIII. Eyelid ectropion Eyelid ectropion is a condition in which the lid margin is turned outward away from the eye and the conjunctiva is often exposed to varying degrees, often in combination with incomplete lid closure. 1. Scarring ectropion is caused by contraction of the skin surface of the eyelid. Lid skin scarring can be caused by trauma, burns, chemical injuries, eyelid ulcers, lid margin osteomyelitis, or facial surgery. 2. Age-related eyelid ectropion Limited to the lower lid. This is caused by the weakening of the orbicularis oculi muscle and the laxity of the eyelid skin and canthal ligaments in the elderly, which prevents the eyelid from fitting only to the eyeball and causes it to drop due to the weight of the lower lid. 3. Paralytic eyelid ectropion is also limited to the lower lid. It occurs when the facial nerve is paralyzed and the orbicularis oculi muscle loses its contractile function and the weight of the lower lid causes it to fall. Treatment: Scarring ectropion requires plastic surgery, with free implantation being the most common method. The principle is to increase the vertical length of the anterior eyelid layer and eliminate vertical traction on the eyelid. (1) Age-related ectropion can also be treated surgically, using a “Z” flap for corrective surgery or a “V” or “Y” reshaping procedure. (2) The key to paralytic ectropion is treatment of facial nerve palsy, which can be treated conservatively by pulling the eyelid with tape to protect the cornea and conjunctiva, or by temporary lid margin suturing. 9. Eyelid defect A lid margin defect is a partial or complete loss of the lid margin or eyelid. The clinical manifestations are: the defect can be as small as a cut or as large as the entire eyelid. It is more dangerous in the upper lid than in the lower lid. The central part of the upper eyelid is particularly severe, as the cornea loses the protection of the eyelid, making it susceptible to keratitis, light ulceration, and severe perforation. Lower lid defects mainly produce symptoms such as tearing. There are two types of eyelid defects, congenital and acquired. Congenital defects, mostly in the upper lid, unilateral or bilateral, are often associated with deformities of the {angle, tear ducts, eyebrows, etc., or defects of the orbital bone. Visual acuity is normal or impaired. Acquired cases are caused by trauma, burns, or after removal of a tumor. There is often adjacent scar tissue and tissue displacement elements. Visual acuity can be normal or impaired, and there are many methods of treatment and repair that should be implemented in conjunction with each individual case. Treatment principles: 1. Upper lid margin defects: local pulling, advancing, and splitting surgery. 2. Small lower lid margin defect: same as above. 3, Upper lid margin and partial lid defect: local flap repair. 4.Repair of partial defect of lower lid margin and lower lid plate: local repair or local advancement flap repair. Eyebrow defects and deformities Eyebrow defects or deformities are mostly caused by burns, infections (leprosy), resection of tumors, or can be congenital. It can be partial or total absence. The eyebrows can also be pulled by the frontal or lid scar, resulting in abnormal position. 1, the formation of eyebrow deformity. It is caused by misaligned healing due to improper treatment of local skin and soft tissue lacerations after early treatment and failure to accurately dock and repair with fine sutures. 2.The formation of eyebrow defect. Most of them are caused by trauma, mainly burns, or by tumor removal of the brow skin, and occasionally by leprosy, limited alopecia, syphilis and other diseases. Treatment: 1, eyebrow deformity plastic surgery (1) eyebrow ptosis, simple or simultaneous with the upper blepharoplasty. Separate the eyebrow from under the orbicularis oculi muscle to the level of 1 to 37.5 px above the supraorbital rim, remove the hanging eyebrow fat pad and then suspend the sagging eyebrow to the periosteum above the supraorbital rim to reset it. (2) eyebrow displacement “Y ~ V” shaping surgery correction, trauma-induced eyebrow displacement can be designed according to the specific circumstances of the deformity, “Z” shaping repair correction. 2, eyebrow defect plastic surgery (1) eyebrow partial defect treatment 1/3, according to the elasticity of the skin, the use of “YmV” surgery, so that the healthy eyebrow area tissue to extend the defective part of the sliding flap repair; or flap creeping advance method, that is, the first end of the defect as the tip, the formation of the flap as close as possible to the missing end, while the flap in 1/3 of the section temporarily let it glisten into the crease. 3m4 weeks later, the second phase of surgery to the other end After 3m4 weeks, the other end of the flap is used as the tip to dissect the crease, unfold the defect, and laterally shift the flap to obtain visual improvement. (2) Plastic surgery for large or total eyebrow defects 1) transposition of the healthy side of the eyebrow flap repair. A flap containing half of the eyebrow hairs is cut from the healthy side of the eyebrow and the 1/2 width of the flap is located at the midpoint of the two eyebrows, then the affected side is cut in an arc equivalent to the arch of the eyebrow, and the healthy eyebrow flap is rotated 180 degrees and transplanted to the wound surface after subcutaneous peeling. 2) Scalp slice free grafting eyebrow reconstruction, if it is a unilateral defect, it should be depicted according to the positioning of the healthy eyebrow; if it is a bilateral eyebrow defect, it should be positioned along the brow crest. The scalp slice is mostly taken from the edge of the hairline behind the ear, and the full-thickness scalp is cut according to the desired shape and size of the eyebrow. 3) Superficial temporal artery island scalp flap brow reconstruction, through the subcutaneous fall channel transfer to the defective part of the bed wound. The advantage is that the flap has a good blood supply and the reconstructed eyebrows grow densely, which is suitable for male patients with thick eyebrows and large eyes. Eyelash defects The eyelashes have a protective effect. The eyelashes on the upper and lower lid margins are arranged like rows of guards at the edge of the lid fissure. The eyelashes are the second line of defense for the eye. If a foreign object such as dust touches the eyelashes, the eyelids reflexively close to protect the eye from foreign intrusion. They have the function of blocking light, preventing dust, foreign objects and sweat from entering the eye and providing protection to the cornea and eyeball. Eyelashes also protect the eyes from UV rays. Eyelash loss can be effectively repaired by using a single eyelash transplant. And perfect results can be achieved, making the eyelashes more attractive and glowing.