Simultaneous Fat Removal with Suture Upper Blepharoplasty

Background Suture blepharoplasty for double eyelids is one of the most common aesthetic plastic surgery procedures in Asia. Because the technique of celebrity arcade suture blepharoplasty is effective and reliable, it has gained in popularity over the past 10 years. During this period, a significant group of patients has requested double-eyelid suture blepharoplasty combined with correction of upper eyelid puffiness. In the past, upper eyelid fat removal was performed primarily by an open excision technique, which could result in a visible scar and a prolonged recovery period. Fat removal performed simultaneously with suture blepharoplasty was a technique not considered. The reported technique is introduced to achieve simultaneous fat removal and suture blepharoplasty for double eyelids. Methods The operative design is almost the same as that of the celebrity arcade suture blepharoplasty technique. The difference is that the lateral incision should be longer (3-4 mm) and placed 5-mm medially to the vertical line of the lateral canthus. From this lateral incision, a bulky fat pad can be removed with cauterization. Results From June 2001 to December 2011, 79 of 807 patients who received celebrity arcade suture blepharoplasty also had simultaneous fat removal. No complications of hematoma, granuloma, or transient dry-eye symptoms occurred. Conclusions The results show that fat removal simultaneous with celebrity arcade suture blepharoplasty is a reliable and easily duplicated technique for patients who request correction of puffy eyelids and suture blepharoplasty for double eyelids. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors http://www.springer.com/00266.