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Thursday, 31 January 2013

DST 缝制无痕双眼皮


交叉式勾双眼皮(Double sutures and twisting method /DST) 手术法是最复杂的双眼皮手术 。

相对而言,传统的缝合法具有较高的损伤率和不清晰的皱折,其将随着时间的消逝而退化。

交叉式勾双眼皮(Double sutures and twisting method /DST)不仅可以解决这些不足,还可以保有缝合法的优势,如皱折几乎无痕、自然,并有潜在的可逆性、恢复迅速快(仅需要几天而非几周)。

在埋线法手术 中,折痕的生成是通过永久性地埋入无排斥反应的线(聚丙烯纺织纤维,用于心瓣膜手术),至眼睑的深度软组织。分析显示埋入线通常不会断裂,但埋入线可能切 穿上眼睑的软组织。

交叉式勾双眼皮(DST)矫正了这个问题,并让埋入线更结实,还降低了让埋入线切穿软组织的可能性。首先,把埋入线的一端固定在上眼睑 最结实的组织——睑板(其由坚固的软骨组成);埋入线的另一端与临近的埋入线链接,正如两个连接在一条链上。在打结前,眼睑皮肤下方被捏入埋入线。这就形 成一个坚固且互锁的折皱,极为有效地防止了其切穿或断裂。


以下为部分完成的 交叉式勾双眼皮 例子:-















Wednesday, 30 January 2013

A History of Asian Double Eyelid Surgery

Is double eyelid surgery an attempt at Westernization of the Asian Eyelid?

Here is an abstract from PMC:

Asian Blepharoplasty
Marilyn Q. Nguyen, M.D., Patrick W. Hsu, M.D., and Tue A. Dinh, M.D.

Semin Plast Surg. 2009 August; 23(3): 185–197.
doi: 10.1055/s-0029-1224798


The “double eyelid” operation, or surgical creation of a supratarsal crease, is the most commonly performed aesthetic procedure in Asia. Whereas this procedure is considered by some to be an attempt at Westernization of the Asian eyelid, the first published description of the procedure was in the late 1800s, long before the existence of a strong Western presence in Asia.


Early publication in the Japanese medical literature favored the suture ligation method. In 1896, Mikamo described the “double eyelid” feature and how it was considered an indicator of beauty by writers and artists of that time period. Single eyelids that did not possess a distinct supratarsal crease were described as “monotonous and impassive.” He estimated the incidence of the single eyelid in Japanese women to be approximately 17 to 18% and thus concluded that the double eyelid was the physiologically normal appearance. Mikamo's technique was a modification of a surgical procedure used to correct entropion that was first described and used in the ophthalmology literature. He referenced Kamoto by saying that the procedure not only corrected entropion but also created a “clear double eyelid and a more attractive look.” In this first publication on Asian blepharoplasty, Mikamo described how three sutures were passed through the full thickness of the eyelid to include the tarsus. Each suture was placed approximately 3 mm apart, 6 to 8 mm superior to the lid margin, and removed after 4 to 6 days. He emphasized maintaining an appropriate distance between the lid margin and the suture line such that the double lid remained commensurate with those of Japanese women who had a naturally occurring crease. This again highlights the fact that the initial operation was not intended to Westernize the eyelid but to create an overall more expressive look.



After these initial case reports by Mikamo, little was published until the 1920s, when increased Western presence introduced new concepts of beauty and changed the Asian attitude toward aesthetic surgery. The suture ligation technique continued to be the only method and was described by several authors including Uchida. In Uchida's article, he described his results with 1523 eyelids in 396 males and 444 females. The crease was designed similarly to Mikamo's description; it was placed 7 to 8 mm from the ciliary margin, and the sutures were removed on postoperative day 4.

Maruo described the first external incision technique in 1929. His technique required an incision across the lid 7 mm from the ciliary margin. Closure of the incision included a trans-lid passage from the conjunctiva to the superior tarsal border of the anterior skin edge to the tarsal plate.


Over time, a greater Western influence was clearly seen and reflected in the procedures that followed. Hata described creating a higher crease at 10 mm in 1933, and in the 1940s to 1950s, multiple authors including Hayashi, Inoue, Sayoc, Mitsui, Fernandez, and Boo-Chai described techniques including excision of muscle and fat to create a deeper-set eye in addition to creating a double eyelid.

Today, the literature contains abundant material on both suture ligation and external incision techniques, as well as a new focus on procedures to eliminate the epicanthal fold. The surgeon should be aware of the broad range of surgical options in modifying the eyelid and tailor procedures according to each individual patient's preferences, which can vary widely even between different Asian populations. According to the 2006 cosmetic demographics published by the American Society of Plastic Surgeons, Asian Americans compose 6% of the cosmetic patient population with blepharoplasty ranking as the third most commonly requested surgical procedure behind rhinoplasty and breast augmentation. Although most patients desire the creation of a supratarsal crease, the expectation of the size, shape, and height of the crease can differ significantly between different subsets of the Asian population. All in all, most surgeons agree with the idea that the double eyelid procedure should create a lid that remains within the norms for the Asian face, rather than Westernize the eyelid altogether.