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Mikamo's Double-Eyelid Blepharoplasty and the Westernization of Japan

Samuel M. Lam, MD
Arch Facial Plast Surg. 2002;4(3):201-202. doi:.
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THE SECOND half of the 19th century was a period of profound change for Japan on every major front: societal, cultural, political, and military. After 250 years of Tokugawa sovereign rule, the isolated feudal Japan that was dominated by the system of shogun and samurai gave way to the modern era that would become steeped in Western culture. During this protracted period of Tokugawa rule, no foreigner was permitted entry into the cloistered environs of Japan; and sailors who found themselves washed ashore were forced to remain to preclude disclosure of Japanese secrets. The revolution began in 1853, when US Commodore Matthew C. Perry ventured to the shores of the Japanese archipelago with his ominous colonial fleets to impart western values and to compel his Japanese brethren to engage in foreign commerce. The dismantling of the traditional Japanese system evolved over a 20-year period as political unrest in response to the foreign threat grew. Tokugawa rule ended on January 3, 1868, when Satsuma radicals seized the imperial palace and claimed authority under the Emperor Meiji.

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Figure 1.

Illustration of Mikamo's procedure in which 3 sutures of 4-0 silk spaced 3 mm apart are placed on the proposed crease set at 6 to 8 mm above the ciliary margin and passed through the palpebral conjunctiva. The sutures were removed 4 to 6 days after surgery.

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Figure 2.

Illustration of a woman from Mikamo's original article. She had a natural double eyelid on her left eye (B), and Mikamo successfully operated on the right eyelid to match it. Note that the figure is presented unconventionally here, as in the original, with the preoperative view (B) on the right and the 3-week postoperative view (A) on the left.

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