Abstract Background Double eyelid blepharoplasty is the most popular cosmetic surgery among Asian population. Although various surgical procedures have been reported, limitations, including asymmetry or the disappearance of the double eyelid crease, an unnatural double eyelid crease curve and distinct scars, still exist in patients. Objectives The authors aim to provide a new technique to reduce the various complications of blepharoplasty mentioned above and to create dynamic, natural-looking double eyelids. Methods From September 2018 to June 2019, the new technique was performed on 92 Chinese patients. The core of our technique was to rebuild a reliable motion transmitter: the orbital septum-levator aponeurosis flap, which was sutured to the tarsus. The outcomes were assessed six months after the surgery by reviewing the medical records and the photographs to assess the aesthetic outcomes, the relapse rate and the incidence of complications. Results In the aesthetic outcome assessment, 86 patients were graded as good, four graded as fair, two patients among whom having uneven scars and the other two showing a slight asymmetry of the double eyelid curve in length or width. Two patients were graded as poor because of the disappearance of the double eyelid crease. The relapse rate was 2.2%. Two patients had temporary hematoma. Six patients had lagophthalmos that subsided within 30 days. No cases of infection or ptosis were observed. Conclusion The bridge technique is an effective method for creating dynamic, natural-looking double eyelids. However, the long-term outcome of this new surgical approach requires further study.

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