Blepharoplasty (eyelid surgery) is the most common plastic surgery in Taiwan. Because it is able to enlarge the eyes and sharpen eye expression, it is generally considered as the first step in facial plastic surgeries locally. Selecting a safe procedure with natural result is the greatest preoperative concern for many patients. Nevertheless, because the congenital eyelid structure is relatively exquisite and the eyeball curvature, levator palpebrae muscle strength, eye shape or length, and eyelid skin thickness differ to some extent, the evaluation should be more accurate; otherwise, any factor can undermine the surgical results. Therefore, the most important part of the preoperative communication between Dr. Chuang and his patient is to recommend and offer a customized surgery under the precondition that the patient’s requirements are satisfied.
The eyelid appears like a thin layer of skin but is actually made up of several layers: from the superficial skin, dermis, subcutaneous fascia, orbital fat, levator palpebrae aponeurosis, and levator palpebrae muscle to the deepest tarsal plate, which all assume different functions. Physicians should not only familiarize themselves with the characteristics of these physiological structures but also understand their mutual connections to correct the various palpebral problems of patients. In spite of the fact that eyelid surgeries are not varied quite much, the surgical design and physician’s esthetic outlook determine the surgical results. Dr. Chuang not only reproduces high/low or deep/shallow creases during double eyelid surgery but also takes into account the correlation between the following individual variables and proportions to sculpt a pair of charming double eyelids.