To investigate the application of microsurgical technique assisted subcutaneous fixation (orbicularis oculi-levator aponeurosis/tarsus fixation) in double-eyelid operation.

From August 2015 to August 2019, 21 male and 367 female patients (76 patients with ptosis) were selected to receive the treatment by microsurgical technique assisted subcutaneous fixation technique. Follow-up was performed to evaluate wound healing and aesthetic effects (double eyelid stability and symmetry).

The incisions of 388 patients healed well without obvious postoperative hematoma. One hundred and sixty patients were followed for 3-24 months (mean, 9.6 months) after operation. Most patients had smooth and natural upper eyelid crease. The skin tended to spread evenly without dimple or overly puff. The ptosis was also corrected. Still, there were three patients with shallower supratarsal folds on one side, and they underwent secondary repair. Three patients complained about asymmetry, and two patients underwent secondary repair. Four patients complained for too narrow crease. Double eyelid stability evaluation results were: good, 97.5% (156/160); fair, 1.9% (3/160); and poor, 0.6% (1/160). Double eyelid symmetry evaluation results were: good, 96.3% (154/160); fair, 2.5% (4/160); and poor, 1.2% (2/160).

The microsurgical technique assisted subcutaneous fixation is a solid suture technique, and it can avoid sunken, depression, and puffiness. The created eyelid has a natural and dynamic appearance because of reserving the majority of orbicularis oculi muscle.