The Application Of Orbicularis Muscle Above The Cutting Margin And Orbital Septum Dropped And Fixed To Pretarsal Fascia In Upper Eyelid Plasty

Objective:To explore the application and effects of the part of the orbicularis oculi muscle above the cutting margin and the orbital septum fixed to pretarsal fascia in upper eyelid plasty.Method:We selected 150 aesthetic seeking patients who asking for upper eyelid plasty.They were divided into A,B,C groups depending on the operation method.50 cases in each group.They were respectively Improved double eyelid surgery group,the traditional double eyelid surgery group,and surgery group of Park method.We adoptted modified double eyelid operation in group A.The lower two-thirds of the orbicularis oculi muscle above cutting margin and bottom of the orbital septum were fixed to pretarsal fascia.Cases accompanied by moderate and severe hypertrophy of upper eyelid,we directly fixed orbicularis oculi muscle above cutting margin and pretarsal fascia without the orbital septum.We adoptted traditional double eyelid surgery in Group B.We sutured skin by hanging tarsus simplly.We adoptted Park operation in Group C by fixing orbicularis oculi muscle bellow the cutting margin to upper eyelid aponeurosis internally.6 months postoperatively,all aesthetic seeking patients completed a questionnaire,mainly from the evaluation of surgical effects including the double eyelid line symmetry,the double eyelid line natural fluency,the width of double eyelid,double eyelid ditch and the degree of skin hypertrophy.Patients could selected from the four levels of excellent,good,but and poor as a evaluation.Through the five point Likert scale,aesthetic seeking patients gave a mark for satisfaction of each aspect(5 = very satisfied,4 = satisfaction,3 =general,2 = are not satisfied,1= very dissatisfied,).Aesthetic seeking patients could write advices on the questionnaire specificly.We compared each patient satisfaction scores.We Appliyed of SPSS17.0 statistical software and analysised aesthetic seeking patients age differences between groups by Using t test.Various satisfaction differences between groups by Using the Mann-Whitney U test analysis with P < 0.05 for the difference was statistically significant.Results:All surgeries went well.The survey showed that all survey project evaluations of group A were higher.3 aesthetic seeking patients of group B reflected the double eyelid line became shallow.4 aesthetic seeking patients in group C thought that hypertrophy of upper eyelid blow the incisal margin was obvious.The width of the double eyelid of 1 aesthetic seeking patient was slightly asymmetric after taked out stitches.This situation improved after 3 months.We achieved approximate satisfactory after six months.Satisfaction statistics showed: the statistical difference of double eyelid ditch between group A and group B was significantly(P <0.05).The statistical difference of the degree of skin hypertrophy between group A and group C was also significantly(P <0.05).Conclusion:By fixing the bottom of the orbital septum and the orbicularis oculi muscle above cutting margin to pretarsal fascia,we can achieve good clinical effects and persistence compared with the traditional double eyelid surgery and surgery of Park method.