The Application of Perforation Technique and Dual-Target Fixation Technique in Double-Eyelid Blepharoplasty.

Objective: This article introduces a surgical approach that emphasizes minimizing the removal of pretarsal tissue to achieve a stable and dynamic upper eyelid morphology while effectively preventing concave scarring at the incision site.

Methods: A total of 338 Chinese patients underwent double-eyelid surgery using the double-fixed target point technique at our institution between May 2018 and December 2022. Pre-operative and post-operative follow-up photographs were taken and assessed.

Results: The study included 338 patients, with 323 females and 15 males. Among them, 260 patients (76.9%) reported satisfaction, 59 patients (17.5%) reported being somewhat satisfied and 19 patients (5.6%) reported dissatisfaction. Complications recorded during the follow-up period included asymmetry of folds (n=17, 5.0%), partial disappearance of double-eyelid folds (n=8, 2.4%), and complete disappearance of double-eyelid folds (n=2, 0.6%). No reports of concave scars were documented.

Conclusion: Double-fixed target point technique upper blepharoplasty can create stable upper eyelid folds. Utilizing the "punch technique" to preserve sufficient pretarsal tissue, in combination with the stacking of residual orbital septum, helps prevent the formation of concave scars, resulting in dynamic upper eyelid folds.

Level of evidence iv: '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 .'