Research suggests that modifying buried suture double-eyelid blepharoplasty may decrease the risk for complications and double-eyelid fold loss rate.
The study showed that buried suture double-eyelid blepharoplasty alone using transconjuctival tarsal fixation decreased the risk for complications compared with blepharoplasty combined with resection.
However, double-eyelid blepharoplasty combined with resection of the pretarsal obicularis oculi muscle enhanced the durability of the double-eyelid fold after surgery, reports Tsutomu Mizuno (Anesis Biyogeka Clinic, Okazaki, Japan).
He concludes that resection of the pretarsal obicularis oculi muscle as part of buried suture double-eyelid blepharoplasty is a suitable alternative to multiple sutures or continuous buried suture methods for achieving long-term results.
"The goals of buried suture double-eyelid blepharoplasty are simplicity, minimal invasiveness, quick recovery time, fewer complications caused by the foreign body (ie, sutures), reversibility by suture removal and creation of aesthetically pleasing double-eyelid folds," Mizuno explains.
"The number of buried sutures should be minimal, and use of a simple stitch is best as complex suturing procedures hamper radical removal of sutures."
In a retrospective analysis of 349 patients who underwent buried suture double-eyelid blepharoplasty between 2002 and 2010, Mizuno found no conjunctival complications, such as chronic inflammation of the tarsal plate or suture extrusion, with the transconjunctival tarsal fixation technique.
By contrast, 1.4% of the 73 patients who underwent blepharoplasty combined with resection experienced blepharoptosis.
Of note, the loss rate of the double-eyelid fold after buried suture double-eyelid blepharoplasty combined with resection of the pretarsal obicularis oculi muscle was lower, at 9.6%, than after buried suture double-eyelid blepharoplasty alone, at 26.0%.
"This result highlights the benefits of resection of the pretarsal obicularis oculi muscle, although the rate of blepharoptosis potentially increases," surmises Mizuno.
The patients in the study were aged a mean 25.4 years and underwent the surgery for cosmetic indications. As reported in the Journal of Plastic, Reconstructive, and Aesthetic Surgery, all patients were followed up for a mean duration of 9 months.
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