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Wide Double-Eyelid Fold Repair Using an Orbital Septum Flap and Suborbicularis Oculi Fascial Fat Flap in Cases Requiring Preservation of the Original Incision Scar

Aesthet Surg J. 2025 Apr 25:sjaf064. doi: 10.1093/asj/sjaf064. Online ahead of print.

ABSTRACT

BACKGROUND: Double-eyelid blepharoplasty is a common cosmetic surgery. However, blepharoplasty can lead to poor results, necessitating repair surgery. One of the most frequent poor results after double-eyelid blepharoplasty is an excessively wide double-eyelid fold.

OBJECTIVES: To evaluate the clinical efficacy of wide double-eyelid repair using orbital septum and suborbicularis oculi fascial-fat flap in cases requiring preservation of the original incision scar.

METHODS: From June 2019 to June 2022, This retrospective study included 35 patients who underwent wide double-eyelid repair. The orbital septum and suborbicularis oculi fascial-fat flap were prepared. Deep and superficial scar adhesions were fully released to correct the uneven contour at the original incision scar site. The orbital septum flap was turned downward and sutured to the inferior orbicularis oculi muscle and pretarsal fascia. Thereafter, a postoperative follow-up was conducted to observe the results in terms of width of double eyelid, postoperative scars, and patients’ satisfaction.

RESULTS: The difference of double eyelid width before operationat and the last follow-up after operation was statistically significant. No visible scars were seen in patients after the operation, and The width of double eyelid was corrected. The operation was effective, the surgical results were rated as satisfactory in 21 patients and basically satisfactory by 10 patients. The satisfaction rate was 88.57%.

CONCLUSIONS: For wide double-eyelid fold repair in cases requiring preservation of the original incision scar, the use of the orbital septum flap and suborbicularis oculi fascial-fat flap achieves good effects in releasing adhesions, preventing abnormal re-adhesions, and reconstructing natural-looking double-eyelid folds.

PMID:40279382 | DOI:10.1093/asj/sjaf064

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