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Surgical Technique |

A Simple, Minimally Invasive Method for Creation of the Superior Palpebral Fold in Asians With the Modified Continuous Buried Tarsal Stitch A Joint Assessment From Toronto, Ontario, Canada, and Chengdu, China

Joseph K. Wong, MD, FRCSC; Xiaoli Zhou, MD; Yufeng Ai, MD; Zhao Wang, MD
Arch Facial Plast Surg. 2010;12(4):269-273. doi:10.1001/archfacial.2010.43.
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  A simple, minimally invasive stitch method to construct the superior palpebral fold in Asian upper eyelids is described. With the use of a clear 6-0 monofilament polypropylene suture and a continuous stitch and by securing multiple consecutive transcutaneous intratarsal fixations, we were able to produce a consistent, natural result with high success rates and no noticeable scarring in 1648 cases over a 9-year period at 2 surgical centers in Toronto, Ontario, Canada, and Chengdu, China.

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Figure 1.

Photographs showing the modified continuous buried tarsal stitch technique. A, The width of the tarsal plate is measured. B, The incision is marked. C, The skin is perforated with a No. 11 Bard-Parker blade. D, The tarsal fixation is anchored with a suture. E, Both ends of the thread are on a free needle, taking a deep bite to exit at the lateral end. F, Symmetry and the shape of the folds are accessed during and at the end of surgery.

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Figure 2.

Marking the incisional dots at points a through h; both threads reenter at lateral end x, and the knot is tied.

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Figure 3

. Cross section of a continuous buried tarsal stitch.

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Figure 4.

A young female Asian patient who underwent surgery with the modified continuous buried tarsal stitch technique. A, Preoperative view. B, View 1 week after surgery. C, The same patient with eyes closed.

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Figure 5.

A patient with puffy upper eyelids requiring lateral removal of fat. A, Preoperative view. B, View 6 weeks after surgery. C, The same patient with eyes closed.

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Figure 6.

A patient who requested to have outside folds with no fat removal. A, Preoperative view. B, View 6 weeks after surgery. C, The same patient with eyes closed.

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