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    Minimally Invasive Eyelid Lift (MINEL) Technique

    AAO 2023 Video Program
    Blepharoplasty, Oculoplastics/Orbit

    Upper blepharoplasty is the most common eyelid surgery for rejuvenating the upper eyelid. The surgery involves excision of skin, orbicularis oculi muscle and orbital fat. The recent trend has been toward volume preservation, where orbicularis oculi muscle and orbital fat are preserved, but the mainstay of surgery still focuses on removal of excess eyelid skin. This video describes a new technique, MINEL, to address eyelid hooding without need for skin removal. The excess upper eyelid skin is tucked in by shifting the crease to a higher level. After determining the new crease height, 2-3 mini skin incisions measuring 3-5 mm are made. Through each incision, the pretarsal 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 are closed with nylon 7/0.