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By William P. Chen MD FACS

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4-5 Interrelated parameters of the configuration of an eyelid crease. Shape Continuity Height Permanence The author informs the patient that a properly applied crease will invariably appear high postoperatively because of tissue swelling (Fig. 4-6). Patients are told to expect postoperative edema to last for at least 10 days, and that the crease configuration may vary from month to month and from one eyelid to the other. Patients are instructed not to expect a stable and satisfactory appearance until 2 months after the operation.

Arch Ophthalmol 1961;65:783–784. 13. Fernandez LR. Double eyelid operation in the Oriental in Hawaii. Plast Reconstruct Surg 1960;25:257–264. 14. Uchida J. A surgical procedure for blepharoptosis vera and for pseudoblepharoptosis orientalis. Br J Plast Surg 1962;15:271–276. 15. Boo-Chai K. Plastic construction of the superior palpebral fold. Plast Reconstruct Surg 1963;31:74–78. 16. Boo-Chai K. Further experience with cosmetic surgery of the upper eyelid. In: Broadbent TR, ed. Transactions of the Third International Congress of Plastic Surgery.

5-6D) is twirled through the subcutaneous plane and then through the suborbicularis plane along the pretarsal region of the upper lid (step A in illustration), first from the lateral to the central stab incision and then from the central to the medial incision. Sutures of 4/0 silk are then used to close the wound in a continuous manner, taking a bite of the tarsus and passing back to the skin side, as in steps B or Chapter 5 Suture Ligation Methods 43 2 3 2 3 Skin Orbicularis muscle Levator aponeurosis ..

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