title: New technique combined with suture and incision method for creating a more physiologically natural double-eyelid.
abstract: BACKGROUND
  A combination of incision and nonincision surgical approaches is necessary to create a more physiologically natural double-eyelid.
  
  
  METHODS
  The location of the partial incision and the burying location are determined. Through a partial incision, the levator aponeurosis is isolated and fixed to the tarsal plate. A single-knot continuous suture is performed. The location of the continuous suture passing through the tarsal plate is at a level that is slightly lower than that at which the levator aponeurosis is fixed to the tarsal plate.
  
  
  RESULTS
  A total of 562 patients were operated on from November of 2006 through October of 2008. The double-eyelid operation was performed on 386 patients, the upper blepharoplasty with skin excision was performed in 91 patients, and a secondary operation was performed in 85 patients. Combined mild to moderate blepharoptosis was corrected simultaneously in all cases. The follow-up period ranged from 6 months to 2 years. Individual patient recovery time varied from 2 weeks to 2 months.
  
  
  CONCLUSIONS
  The advantages of the authors' technique are as follows: (1) the process of forming a double-eyelid is natural; (2) the power of the levator palpebrae muscle regarding the eye-opening process is transmitted to pull up the entire lid margin, allowing the eyes to be easily opened with minimal effort; and (3) there is minimal surgical scarring when the eyes are closed.
authors.affiliation: Daegu, Korea From the Department of Plastic and Reconstructive Surgery, Kyungpook National University Hospital, and BS Aesthetic Clinic.
authors.forename: Byung Chae
authors.initials: BC
authors.lastname: Cho
authors.forename: Jin Suk
authors.initials: JS
authors.lastname: Byun
mesh_terms: D000328:Adult; D044466:Asian People; D019882:Blepharoplasty / Q000379:methods*; D002921:Cicatrix / Q000517:prevention & control; D006801:Humans; D009801:Oculomotor Muscles / Q000502:physiology; D011183:Postoperative Complications / Q000517:prevention & control; D013536:Suture Techniques; D016896:Treatment Outcome