Invited Discussion on: Supraciliary Incision as a New Double-Eyelid Approach for Asian Patients: Clinical Experience of
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EDITOR’S INVITED COMMENTARY
Invited Discussion on: Supraciliary Incision as a New DoubleEyelid Approach for Asian Patients: Clinical Experience of 528 Cases Michelle Lee1
Received: 12 July 2020 / Accepted: 13 July 2020 Ó Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2020
Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. Upper blepharoplasty is one of the most common procedures performed on Asian patients. Multiple techniques have been reported in the literature. The authors of the study report their experience using a new surgical technique for the creation of a supratarsal fold in 528 cases. The technique combines the non-incision buried suture technique with a novel incision technique. Instead of placing the incision 6–8 mm above the palpebral margin, the operation is approached through a supraciliary incision. The advantages of this technique are that the incision in the supraciliary crease produces less scar visibility and keeps the upper eyelid’s subdermal vascular network and skin intact. After resection of the redundant skin and a strip of orbicularis oculi, the levator aponeurosis is exposed. Internal buried fixation sutures between dermal tissue and the fusion line of the orbital septum and levator aponeurosis are then placed to create the crease. The authors evaluated this novel technique on 528 patients. All patients had a telephone visit 1 month after surgery to evaluate for immediate postoperative complications such as dysfunction of the eyelid movement, dry & Michelle Lee [email protected] 1
PERK Plastic Surgery, 416 N Bedford Drive Ste 400, Beverly Hills, CA 90210, USA
eye and visual impact. A total of 288 patients had an inperson visit between 6 and 78 months of follow-up. In the study cohort, 92.3% of the patients reported a satisfactory result. The authors report the advantages of this technique are as follows: (1) the supraciliary incision produced a less visible scar, (2) early resolution of edema, (3) natural contour of the fold and (4) dynamic and anatomic morphology of the eyelid. The authors should be applauded for the gallery of impressive results with minimal scarring and natural dynamic eyelid movement. Although this is a technique paper, it should be noted that the reporting of postoperative course could be better. The initial assessment was done by patient-reported telephone calls. In-person follow-up occurred in less than 50% of the patients. The evaluation of postoperative result is not standardized since patient-reported outcomes are subject to individual biases. The supraciliary incision is a novel approach and a valuable addition to the armamentarium of Asian blepharoplasty. Although the scars presented here are barely noticeable, it would be interesting to see whether the scar is signif
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