Clinical application of combining double suture fixation and resection partial fat retro-orbicularis oculus in some specially difficult blepharoplasty

Objective To summarize the experience of clinical application of combining double suture fixation and resection of partial fat retro-orbicularis oculus in some specially difficult blepharoplasty. Methods During upper blepharoplasty, patients with heaviness and bulkiness in the both upper eyelid and lateral upper orbital region, we combined double suture fixation and resection partial fat retro-orbicularis oculus. First, partial pretarsal bulky fat was resected, and to form skin-orbicularis-oculi composite below incision line. And then, some thickened fat retro-orbicularis oculus was resected, which was also named preseptal and retro-orbicularis oculus fat (ROOF). Double suture fixation techniques were applied to form dynamic and physiological double eyelid. Results 146 cases had satisfactory effectiveness, except for 2 cases with secondary operation because of some superficial double eyelid creases, and 1 case had hematoma, and 3 had transient numbness in the lateral supraorbital nerve region. They were satisfied with healthy eyelid skins, concealed incision and non-serious complications followed at 3-24 months postoperatively. Conclusions Combining double suture fixation and resection of partial fat retro-orbicularis oculus would appear to be a useful adjunct to standard blepharoplasty techniques in selected patients. Key words: Blepharoplasty; Double suture fixation; Fat retro-orbicularis oculus