Use of a Novel Orbicularis Oculi Muscle Overlap Method for Correction of Tear-Trough Deformity

AbstractThe subciliary lower eyelid blepharoplasty has evolved considerably to create a more harmonious natural appearance with a fuller and unoperated look and also to minimize the complications. While lower eyelid malposition was very common in the past, now this complication is significantly reduced by attention to preoperative evaluation, meticulous surgical planning, precise surgical technique, and postoperative care. Various prophylactic maneuvers maintaining/strengthening lower lid support can be utilized to prevent lower lid malposition including preservation of the pretarsal orbicularis oculi muscle, conservative resection of skin and muscle, and suspension of the orbicularis oculi muscle and/or tarsus to the periosteum of the lateral orbital rim. The release of the orbicularis retaining ligament and surgical transposition of orbital fat over the rim rather than excision allows for smoothing of the lid-cheek junction, filling the tear trough deformity, and reducing the appearance of bulging fat in the lower eyelid. In this article the reader will find a comprehensive approach for achieving a smooth contour with gradual blending at the lower eyelid–cheek junction while maintaining/restoring normal lower lid support. A descriptive outline of postoperative care is also provided to help in optimal healing for the patient.

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Real-Time Ultrasound Imaging of the Tear Trough: Lessons Learned from Functional Anatomy

Aesthetic Surgery Journal ◽

10.1093/asj/sjab351 ◽

2021 ◽

Author(s):

Mariana Calomeni ◽

Michael G Alfertshofer ◽

Konstantin Frank ◽

Nicholas Moellhoff ◽

Rebekah Dennison ◽

...

Keyword(s):

Blood Flow ◽

Facial Expressions ◽

Ultrasound Imaging ◽

Venous Blood ◽

Functional Anatomy ◽

Lessons Learned ◽

Venous Blood Flow ◽

Orbicularis Oculi Muscle ◽

Orbicularis Oculi ◽

Tear Trough

Abstract Background The tear trough is one of the most challenging facial regions for soft-tissue filler injections. A thorough understanding of the underlying fascial, muscular, and vascular anatomy is crucial to perform safe and effective tear trough injectable treatments. Objectives To evaluate the location and function of the angular vein in the tear trough in three different facial expressions: repose, smiling, and max. orbicularis oculi contraction. Methods Twenty study participants with a mean age of 48.3 years and mean BMI of 24.5 kg/m 2 were investigated via functional ultrasound imaging. The diameter of the angular vein, the velocity, and direction of venous blood flow were analyzed in repose, smiling and during max. orbicularis oculi contraction. Results The angular vein was identified in 100% of the cases to travel inside the orbicularis oculi muscle (= intra-muscular course) within the tear trough whereas the angular artery was not identified in this location. The distance between the angular vein the inferior orbital rim was (lateral to medial): 4.6 mm, 4.5 mm, 3.9 mm, and 3.8 mm. The caudally directed blood flow was in repose 10.2 cm/sec and was 7.3 cm/sec at max. orbicularis oculi muscle contraction; however, no blood flow was detectable during smiling. Conclusions The diameter and the venous blood flow of the angular vein varied between the three tested facial expressions. Based on these anatomical findings, the deep injection approach to the tear trough is recommended due to the intramuscular course of the angular vein

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Invited Discussion on: Tear Trough Treatment with Orbicularis Oculi Muscle Suspension

Aesthetic Plastic Surgery ◽

10.1007/s00266-020-02040-2 ◽

2020 ◽

Author(s):

Dirk F. Richter

Keyword(s):

Orbicularis Oculi Muscle ◽

Orbicularis Oculi ◽

Tear Trough

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Tear Trough Treatment with Orbicularis Oculi Muscle Suspension

Aesthetic Plastic Surgery ◽

10.1007/s00266-020-01922-9 ◽

2020 ◽

Author(s):

Ruth Graf ◽

Daniele Pace

Keyword(s):

Orbicularis Oculi Muscle ◽

Orbicularis Oculi ◽

Tear Trough

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Orbicularis Oculi Muscle Size and Function: Exploring the Influence of Aging and Exercise Training

Cosmetics ◽

10.3390/cosmetics8020029 ◽

2021 ◽

Vol 8 (2) ◽

pp. 29

Author(s):

Takashi Abe ◽

Jeremy P. Loenneke

Keyword(s):

Older Adults ◽

Exercise Training ◽

Muscle Hypertrophy ◽

Peak Velocity ◽

Muscle Thickness ◽

Muscle Size ◽

Sphincter Muscle ◽

Orbicularis Oculi Muscle ◽

Orbicularis Oculi ◽

And Function

The orbicularis oculi muscle is the sphincter muscle of the eyelids that blinks and closes the eyes. In this review, our aim was threefold: (1) to introduce the performance characteristics of blinking activity in young and older adults, (2) to discuss the influence of aging on the orbicularis oculi muscle in healthy adults, and (3) to provide information about the effect of facial exercise training on the orbicularis oculi muscle. To achieve the purpose of this review, a search using two electronic databases (PubMed and Scopus) and a search engine (Google Scholar) was conducted. The amplitude and peak velocity of spontaneously blinking behavior, which is an index of muscle function of the orbicularis oculi, appear to be affected by aging. The muscle thickness of the orbicularis oculi tends to be low in older adults, but there are issues that need to be examined further, such as differences in sex and measurement positions. There was no study on the effect of exercise training; however, the results of a highly trained man indicate that the orbicularis oculi muscles might elicit muscle hypertrophy through non-traditional resistance exercise.

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