| Objective:1.To perform an anatomical study of the upper eyelid while simulating double eyelid blepharoplasty and to observe the anatomical characteristics of the fibers of the levator aponeurosis and surrounding tissues.2.To apply double eyelid blepharoplasty based on the results of the anatomical study to the levator aponeurosis fiber flap method and to analyze its postoperative results.Methods:1.Five Chinese cadavers were subjected to gross anatomical study.A layer-by-layer dissection method was used to reveal the anatomical structure of the upper eyelid tissues.The alignment,location,and adjacency of the levator aponeurosis fibers and their surrounding tissues were clarified.2.A clinical practice study was performed on 40 candidates(80 eyes)for double eyelid blepharoplasty using the levator aponeurosis flap method in our department between 2021 and 2022.Postoperative follow-up was performed for 6 months to evaluate the surgical results and to investigate postoperative satisfaction.Result:1.The levator aponeurosis was divided into two layers.The anterior layer of the levator aponeurosis fused with the end of the orbital septum and formed a white line.The posterior layer migrated toward the orbicularis oculi muscle and the lid plate.2.Four of the 40 candidates were lost to follow-up,and the remaining 36 candidates all had the right height of the lid line,a smooth and natural shape,and no obvious scarring.The overall satisfaction rate was 91.6% at 2 months and 97.2% at 6 months after surgery.In all cases,no loss of heavy lids,ptosis,or other serious complications were noted.Conclusion:Anatomy can better show the structural characteristics of the upper eyelid layers.The upper lid levator tendon membrane fiber flap method of double eyelid blepharoplasty based on the bilayer structure and travel characteristics of the levator tendon membrane has a high clinical application with natural postoperative appearance,few complications,and high patient satisfaction. |
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