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

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 The aim of this study was to evaluate the clinical efficacy of wide double-eyelid repair using an orbital septum flap and a suborbicularis oculi fascial-fat flap in cases requiring preservation of the original incision scar. Methods This retrospective study, undertaken between June 2019 and June 2022, included 35 female patients who underwent wide double-eyelid repair. An orbital septum flap and a 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 patient satisfaction. Results The difference between the double eyelid width before operation and at the last postsurgical follow-up 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; 4 patients rated the results as unsatisfactory. 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 an orbital septum flap and a suborbicularis oculi fascial-fat flap achieves good effects in releasing adhesions, preventing abnormal readhesions, and reconstructing natural-looking double-eyelid folds. Level of Evidence: 4 (Therapeutic)