Dermis-Orbicularis Oculi Muscle-Septoaponeurosis Junctional Thickening Fixation Technique for Double Eyelid Blepharoplasty.

[BACKGROUND] Full-incision double eyelid blepharoplasty is a widely sought-after procedure in East Asia. However, tarsus-skin or levator aponeurosis-skin fixation techniques may lead to deep folds and scarring. This study aimed to evaluate the outcomes of the Dermis-Orbicularis Oculi Muscle-Septoaponeurosis Junctional Thickening Fixation (DOSF) technique and share our clinical experience.

[METHODS] This retrospective study included 4,129 patients who underwent double eyelid surgery using DOSF technique at Jishuitan Hospital from January 2017 to December 2024. Patients completed FACE-Q questionnaires preoperatively and 6 months postoperatively. Outcomes were evaluated based on aesthetics, FACE-Q scores, and complications.

[RESULTS] 4,129 patients (4,121 females and 8 males), aged between 18 and 51 years (average age: 29.88 ± 9.08 years), underwent double eyelid blepharoplasty using the DOSF technique. The median follow-up was 12 months. FACE-Q scores in satisfaction with upper eyelid increased significantly from 51.43 ± 8.14 to 73.36 ± 12.40 (P<0.05). No severe complications were reported. One lactating woman developed an infection, and five cases of depressed scars were observed. Partial fold loss was noted in 86 patients, with fading and narrowing of the folds. Two hundred and thirty patients had palpebral fold asymmetry. Most patients were satisfied with the results.

[CONCLUSIONS] DOSF technique provides several benefits in double eyelid blepharoplasty. It accommodates the characteristic puffy lateral upper eyelid in East Asians, reduces the bleeding risk, and promotes recovery. Additionally, it facilitates repositioning of the lacrimal gland and orbital fat, correcting mild blepharoptosis, and conducting revision surgery. Overall, it enhances surgical outcomes in the formation of dynamic double eyelid creases.

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