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Overall Advancements in Asian Eyelid Surgery

Technical and Scientific Aspects

Since the early 90's, there has been immense development and research in the area of double eyelid surgery. These new innovations in technique have resulted in more natural surgery outcomes compared to the primitive double eyelid surgery of the past. The three main areas of tremendous advancement and improvement with double eyelid surgery are: (1) minimally invasive techniques, (2) biophysics, and, (3) thermal control.

Minimally Invasive Techniques

There are special issues with Asian skin and scarring. Asian skin tends to have more pigmentation and higher incidence of keloid scarring after surgery. With double eyelid surgery, Asians are more prone to visible scarring in a highly visible area of the face, therefore it was critical to implement a technique that had very minimal or no scarring at all. Therefore surgeons in this field began to develop a minimally invasive technique; one in which there was minimal amount of incision thus no scarring. The advent minimally invasive double eyelid surgery started to come into practice as surgeons gained detailed understanding of the eye's anatomy and utilization of minimal surgery of instrumentation specifically tailored toward this type of surgery. Today, procedures such as double eyelid surgery, eye enlargements, epicanthoplasty and lateral canthoplasty result in very little to no signs of visible scarring.

Biophysics

In addition to utilizing minimally invasive techniques, the new generation of double eyelid surgery incorporates elements of biophysics. Biophysics requires each surgery to be tailored for each patient and their unique eyelid characteristics. Factors that must be taken into account are the patient's skin thickness, elasticity of skin, soft tissue mass volume and differences in eye aperture and muscle function. These variables must be taken into consideration to have the most optimal results for each individual. Previous double eyelid surgery was performed primarily in the same fashion regardless of the differences in the patients' eyes. This resulted in unnatural and unbalanced results. Today, each surgery is individually calibrated and calculated with all the different factors accounted for resulting in a very natural looking fold.

Thermal Control

The third area of advancement in regards to double eyelid surgery is thermal control. Most all surgeries involve some bleeding. It is crucial the surgeon be able to control bleeding without compromising the surgery and ultimately the final results. The eyelid in particular is extremely vascular and therefore controlling bleeding during double eyelid surgery is crucial. The standard method used to control bleeding during double eyelid surgery involved a constant heat applied to the eyelid vessels. Due to the extremely thin nature of the eyelid skin, usage of constant heat caused a thermal spread to the adjacent eyelid tissue which resulted in a burn. Therefore in the past, the use of laser technology ceased bleeding through constant heat but also caused scarring. Today a major advancement is that of thermal control. Thermal control provides heat which is regulated by censor. This allows heat production to decrease and increase providing only minimal heat. Today, use of thermal control technology controls bleeding without creating thermal spread to the adjacent tissue.