Introduction:
The Asian eyelid has special features. If the surgeon does not recognize this, esthetically satisfying results will rarely be acquired. Asian means something associated with the continent of Asia. Thus, the Asian eyelid possesses various eyelid morphologies in Asia. The Asian population is comprised of diverse races - Chinese, Indian, Middle Eastern, Southeast Asian, and others. Many publications on the Asian eyelid describe the eyelids morphology seen in native Chinese and those of Chinese descent; this morphology has its features. Because the appropriate correction or modification of Asian eyelid structures directs in surprising progress in the esthetic impression of patients, Asian eyelid periorbital surgical procedure has appeared as a new attraction to plastic surgery and also in reconstructive surgery.
Double eyelid surgical procedure is popular procedure worldwide, particularly in East Asia. Even though double eyelid surgery looks easy and uncomplicated, it has multiple complications. These difficulties can be split into disordered difficulties and esthetic difficulties. Plastic surgeons have more additional attention to the esthetic element. These cases with an impression of a double eyelid fold that is either higher, lower, or even absent. Nevertheless, certain plastic surgeons have yet to discover this, and most cases are supposed that inappropriate methods induce esthetic complications at the time of surgery.
What Is Double Eyelid?
A double eyelid is described as the development of a crease or a furrow in the skin of the upper eyelid at the time when the eyes are opened and at the time when the levator palpebrae superioris muscle contracts. Double eyelid surgery aims to make a stable and effective adhesion between the levator palpebrae superioris muscle and the skin of the upper eyelid. The upper eyelid can develop a crease while the eyes are open. A double eyelid surgical procedure is an incredibly typical plastic surgery in the world. It is known differently in other areas. In Europe and in the areas of the United States, it is known as upper blepharoplasty, while in East Asia, it is usually known as double eyelid surgery.
A double eyelid surgical procedure is done for two causes:
-
One is that the periorbital area is a significant cosmetic unit, and double eyelid surgery can cause individuals to look younger and have better energy.
-
The second reason is the presence of mongoloid eyes, more regular in Asians than in Caucasians, which is described by a single eyelid, more concise palpebral fissure, and the epicanthus.
A double eyelid surgical procedure, in such circumstances, can improve the palpebral fissure and enhance the appearance of the eyes. Even though the double eyelid surgical procedure is not challenging, postoperative difficulties are expected. The surgeon’s lack of knowledge regarding the anatomy of the upper eyelid, inappropriate preoperative method or intraoperative activities, and the adverse consequences of patient characteristics may all lead to postoperative difficulties.
What Are the Complications of Double Eyelid Surgery?
Medics with good experience and knowledge in double eyelid surgical procedures may face diverse postoperative difficulties. Nearly all difficulties could be separated into disordered complications and esthetic complications. The former mainly possess hematoma, infection, dry eye, and additional complications that induce local dysfunction or general dysfunction. The latter does not generate any dysfunction, but the postoperative condition does not conform to established esthetic measures, such as high double eyelid form or low double eyelid fold.
Disordered Complications:
1. Hematoma - Hematoma is the most commonly occurring complication of double eyelid surgery, and also it is an efficiently controllable complication. Hemorrhage primarily emerges from the orbicularis oculi muscle vessels or preaponeurotic fat. Hematomas are usually generated by impaired hemostasis, inappropriate application of Epinephrine, or insufficient coagulation. One investigation revealed that administering local anesthetics with unsharpened needles was less probable to induce hemorrhage and ache than with sharp needles. Generally, the application of a cold compress three days after the surgery can actually stop or prevent the formation of hematoma by boosting capillary constriction. Hematomas are typically absorbed in a brief time in the postoperative period, but this duration differs from individual to individual.
2. Infection - Appropriate investigations have revealed that infection following a double eyelid surgical procedure was somewhat rare and that using antibiotic ointment postoperatively was an adequate preventive approach. The vast blood supply in the region of the periorbital is one of the causes of postoperative infection is not familiar. Skin bacterias are the main pathogens that generate most infection cases following the double eyelid surgery, but investigations have also documented infections induced by streptococcus and mycobacterium. Orbital cellulitis is one of the major severe postoperative infections recognized by manifestations like an extreme ache in the orbital region, inflammation, vision loss, and ocular muscle motion conditions.
Cephalosporin antibiotics or other broad-spectrum antibiotics can be given via intravenous drips and can be utilized for therapy. If extreme aches or inflammation is unmanageable and resumes to worsen, a surgical incision must be executed as immediately as needed.
3. Dry Eyes - Dry eyes consistently appear following double eyelid surgery, particularly in middle-aged cases and older ones. Cases with dry eyes typically complain of sensations like tingling, burning, foreign body feelings, or even photophobia. Conjunctivitis may also arise. Intraoperative local anesthesia, injury to the muscle orbicularis oculi, or unreasonable incision skin of the upper eyelid might all be directed to lagophthalmos and dry eye following surgery. Thus, doctors must evade extracting an increased amount of the orbicularis oculi muscle or skin during surgery. Cases with dry eye manifestations can utilize artificial tears or any other kind of lubricant. Using moist chamber spectacles at the time of sleep can effectively prevent or ease dry eyes.
Conclusion:
Some specific discrepancies between the Asian eyelid anatomy and periorbital structures impact the phenotypic formation and function and the development of proper methods for the Asian eyes. Acceptable preoperative assessment, detailed intraoperative measures, and earlier identification and management of negative elements will reduce the incidence of diverse difficulties. Double eyelid surgery is a cosmetic process done to manage monolid. It is a state when the natural fold in the upper eyelid between the eyelashes and the eyebrow is absent.
