Modified Simultaneous Double Eyelid Blepharoplasty and Ptosis Correction With a Single-Knot, Continuous, Nonincisional Technique

Background: "Double eyelid" blepharoplasty is one of the most common cosmetic operations among Asian populations. Some patients might present with concomitant mild to moderate blepharoptosis, even though they choose initially to undergo blepharoplasty for cosmetic reasons. Objective: Using nonincisional double eyelid surgery without ptosis correction tends to produce unsatisfactory results. We introduce our modified suture method for the simultaneous correction of blepharoptosis during double eyelid blepharoplasty. Materials and Methods: We carried out a retrospective review on 13 patients who underwent simultaneous nonincisional ptosis correction and double eyelid surgery, using a single-knot continuous technique, from January 2017 to December 2019. A superior tarsal (Muller's) muscle tagging suture was utilized to achieve an accurate tucking during surgery and create a double upper lid fold simultaneously. Results: The mean patient age was 31.8 years (range=23-54), and 9 patients (69%) were female. The mean marginal reflex distance 1 increased from 2.46 +/- 0.36 mm preoperatively to 4.07 +/- 0.61 mm postoperatively with a statistically significant difference. Most patients showed favorable results with an average of 10.8 months of follow-up and minimal complications. Conclusions: This simultaneous double eyelid blepharoplasty technique using a single-knot, continuous, nonincisional technique is relatively easy and effective, with minimal downtime and few postoperative complications, and avoids scarring for patients with mild to moderate blepharoptosis.