Editor’s Note
**Editor’s Note:**
This study by Dr. Shoichiro Nakajo and colleagues at TCB (Tokyo Central Beauty Surgery) offers valuable clinical evidence that combining upper eyelid lipectomy with buried suture blepharoplasty significantly improves the long-term persistence of the double eyelid crease. Published with extended follow-up and survival analysis, the findings support a refined surgical approach for enhanced aesthetic outcomes.
Doctors including Shoichiro Nakajo from TCB (Tokyo Central Beauty Surgery), a cosmetic clinic chain with 97 locations nationwide in Japan (as of July 2026, chaired by Hiroo Teranishi), conducted a study on the persistence of the double eyelid crease when performing buried suture blepharoplasty concurrently with upper eyelid lipectomy. The research was published as ‘Concurrent upper eyelid lipectomy improves the persistence of the double eyelid fold in buried suture blepharoplasty: a retrospective cohort study with extended follow-up and survival analysis.’
TCB Tokyo Central Beauty Surgery
July 28, 2026, 15:00
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TCB Tokyo Central Beauty Surgery
The results of this study were published in the international journal ‘European Journal of Plastic Surgery’ in July 2026.
Literature Information
Journal: European Journal of Plastic Surgery
Publication Date: July 2026
Authors: Shoichiro Nakajo, Shintaro Hashimoto, Takahiko Tamura, Hiroo Teranishi
DOI: 10.1007/s00238-026-02521-8
URL: https://link.springer.com/article/10.1007/s00238-026-02521-8
Abstract
Buried Suture Double Eyelid Blepharoplasty (BSB) is one of the most frequently performed cosmetic surgeries in East Asia. We previously reported that concurrent Upper Eyelid Lipectomy (UEL) with BSB reduces early postoperative complications. However, the mean follow-up period was only 7.5 months, and the mid-to-long-term effect on crease persistence remained unclear. This study extended the follow-up period and used survival analysis to evaluate whether concurrent UEL reduces the occurrence of suture-related events.
This was a single-center, single-surgeon retrospective cohort study involving 102 consecutive patients who underwent BSB from January to December 2024, followed up until February 2026. Patients were divided into a BSB-only group (monotherapy group, n=61) and a BSB+UEL group (combination group, n=41). The primary endpoint was the occurrence of suture-related events (reoperation or suture removal due to crease loss or laxity). The duration of crease retention was estimated using the Kaplan-Meier method and compared with the log-rank test.
The median follow-up period was 19 months (interquartile range 16–22 months). Suture-related events occurred in 17 patients (16.7%): 14 in the monotherapy group (23.0%) and 3 in the combination group (7.3%) (P=0.056). The duration of crease retention was significantly longer in the combination group (log-rank test, P=0.037). All three cases in the combination group were due to requests for aesthetic revision, with no complications attributable to the buried sutures.
Concurrent UEL was associated with a significant prolongation of crease retention during the mid-term follow-up period, suggesting improved persistence of the double eyelid crease.
Attending Physician
Shoichiro Nakajo
Director, TCB Kyoto Shijo Clinic
TCB Kyoto Shijo Clinic
Kyoto Securities Building 5F, 66 Tachiuri Nishimachi, Shijo-dori Higashinotoin Higashi-iru, Shimogyo-ku, Kyoto City, Kyoto Prefecture 600-8007
2-minute walk from Hankyu Karasuma Station
Previous TCB Academic Research Activities
– July 2026: ‘Preoperative Prediction of Submental Liposuction Volume Using Outpatient-Accessible Measures: A Single-Center Pilot Study Employing the Syringe Technique’ (https://prtimes.jp/main/html/rd/p/000000346.000034186.html)
– June 2026: ‘Safety of Depth-Adjusted Intravenous Anesthesia in Office-Based Aesthetic Surgery: A One-Month Prospective Study of 135 Consecutive Cases’ (https://prtimes.jp/main/html/rd/p/000000338.000034186.html)
– May 2026: ‘Upward vector observed in all 17 cases after non-absorbable polyester–silicone thread lift: a vectra 3-D pilot study’ (https://prtimes.jp/main/html/rd/p/000000333.000034186.html)
– March 2026: ‘The HIROSHIMA Study: A High-Volume, Institutional, Retrospective, Observational Study of Hidden Non-Incisional Suture Double Eyelid Surgery for Multivariate Analysis of Crease Loss’ (https://prtimes.jp/main/html/rd/p/000000325.000034186.html)
– January 2026: ‘Evaluation of a compression method for transconjunctival fat removal: safety and surgical utility compared to a conventional traction approach’ (https://prtimes.jp/main/html/rd/p/000000320.000034186.html)
– January 2026: ‘From Contouring to Rejuvenation: A Nationwide Big-Data Analysis of Hyaluronic Acid Injection Trends in Japan’ (https://prtimes.jp/main/html/rd/p/000000318.000034186.html)
– January 2026: ‘Patient Satisfaction After Transconjunctival Orbital Fat Removal: A Multicenter Prospective Study of 920 Cases’ (https://prtimes.jp/main/html/rd/p/000000317.000034186.html)
– December 2025: ‘Efficacy of Fibrin Sealant in Submental Liposuction: A Prospective Randomized Trial’, ‘Mid-term Results of Buried Suture Blepharoplasty in Middle-aged and Elderly Patients: A Single-Center Retrospective Study’, ‘Study on Complications of Thread Lifts: Clinical Considerations for Improving Procedure Safety’, ‘Significance and Management of Propofol Infusion Syndrome (PRIS) in Aesthetic Surgery Clinics’ (https://prtimes.jp/main/html/rd/p/000000316.000034186.html)
– November 2025: ‘Time-Series and Demographic Trends in Cosmetic Surgery: Multicenter Analysis of Double-Eyelid Embedding in Japan’ (https://prtimes.jp/main/html/rd/p/000000310.000034186.html)
– November 2025: ‘Multicenter Review of More Than 110,000 Facial Thread Lifting Cases From a Cosmetic Surgery Group’ (https://prtimes.jp/main/html/rd/p/000000313.000034186.html)
– November 2025: ‘Safety Profile of 4,397 Consecutive Intravenous Sedations in Office-Based Esthetic Surgery: A Single-Center Retrospective Audit’ (https://prtimes.jp/main/html/rd/p/000000311.000034186.html)
– October 2025: ‘Age-Related Variations in Reoperation Risk from Suture Loosening in Two-Point Buried Suture Double Eyelid Surgery: A Stratified Retrospective Cohort Analysis’
