ArticleAesthetic plastic surgery2026
Septoaponeurotic Junctional Thickening Fixation Technique in 13,500 Asian Upper Blepharoplasties: Evidence-Based Outcomes Driving Technical Refinement.
Article in Aesthetic plastic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTo evaluate the anatomical rationale and clinical efficacy of septoaponeurotic junctional thickening (SAJT) fixation technique in Asian upper blepharoplasty.
methodsRetrospective 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.
resultsPostoperative 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.
conclusionsAs 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 .
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