Through an incision, the loose skin, some of the orbicularis muscle and excess fat are removed and the skin is sutured directly to the anterior lid fascia under direct vision to form a double eyelid. The eyelids formed by this method are generally permanent. The advantages of this procedure are that it is not limited by the conditions of the single eyelid, it is open to all layers of tissue, it is convenient and precise, and it has a wide range of indications. The disadvantages are more complicated operation, longer operation time, more trauma, longer recovery period, and the incision will leave a linear scar.
Suitable people: Generally suitable for all types of single eyelids over 16 years old, especially for single eyelids with thicker skin or more fat on the upper eyelids, sagging upper eyelids, as well as for inner pairs and some more special eye shapes (e.g. “small and large eyes”, “triangle eyes”, “squinting eyes” or The surgery is not recommended for those who have a large amount of fat or thick skin, sagging upper eyelids, single eyelids and some special eye shapes (e.g., “small eyes”, “triangular eyes”, “squinting eyes” or “eight-eyed eyes”).
Contraindications to surgery
1, during pregnancy or menstruation, due to medication and blood clotting disorders, so as not to affect the fetus or surgical bleeding.
2, scar body, or abnormal coagulation mechanism.
3, with heart disease, hypertension, diabetes or other organ disease.
4.Persons with infectious diseases inside or outside the eye, and those with symptoms of cold and fever.
5, in previous surgeries, clearly allergic to local anesthetics, or anti-anesthetics
6, to know that the surgery does not achieve the desired results.
7. Children under 13 years of age are not recommended for blepharoplasty in the purely cosmetic sense.
8. those who have some kind of infectious disease, mental illness or psychological incompetence or psychological instability
9. Those who have high expectations, inadequate psychological preparation or unrealistic questions about the surgery.
10. “Blistering eyes” due to heart and kidney diseases.
11.People with ptosis.
Surgical risks
1. Crease or “triple eyelid”. This is due to the uneven removal of tissues in the eyelid line that is not designed according to the natural curvature. In addition, improper suturing, not according to the natural direction of suturing, misaligned suturing, too tight or too loose, etc. may cause “triple eyelids”.
2, the two eyes are not symmetrical, the curvature is not ideal. Double eyelid one wide and one narrow, or one normal and one abnormal, this is due to the bilateral peeling, removal of tissue differences, suture differences caused by. In particular, the surgery of the two eyes is not operated by one person, which is very likely to cause large errors and make the two eyes asymmetrical.
3.Easy to open the eyes. After double eyelid surgery, it is hard to open the eyes or accompanied by ptosis and discomfort of sedation. This is caused by rough surgical operation, excessive tissue damage, bleeding, hematoma or tissue adhesions. In addition, damage to the levator muscle, adhesions between the orbital septum and levator muscle, and scarring can also cause straining to open the eyes.
4, double eyelid too wide is also a major feature of double eyelid plastic surgery failure, manifested as double eyelid width greater than 8 mm.
5, double eyelid plastic surgery failure may also appear after the phenomenon of internal double, triangle eyes and double eyelids completely disappeared.
Surgical methods.
1, supine position, 75% alcohol disinfection of the face and neck, routine laying of sterile towels.
2, beauty basket marking the incision line.
3, 0.5% lidocaine (containing 1:200,000 epinephrine) for local infiltration anesthesia.
4, cut the skin and subcutaneous tissue along the marked line, and excise the excess skin as needed.
5.Cut the 2mm wide orbicularis oculi muscle on the upper lip of the incision.
6.Cut the orbicularis oculi muscle at the lower lip of the incision, preserving the orbicularis oculi muscle immediately adjacent to the lid margin.
7. trimming the loose connective tissue in front of the lid, making sure to preserve the prelid fascia.
8. cut the orbital septum, enter the orbital septum, free the intraorbital fat mass, remove some of the fat, and stop the bleeding completely.
9, Interrupted 7-0 monofilament sutures are used to close the skin on both sides of the incision edge, with each stitch carrying a small amount of prelid fascia tissue to create adhesions between the skin incision and the lid plate to present double eyelids.
Pre-operative preparation.
1. design a personalized double eyelid shaping plan according to each candidate’s facial features, face shape, age and requirements.
2.Take preoperative photos.
3. upper eyelid lift function check.
4. routine laboratory blood tests.
5. Pre-operative precautions include not taking drugs containing aspirin and Chinese herbal medicines with blood-activating properties within two weeks before surgery, not wearing makeup before surgery, abstaining from smoking and alcohol for two weeks before surgery, and avoiding menstruation and pregnancy for women.
Postoperative care.
1. Half an hour after surgery, moderate pressure should be applied to the surgical area in order to stop the bleeding. If there is still bleeding from the wound, there is no need to panic, you can continue to press for about half an hour again. In case of more than bleeding, serious hematoma and other changes in condition or other abnormalities after surgery, please contact your doctor promptly. Any movement of the eyes after double eyelid surgery can cause pain of varying degrees, but do not keep your eyes tightly closed for fear of pain, as that is not conducive to the formation of the eyelids and the decreasing of swelling. An hour after the surgery, you should do more eye opening and closing movements, you can watch TV or do other things, or you can work as usual. Only by continuously strengthening the movement of opening the eyes can the blood circulation of the eye muscles and surrounding tissues be promoted, the swelling of the surgical site be reduced and gradually eliminated, and the early absorption of the surgical bruises be promoted. Keep the dressing clean and dry and pay attention to the wounded area not to get wet.
2. Change the medication on the 1st day after surgery, remove the gauze, clean the wound with sterile saline for blood scabs and secretions, expose the double eyelid incision and apply erythromycin eye ointment for protection. Within 48 hours after surgery, you can intermittently apply cold compresses to the local area with ice bags, but the pressure should not be too great to avoid damaging the eyes, and you can put sterile gauze strips under the ice sand bag to prevent infection.
3, the 2nd-4th day after surgery can be hot compress to disperse bruises, the temperature of hot compress should not be too high. If there is some blood scab in the incision, it is recommended not to clean it by yourself so as not to mishandle the incision and cause poor healing and obvious scarring, and the doctor will deal with it when removing the stitches.
4, the 5th day after surgery can be removed, clean up the wound and continue to apply erythromycin eye ointment.
5, double eyelid surgery should not take any painkillers. There will be some pain in the incision on the day of double eyelid surgery, but it will gradually reduce with time. Do not rush to take painkillers, because aspirin-based drugs can aggravate wound bleeding. Oral antimicrobials can be taken for three days. Prohibit the use of aspirin, warfarin and blood-activating Chinese medicines.
6.No smoking and alcohol for one month, do not eat spicy and irritating food, and try to eat less seafood hair products. Avoid strenuous exercise within two weeks and do not rub the eyes hard within one month.
7.Prevent scar growth of double eyelid surgery incisions. Some people are still using some wrinkle and sunscreen products that contain heavy metals such as mercury after double eyelid surgery. These makeup and skin care products containing heavy metals may aggravate the scar growth of the surgical incision, and if you are a keloid, it will add to the problem. Therefore, 3-6 months after surgery is the proliferation period of the surgical scar, so do not use cosmetics containing heavy metals during this period. You can use scar inhibiting drugs on the incision location 2 weeks after surgery to prevent scar growth and shorten the time of scar fading.
8. Double eyelid surgery pays attention to good moisturizing and softening of the eyelid tissue. Many people’s eyelid surgery incisions have completely returned to normal, but the surgical site still has a tight and taut feeling, which makes them feel dull and others look awkward. In fact, this phenomenon is a normal phenomenon after surgery. As long as the local moisturizing and softening is done, the tight feeling will be reduced accordingly. Therefore, after the incision of double eyelid surgery is completely healed, you can use some skin care cosmetics produced by regular manufacturers that moisturize and soften the tissue and do not contain heavy metals.
Post-operative recovery: Generally, most of them recover in 2-3 weeks after surgery, and completely natural in about 1-3 months. Swelling is faster in those with good skin elasticity and slower in those with poor skin elasticity; swelling is faster in the young and slower in the old.