Modified Orbicularis-tarsus Fixation in Double Eyelid Blepharoplasty: A New Approach Using Conjoined Fascia Readhesion

Traditional fixation methods for double eyelid blepharoplasty, such as orbicularis-levator and orbicularis-tarsus techniques, have achieved satisfactory results but face challenges like shallow or disappearance of supratarsal folds. To address these limitations, the authors introduced a modified orbicularis-tarsus fixation approach incorporating conjoined fascia readhesion. This technique involves dissecting the orbicularis oculi muscle from the conjoined fascia, allowing for scar-based readhesion between these structures, resulting in enhanced stability of the supratarsal fold. A total of 67 patients underwent double eyelid blepharoplasty by the same surgeon using this modified technique. Patients were followed up from 3 to 24 months, with a mean period of 10.3 months. Of the 67 patients, 62 (92.54%) were very satisfied, and 5 (7.46%) were satisfied with the surgical results. Four patients experienced relatively pronounced early swelling, all resolved without particular treatment within 8 weeks. This novel approach by using conjoined fascia readhesion ensures a firmer fixation and improves the aesthetic outcomes. It is a highly applicable and reliable approach for upper-eyelid blepharoplasty.