Principles for Natural, Symmetric, and Reliable Double Eyelid Surgery

林宣君 Shan-Jiun LinTaiwan Speaker Principles for Natural, Symmetric, and Reliable Double Eyelid SurgeryThe fundamental principle for a natural result is the replication of the native anatomical connection between the anterior and posterior lamellae. Common issues that can produce an unnatural appearance include direct skin-to-posterior lamella fixation after orbicularis oculi muscle (OOM) disruption. Achieving symmetry extends beyond basic consistency in width and suture tension; it requires advanced adjustments based on individual patient anatomy, including levator function, eyelid thickness, and globe position (e.g., enophthalmos or proptosis). Reliability is secured by creating a stable, non-shallow fold, ensuring appropriate skin tightness, and maintaining a clear anatomical view of structures like orbital fat and the levator muscle during the procedure. The presentation also addresses common challenges and pitfalls, including the difficulty of precise measurement on aging or lax skin, the importance of patient marking in a seated position to account for gravity, and the cautious preservation of functional tissues, such as the orbicularis oculi muscle (OOM) and orbital septum, to prevent complications like lagophthalmos and facilitate potential future revisions.