Aesthetic plastic surgery · 2026
Septoaponeurotic Junctional Thickening Fixation Technique in 13,500 Asian Upper Blepharoplasties: Evidence-Based Outcomes Driving Technical Refinement.
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Liu Yufeng, Liu Ning, Chen Shuang, Li Xinxin, Ni Xiaodong, Wang Huili, Hu Liang
Аннотация
BACKGROUND: To evaluate the anatomical rationale and clinical efficacy of septoaponeurotic junctional thickening (SAJT) fixation technique in Asian upper blepharoplasty.
METHODS: Retrospective analysis of 13,500 consecutive cases (12,150 primary blepharoplasties; 1,350 revisions) performed between 2016 and 2025 utilizing the SAJT fixation technique. Critical technical refinements included: (1) precise delineation and surgical isolation of the SAJT zone as a distinct fibrous flap and (2) precise fixation of this fibrous flap to the dermal layer of the lower skin flap to achieve physiologically dynamic fold formation.
RESULTS: Postoperative evaluation at 6 months revealed: 95.6% high satisfaction and 2.3% basic satisfaction. All achieve natural-appearing double eyelids without visible scarring: unilateral or bilateral fold loss or bilateral asymmetry: 210 cases (n=13,500, 1.6%). Dissatisfaction with fold height ( inadequate height and excessive height) was reported in 62 cases (0.46%). All cases requiring revision for postoperative complications achieved 100% patient satisfaction following surgical re-exploration and readjustment of the original SAJT fixation architecture.
CONCLUSIONS: As the largest reported series, this study establishes SAJT fixation technique as the top choice for Asian upper blepharoplasty, combining anatomical fidelity with surgical practicality.
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 www.springer.com/00266 .
METHODS: Retrospective analysis of 13,500 consecutive cases (12,150 primary blepharoplasties; 1,350 revisions) performed between 2016 and 2025 utilizing the SAJT fixation technique. Critical technical refinements included: (1) precise delineation and surgical isolation of the SAJT zone as a distinct fibrous flap and (2) precise fixation of this fibrous flap to the dermal layer of the lower skin flap to achieve physiologically dynamic fold formation.
RESULTS: Postoperative evaluation at 6 months revealed: 95.6% high satisfaction and 2.3% basic satisfaction. All achieve natural-appearing double eyelids without visible scarring: unilateral or bilateral fold loss or bilateral asymmetry: 210 cases (n=13,500, 1.6%). Dissatisfaction with fold height ( inadequate height and excessive height) was reported in 62 cases (0.46%). All cases requiring revision for postoperative complications achieved 100% patient satisfaction following surgical re-exploration and readjustment of the original SAJT fixation architecture.
CONCLUSIONS: As the largest reported series, this study establishes SAJT fixation technique as the top choice for Asian upper blepharoplasty, combining anatomical fidelity with surgical practicality.
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 www.springer.com/00266 .