LAUSR

Double-eyelid blepharoplasty remains popular in east Asia. To avoid rigid eyelids and sinking scar after double-eyelid blepharoplasty, a new surgical approach with selective neurovascular preservation (SNVP) method is proposed to crease more physiological and dynamic double-eyelid crease. During the full-incision double-eyelid surgery, a strip of preseptal orbicularis oculi muscle was resected. The longitudinally spreading upper eyelid nerves and vessels were preserved carefully. Four to five anchoring points between these neurovascular branches were made to reach the pretarsal fascia. Skin- orbicularis oculi muscle–pretarsal fascia sutures were placed on the anchoring points. From May 2018 to April 2020, 385 patients received double-eyelid surgery with SNVP method. Eyelid edema resolved quickly within a week and generally disappeared in 4 weeks. In total, 259 (67.27%) patients scored very satisfied, and 109 (28.31%) patients scored satisfied on six-month follow-up. The SNVP approach can produce reliable and dynamic palpebral crease with inconspicuous scar. Vital neurovascular branches of upper eyelid could be saved, thus reducing postoperative complications and recovery period. 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 www.springer.com/00266.