Single Stitch Orbicularis Suspension (SOS technique) in Combined Upper and Lower Blepharoplasty

Background and objectives: Lateral lower eyelid support has been employed for a long-time during blepharoplasty to avoid postoperative complication. The aim is to evaluate this new technique’s effectiveness in providing enough support & preventing lower lid retraction. Methods: This is a single armed interventional study performed in Sulaymaniyah Burn, Reconstructive & Plastic Surgery Hospital in Sulaymaniah city/Kurdistan Region-Iraq between Nov 1st 2020 to Mar 25th 2022. The study included 20 patients of both genders who had mild to moderate lower lid laxity, they underwent combined upper and lower blepharoplasty with lateral lower eyelid suspension using a single stitch. Postoperatively lower eyelid was examined for retraction and patients’ feedback was recorded for their satisfaction. Result: This study included 20 patients with eyelid laxity (13 mild and 7 moderate) who underwent upper and lower blepharoplasty with a mean age of 50.7± 8.0 years (1 male and 19 female). With an average follow-up of 17.1±3.9 months, no patient showed clinically significant lower eyelid retraction or laxity postoperatively. The average Blepharoplasty Outcome Evaluation score before surgery was 22.0±13.1%, which increased significantly to 92.1±11.8% postoperatively based on Wilcoxon Signed Ranks Test. Conclusion: This technique is effective and practical for prevention of post blepharoplasty lower lid retraction.