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J Korean Soc Aesthetic Plast Surg. 2007 Mar;13(1):81-84. Korean. Case Report.
Park SG , Choi JH , Lee JH , Baek RM , Heo CY .
Department of Plastic and Reconstructive Surgery, Seoul Paik Hospital, Inje University Medical Center, Korea.
Cosmetic Eye Reserch Institute, Inje University, Seoul, Korea.
Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Seoul, Korea.

Korean small eyes are characterized in thickness and pseudoptosis of the skin of the upper eyelid. They also have a large amount of subcutaneous and preaponeurotic fat. The hypertrophic orbicularis oculi muscles and the lower positioned transverse ligaments are included in their structural characteristics. These special features act as various burden factors in Korean double eyelid operation. Just burden factors restrict the movement of the upper eyelid and so Korean eyes looks like Ptosis (pseudoptosis). For creation of double fold eyelid, we performed continuous 2-loop single stitch buried suture to make an en bloc fixation with dermis, levator aponeurosis and Muller muscle through three small incisions. And then we tried to eliminate the burden factors through small sized lateral incision. After removal of the external sutures at postoperative 3 days, we obtained our intended double fold lines such as in-fold, in-ward fold and out fold successfully and only experienced minor complications such as edema, ecchymosis and loss of fold. And also the range of excursion in the upper eyelid improved without levator shortening or any other operation such as a sling. The objective of this article is to share our experience and to introduce our method of treating Korean pseudoptotic eyes by using 2-loop en bloc fixation through three small incisions with various reviews of literature.

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