Tarsus-Orbicularis-Septum Fixation in Double-Eyelid Blepharoplasty: A Reliable and Flexible Technique

Yixin Sun; Runzhu Liu; Nanze Yu; Dingyue Zhang; Juan Chen; Jiuzuo Huang; Xiao Long

doi:10.2147/CCID.S367202

Tarsus-Orbicularis-Septum Fixation in Double-Eyelid Blepharoplasty: A Reliable and Flexible Technique

Clin Cosmet Investig Dermatol. 2022 Jun 21:15:1125-1132. doi: 10.2147/CCID.S367202. eCollection 2022.

Authors

Yixin Sun^#¹, Runzhu Liu^#¹, Nanze Yu¹, Dingyue Zhang², Juan Chen³, Jiuzuo Huang¹, Xiao Long¹

Affiliations

¹ Division of Plastic Surgery, Department of Surgery, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
² Department of Clinical Medicine, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
³ Institute of Medical Information/Medical Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: Incisional double eyelid blepharoplasty is the most common cosmetic operation in East Asia. Although numerous articles on surgical techniques have been published, complications, such as fold loss, asymmetry, and visible scars, still exist. To create a stable and dynamic double-eyelid crease, the author has introduced a modified technique of double-eyelid blepharoplasty.

Patients and methods: The authors introduced a new surgical technique to reduce complications and create reliable and dynamic double eyelids. The orbicularis oculi muscle of the lower flap was anchored on the tarsus and sutured with the distal part of the septal flap. The skin incision was closed by skin-septal flap-skin suture. Postoperative evaluations were assessed at the twelfth postoperative month.

Results: One hundred ninety-three patients underwent double eyelidplasty with the TOS fixation technique. The mean follow-up duration was 18.6 months (range, 12-30 months). In the aesthetic outcome evaluation, 88 (45.6%) patients had very much improved results, 56 (29.0%) had much improved results, 29 (15.0%) had improved results, 8 (4.1%) had no change and 12 (6.2%) had worse results. Complications included crease asymmetry (n=7, 3.6%), partial fold loss (n=8, 4.1%) and complete fold loss (n =5, 2.6%).

Conclusion: Tarsus-orbicularis-septum (TOS) fixation is a reliable and flexible surgical technique for creating stable and dynamic double-eyelid creases.

Keywords: double eyelidplasty; orbital septum; primarily blepharoplasty; tarsus.

Grants and funding

This manuscript is funded by the CAMS Innovation Fund for Medical Sciences (CIFMS), No. 2020-I2M-C&T-A-004 and the National Key R&D Program of China, Key Project of the Strategic International Science and Technology Innovation Cooperation, Ministry of Science and Technology, grant No. 2020YFE0201600.