1, local anesthesia, lateral canthus incision, the length of incision needs to be enlarged according to the specific degree of ptosis, blunt scissors are inserted from the incision, and invisible peeling is carried out under the bulbar conjunctiva;

2. Both the upper and lower parts are peeled off to the fornix, and the peeling range should include the whole outer canthus, so that the conjunctiva is fully relaxed and can be pulled down to the wound surface of the outer canthus without tension;

3. Suture the temporal tip of bulbar conjunctiva with the sharp corner of canthus wound, and suture the other upper and lower eyelid margin wounds intermittently;

4. Use the lateral conjunctiva for mattress suture, insert the needle from the new lateral canthus conjunctiva, pull it out from the skin about 4~5cm away from the canthus, put on a small gauze and tie a knot to form a new lateral vault;

5. Take out stitches 5-7 days after operation.

Note: If the bulbar conjunctiva has tension and cannot be pulled to the outer canthus to contact with the skin edge, peel the bulbar conjunctiva to the corner edge and make an arc incision along the corner edge to reduce the tension and make it easier to pull the outer canthus.

The disadvantage of this operation is that the radian of the lateral upper and lower eyelid margins needs to be trimmed during the operation, and the length of the big eyelid fissure is shorter than the design length due to the partial retraction of the conjunctiva after the operation.

Blascovics lateral canthoplasty

1, cut the skin ad from the lateral canthus downward along the upper eyelid arc, and the length is about1cm;

2. Make another incision db with ad from the lower end of this incision, with the length of 1cm, and form a triangular flap adb at the included angle between these two incisions;

3. Peel off the triangular adb flap, and cut it off at a distance of 0.75cm from the tip of the triangle;

4. Subcutaneous stealth separation of about 1cm was performed at the temporal edge of the incision. The wound edge bd was sutured with ad, and the wound edge ab was pushed to the nose as an extension of the upper eyelid edge.

5. Release the bulbar conjunctiva from the wound in the corner of the eye, and suture the bulbar conjunctiva with triangular base ab.

Note: this method mainly extends the upper eyelid from the outer canthus, and is suitable for medical practitioners of all ages with congenital epicanthus, round eyes, slight or moderate eye fissure, severe trachoma or congenital ptosis and shrinkage.

Third, lateral canthoplasty of fox.

1. Fix point Aa in the actual outer corner of the eye and point B in the new outer corner of the eye. Point B is 4-6 cm away from the actual outer corner of the eye.

2. Make point C downward about 4mm along the arc of the upper eyelid margin, and connect Aac with point B;

3. Divide the eyelid into anterior and posterior lobes at the outer edge of the upper eyelid 1/4, extend the incision downwards, and fully peel off Aa and bc, but not beyond the new outer canthus point B. Provided by experts from Harbin Armed Police Plastic Surgery Hospital.