CC BY-NC-ND 4.0 · Facial Plast Surg 2023; 39(01): 057-062
DOI: 10.1055/a-1980-8755
Original Article

Three-Point Vertical Mattress Suture: A Simple Technique for Mild Blepharoptosis Correction in Partial-Incision Double-Eyelid Surgery

Bo Chen
1   Plastic Surgery Department, China-Japan Friendship Hospital, Beijing, China
,
Li Ma
1   Plastic Surgery Department, China-Japan Friendship Hospital, Beijing, China
,
Jingyi Wang
2   MAGIC BeauCare Clinic, Beijing, China
› Author Affiliations

Abstract

The aim of this study was to introduce a simple technique for mild blepharoptosis correction using a three-point vertical mattress suture in partial-incision double-eyelid surgery. The medical records and preoperative and postoperative images of 57 patients who underwent simultaneous mild blepharoptosis correction and partial-incision double-eyelid surgery from January 2018 to July 2021 were retrospectively reviewed. The surgical procedure mainly involves three small incisions in the proper eyelid crease, levator aponeurosis exposure by conservative dissection, and three-point vertical mattress suture to plicate levator aponeurosis and fix the orbicularis muscle with the plicated levator aponeurosis. All patients underwent bilateral partial-incision double-eyelid surgery: 10 unilateral and 47 bilateral blepharoptosis corrective surgeries. The average age was 25.3 ± 7.4 years. The mean operative and follow-up duration were 50 minutes and 13 months, respectively. The pre- and postoperative mean marginal reflex distance was 3.04 ± 0.27 and 3.75 ± 0.35 mm, respectively. The overall surgical success rate was 93%. Complications including undercorrection (5.3%), asymmetry (7.0%), and double-eyelid crease disappearance (5.3%) were reported. Three-point vertical mattress suture is considered an effective, safe, and simple technique for mild blepharoptosis correction in partial-incision double-eyelid surgery.



Publication History

Accepted Manuscript online:
16 November 2022

Article published online:
27 January 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Zhang MY, Yang H, Li CY, Du FY, Huang XJ, Tan WQ. Removal of a large amount of pretarsal tissue through three mini incisions in the construction of a double eyelid. Aesthetic Plast Surg 2012; 36 (05) 1039-1046
  • 2 Suhk JH, Kiranantawat K, Nguyen AH. Physical evaluation of the Asian blepharoplasty patient. Semin Plast Surg 2015; 29 (03) 145-157
  • 3 Saonanon P. Update on Asian eyelid anatomy and clinical relevance. Curr Opin Ophthalmol 2014; 25 (05) 436-442
  • 4 Lee JH, Nam SM, Kim YB. Blepharoptosis correction: levator aponeurosis-Müller muscle complex advancement with three partial incisions. Plast Reconstr Surg 2015; 135 (02) 388-395
  • 5 Lucarelli MJ, Lemke BN. Small incision external levator repair: technique and early results. Am J Ophthalmol 1999; 127 (06) 637-644
  • 6 Frueh BR, Musch DC, McDonald HM. Efficacy and efficiency of a small-incision, minimal dissection procedure versus a traditional approach for correcting aponeurotic ptosis. Ophthalmology 2004; 111 (12) 2158-2163
  • 7 Baroody M, Holds JB, Sakamoto DK, Vick VL, Hartstein ME. Small incision transcutaneous levator aponeurotic repair for blepharoptosis. Ann Plast Surg 2004; 52 (06) 558-561
  • 8 Eshraghi B, Ghadimi H. Small-incision levator resection for correction of congenital ptosis: a prospective study. Graefes Arch Clin Exp Ophthalmol 2018; 256 (09) 1747-1750
  • 9 Ahuero AE, Winn BJ, Sires BS. Standardized suture placement for mini-invasive ptosis surgery. Arch Facial Plast Surg 2012; 14 (06) 408-412
  • 10 Bernardini FP, de Conciliis C, Devoto MH. Mini-invasive ptosis surgery. Orbit 2006; 25 (02) 111-115
  • 11 Elabjer BK, Busić M, Elabjer E, Bosnar D, Sekelj S, Krstonijević EK. Microincision aponeurotic ptosis surgery of upper lid. Coll Antropol 2009; 33 (03) 915-918
  • 12 Lee CK, Ahn ST, Kim N. Asian upper lid blepharoplasty surgery. Clin Plast Surg 2013; 40 (01) 167-178
  • 13 Bellinvia G, Klinger F, Maione L, Bellinvia P. Upper lid blepharoplasty, eyebrow ptosis, and lateral hooding. Aesthet Surg J 2013; 33 (01) 24-30
  • 14 Matsuda H, Shiba T, Takahashi Y, Tsuneoka H. Transcutaneous aponeurotic repair with small detachment of the levator aponeurosis for aponeurotic blepharoptosis in Japanese patients. J Plast Reconstr Aesthet Surg 2018; 71 (03) 425-430
  • 15 Ranno S, Sacchi M, Gonzalez MO, Ravula MT, Nucci P. Evaluation of levator function for efficacy of minimally invasive and standard techniques for involutional ptosis. Am J Ophthalmol 2014; 157 (01) 209-213.e1
  • 16 Makeeva V, Collawn SS, Pierce EN. et al. Numerical correlation of levator advancement in preoperative planning. Ann Plast Surg 2017; 78 (6S, Suppl 5): S279-S281
  • 17 Alkeswani A, Hataway F, Westbrook B, Gulamani S, Collawn SS. Changes in lid crease measurements in levator advancement for ptosis. Ann Plast Surg 2020; 84 (6S, Suppl 5): S358-S360