Comparative Clinical Efficacy of Septoaponeurotic Junctional Thickening Versus Bridge Technique in Double-Eyelid Blepharoplasty

Objective This study compared the clinical efficacy, safety, and fold stability of the septoaponeurotic junctional thickening (SAJT) method and the bridge technique (BT) in double-eyelid blepharoplasty. Methods This retrospective analysis included 82 patients aged 18–40 years from a prospectively collected randomized comparative cohort who underwent primary double-eyelid surgery between June 2023 and October 2024. Patients had been assigned to the SAJT group (n = 42) or the BT group (n = 40). Outcomes included operative time, edema resolution, complications, objective esthetic outcomes at 6 and 12 months, dynamic eyelid movement score, and patient satisfaction. Results The SAJT group had a significantly shorter operative time and faster postoperative edema resolution than the BT group ( P < 0.05). Hematoma was numerically less frequent in the SAJT group, without a significant between-group difference. At 6 months, the overall improvement rates were comparable between groups ( P > 0.05), whereas the dynamic movement score was higher in the SAJT group ( P < 0.05). Patient satisfaction at 6 months was similar between groups ( P > 0.05). Objective crease attenuation or disappearance was observed in three of 42 SAJT cases and two of 40 BT cases at 6 months. At 12 months, 36 patients in the SAJT group and 33 in the BT group remained in follow-up. The overall improvement rates remained comparable at 12 months ( P > 0.05), and the dynamic movement score remained higher in the SAJT group ( P < 0.05). Conclusion Both techniques achieved favorable outcomes. SAJT was associated with greater operative efficiency and better dynamic fold performance, whereas BT provided comparable short-term and 12-month fold stability. Technique selection should be individualized according to eyelid anatomy and surgical goals. Level of Evidence III 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 .