重瞼術のタッチアップ

Touch-Up Procedures in Double-Eyelid Surgery

はじめに

　近年，重瞼術について感じることは，患者が希望する二重幅が変わったことである。以前は平行型の二重や幅広い二重を希望する患者が圧倒的に多かった印象であるが，最近は末広型や自然な二重を希望する患者が増えている。その背景として，美容医療に対するハードルが下がり，より多くの方々が美容医療に対して興味をもっているため，自然な仕上がりを希望する患者が増えていること，またSNSの普及により美容医療の情報が増えたことが関係しているではないかと考えている。そのため，施術者には自然な仕上がりとなることを目指した治療プランや，術後の微細な修正を行うことが求められている。その結果，術後のタッチアップ施術がより重要になると考えられる。

　In recent years, patient preferences in Japan regarding double-eyelid surgery have shifted toward more natural and subtle outcomes, leading to an increased emphasis on postoperative touch-up procedures. This article reviews the role of touch-up interventions in achieving optimal aesthetic results after double-eyelid surgery.

　Touch-up procedures are classified into two categories: corrective touch-ups performed to address postoperative dissatisfaction or complications, and staged touch-ups planned as part of the initial treatment strategy. Common indications for a touch-up procedure after the use of non-incisional techniques include loss of the eyelid crease, asymmetry, inappropriate eyelid width, suture exposure, and postoperative fullness inferior to the crease, which is often referred to as a “sausage eyelid.” Management options range from repeat fixation and suture removal to adjunctive procedures such as subbrow blepharoplasty. After incisional techniques are applied, touch-up procedures may be required for crease loss, excessive or insufficient eyelid width, asymmetry, postoperative fullness, scarring, and issues related to levator function, frequently necessitating surgical revision.

　This brief review emphasizes the importance of thorough preoperative assessment, precise simulation, and individualized, anatomy-based treatment planning. Incorporating the possibility of touch-up procedures into the initial treatment strategy allows for more predictable outcomes and improved patient satisfaction in double-eyelid surgery.