摘要

Objectives: To introduce a novel technique to lift hooded upper eyelid without the need of skin removal. Introduction: Upper blepharoplasty is the most common eyelid surgery to rejuvenate the upper eyelid. The surgery involves excision of skin, orbicularis oculi muscle, orbital fat. The recent trend of has been towards volume preservation where orbicularis oculi muscle and orbital fat are preserved but the mainstay of surgery still focuses on removal of excess eyelid skin. Materials / method: A new technique is described to address eyelid hooding without the need of skin removal. The excess upper eyelid skin is tugged in by means of shifting the crease to a higher level. After determining the new crease height, 2-3 mini skin incisions measuring 3-5mm are made. Through each incision, the subcutaneous tissues are removed layer by layer to reach the levator aponeurosis. A bite of levator aponeurosis is taken and anchored to pretarsal orbicularis using Nylon 7/0, forming the new crease. Skin incisions closed with Nylon 7/0 whenever necessary. Results: 402 patients (960 eyes) underwent minimally invasive eyelid lift by a single surgeon from Jan 2021 to November 2023. Age ranged from 18 to 69 years old with a mean age of 42. There were 366 females and 36 males in this study. The follow up period range from 1 week to 34 months. More than 90% of patients were happy with the result. There were no major complications from this procedure. The common complications were loosening of crease and asymmetrical crease where touch up surgery were done in 189 eyes (19%). Complete disappearance of crease was seen in 2 patients (0.5%). Conclusion: Minimally INvasive Eyelid Lift (MINEL) is a novel technique to lift the upper eyelid without any skin removal. This technique of upper eyelid lifting without removing any skin has never been described in the literature. In selected cases this can be a good minimally invasive alternative for patients who are not ready for a more invasive upper blepharoplasty.