Improved Epicanthus Correction Combined with Double Eyelid Surgery

Objective: To explore the clinical effect of improved epicanthus correction combined with double eyelid surgery. Methods: From February 2019 to February 2020, 70 patients with epicanthus who underwent surgical treatment were treated as study participants. The computer 1:1 grouping method was adopted. Thirty-five patients in the reference group were treated with epicanthus correction, and 35 patients in the experimental group were treated with improved epicanthus correction combined with double eyelid surgery. The operation effect was compared. Results: The satisfaction scores of morphological aesthetics and prognosis recovery in the experimental group were higher than those in the reference group (P < 0.05). The recurrence rate of scar hyperplasia and epicanthus in the experimental group was lower than that in the control group (P < 0.05). Conclusion: The improved epicanthus correction combined with double eyelid surgery can engender ideal correction effect and reduce postoperative adverse outcomes. Therefore, the combined operation scheme is feasible.

The methods to shape the upper eyelid fold

With nearly half of the Asian population having no obvious double eyelid, cosmetic surgery to create double eyelids or create upper eyelid fold is the most common cosmetic procedure requested in Asia, including Vietnam. In this article, we summarized and explored the techniques for creating upper eyelid fold for those who have no crease or not apparent crease. We also review the development of upper eyelid surgery throughout history in Asia and analyze the technical and risks of each eyelid surgical technique.

Eight years experience with botulinum toxin A and eyelid surgery in the treatment of hemifacial spasm

AIM: To report the therapeutic outcomes of botulinum toxin A (Botox) and eyelid surgery in patients with hemifacial spasm (HFS). METHODS: Patients’ images and medical notes were retrospectively reviewed with subsequent analysis of both the therapeutic outcomes and complications of Botox injections. RESULTS: The information of 76 patients (female=58) with HFS who received a minimum of 4 Botox injections were included. The mean follow-up interval was 83±50 (20-112)mo with an average of 16±10 (4-34) injections. The peak incidence was between 55 and 64 years and the average age of onset was 66±11 (32-85)y. Up to 23% of patients with HFS had aberrant vascular structures (right=8, left=7) in close relationship to the facial nerve (MRI=14, CT=1), where the vertebral artery (n=6) was the most involved vessel followed by the anterior inferior cerebellum artery (n=5). Patients with primary HFS had a shorter effective duration (2.5 vs 3.1mo, P<0.05), a longer onset time (4.1 vs 3.8d, P=0.739) and a lower Subjective Spasm Alleviation score (SSAs; 1.7 vs 1.9, P=0.179) than those with secondary HFS. Twelve of the 19 patients with preexisting eyelid diseases underwent surgical correction including upper blepharoplasty (n=12), limited myectomy (n=7), browplasty (n=7) and advancement of levator aponeurosis (n=5). Five (41.7%) of those with surgical correction and suboptimal response to Botox showed improvement 6mo after surgery [onset time (P=0.0256), effective duration (P=0.374) and SSAs (P=0.0161)]. Those 12 patients with eyelid surgery had a lower complication rate than those without eyelid surgery (23% vs 42%, P≤0.05). CONCLUSION: Botox is an effective and safe treatment for HFS. Patients with primary HFS had a less favorable therapeutic outcome with Botox than those with secondary HFS. Eyelid surgery for patients with concurrent eyelid diseases can augment the effect of subsequent Botox injections by improving patient satisfaction and reducing complication rate.