Effect of Orbicularis Muscle Resection during Blepharoplasty on the Position of the Eyebrow

2018 ◽  
Vol 34 (02) ◽  
pp. 178-182 ◽  
Author(s):  
Lucas Patrocinio ◽  
Jose Patrocinio ◽  
Tomas Patrocinio
Keyword(s):  
Peripheral Vision ◽  
Standard Procedure ◽  
Orbicularis Oculi Muscle ◽  
Orbicularis Muscle ◽  
Upper Eyelid ◽  
Orbicularis Oculi ◽  
Excess Skin ◽  
Skin Excess ◽  
Functional Defect ◽  
Upper Blepharoplasty

AbstractDermatochalasis is a skin excess in the upper eyelid which may be associated with either an aesthetic and functional defect, blocking the peripheral vision. Upper blepharoplasty is the gold standard procedure for correction of dermatochalasis and to restore youthful contours to the periorbita. It is one of the most commonly performed procedures in aesthetic plastic surgery; however, there is still a lack of consensus about this procedure. The excess skin is sometimes removed alone or in conjunction with a strip of orbicularis oculi muscle. The rationale for both muscle and skin resection or skin alone preserving the muscle is uncertain. Some authors have studied the aging influence in brow position, and a few studies pointed out the influence of the upper blepharoplasty on brow height. The true effects, regarding the position of the eyebrow, of both techniques, with or without resection of the preseptal orbicularis oculi muscle, are unclear. The authors present a review of the literature to find the rationale for resecting or preserving the orbicularis oculi muscle in upper eyelid blepharoplasty and its relation to eyebrow position.

scholarly journals Subbrow Lift Using Frontalis Sling to Correct Lateral Orbital Laxity

2020 ◽  
Vol 44 (6) ◽  
pp. 2119-2126 ◽  
Author(s):  
Hong Seok Kim ◽  
Kenneth K. Kim
Keyword(s):  
Skin Incision ◽  
Full Description ◽  
Orbicularis Oculi Muscle ◽  
Orbicularis Muscle ◽  
Level Of Evidence ◽  
Upper Eyelid ◽  
Forehead Lift ◽  
Orbicularis Oculi ◽  
Frontalis Muscle ◽  
Eyelid Skin

Abstract Background In order to correct upper lid laxity, upper blepharoplasty, subbrow excision, and forehead lift have been utilized. Our newly developed subbrow excision attaches the orbicularis oculi muscle to the frontalis muscle. This improves the longevity of the result without inhibiting the gliding plane of the periorbita. Method From January 2016 to July 2018, 564 patients were operated on using this technique. Among them, 41 were male and 523 were female with the average age of 59.5 years. The average size of the subbrow excision was 55 mm × 8 mm. From the upper skin incision site, the upper dissection proceeded cephalad in the subcutaneous plane just above the orbicularis oculi muscle to the point where the frontalis muscle was seen. The lower flap was created by incising the orbicularis oculi muscle 5 mm cephalad to the distal skin incision. From this 5-mm orbicularis muscle stump, the dissection proceeded caudally in a plane between the orbicularis muscle and the orbital septum. Once this flap was created, the 5-mm muscle stump was attached to the exposed frontalis muscle in a horizontal mattress fashion in three areas. The skin incision was then closed. Three months after the operation, a satisfaction survey was conducted using the Likert scale. Results The patients were followed postoperatively for at least 6 months. In all but two cases, the orbital laxity improved. However, in the brow’s lateral third where the frontalis muscle does not exist, a slight lowering of the brow had occurred. The incision healed well without any keloid or hypertrophic scars. There were no significant complications such as superior orbital nerve entrapment-related sensory problems. Conclusions Subbrow lift utilizing the frontalis muscle attachment to the lower flap orbicularis muscle is a novel method of correcting upper eyelid skin hooding. The technique does not rely on periosteal fixation. Therefore, the eyebrow gliding plane is not violated. Thus, the natural eyebrow movement is maintained. There were no cases of injury to the deep branch of the supraorbital nerve, poor wound healing, or other significant complications. Level of Evidence IV 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.

Resecting orbicularis oculi muscle in upper eyelid blepharoplasty – A review of the literature

2010 ◽  
Vol 63 (5) ◽  
pp. 787-792 ◽  
Author(s):  
Lidewij E. Hoorntje ◽  
Berend van der Lei ◽  
Guido A. Stollenwerck ◽  
Moshe Kon
Keyword(s):  
Review Of The Literature ◽  
Orbicularis Oculi Muscle ◽  
Upper Eyelid ◽  
Orbicularis Oculi

scholarly journals A Novel Test of the Duchenne Marker: Smiles After Botulinum Toxin Treatment for Crow’s Feet Wrinkles

2021 ◽  
Vol 11 ◽  
Author(s):  
Nancy Etcoff ◽  
Shannon Stock ◽  
Eva G. Krumhuber ◽  
Lawrence Ian Reed
Keyword(s):  
Botulinum Toxin ◽  
Orbicularis Oculi Muscle ◽  
Orbicularis Muscle ◽  
Orbicularis Oculi ◽  
Lateral Eye ◽  
Crow’S Feet ◽  
Before And After ◽  
Botulinum Toxin Treatment ◽  
Combined Actions ◽  
Duchenne Smiles

Smiles that vary in muscular configuration also vary in how they are perceived. Previous research suggests that “Duchenne smiles,” indicated by the combined actions of the orbicularis oculi (cheek raiser) and the zygomaticus major muscles (lip corner puller), signal enjoyment. This research has compared perceptions of Duchenne smiles with non-Duchenne smiles among individuals voluntarily innervating or inhibiting the orbicularis oculi muscle. Here we used a novel set of highly controlled stimuli: photographs of patients taken before and after receiving botulinum toxin treatment for crow’s feet lines that selectively paralyzed the lateral orbicularis oculi muscle and removed visible lateral eye wrinkles, to test perception of smiles. Smiles in which the orbicularis muscle was active (prior to treatment) were rated as more felt, spontaneous, intense, and happier. Post treatment patients looked younger, although not more attractive. We discuss the potential implications of these findings within the context of emotion science and clinical research on botulinum toxin.

Upper Blepharoplasty: Management of the Upper Eyelid and Brow Complex via Transblepharoplasty Approach

2018 ◽  
Vol 34 (02) ◽  
pp. 183-193 ◽  
Author(s):  
Tuan Pham
Keyword(s):  
Patient Expectations ◽  
Upper Eyelid ◽  
Orbicularis Oculi ◽  
Brow Lift ◽  
Facial Plastic ◽  
Assessment Techniques ◽  
Upper Lid ◽  
Upper Blepharoplasty ◽  
Levator Aponeurosis

AbstractUpper blepharoplasty is one of the more common facial plastic procedures. The upper lid and brow complex are managed together. Whether upper blepharoplasty is performed for medical or cosmetic reasons, the aim is to improve appearance while retaining natural shape and maintaining (or improving) function. For optimal results, it is important to understand relevant eyelid anatomy and the concept of maintaining youthful volume and position of the eyelid brow orbit complex. Management of patient expectations, meticulous planning, and a degree of surgical finesse all contribute to the desired outcome. The article will focus on the assessment, techniques, and complications of upper blepharoplasty, which involve management of the skin, orbicularis oculi, preaponeurotic fat, levator aponeurosis and muscle as related to concomitant ptosis, and lateral brow complex via transblepharoplasty (internal) brow lift and fixation.

A Closed-Loop Stimulation System Supplemented with Motoneurone Dynamic Sensitivity Replicates Natural Eye Blinks

2011 ◽  
Vol 146 (2) ◽  
pp. 230-233 ◽  
Author(s):  
Alice Frigerio ◽  
Paolo Cavallari
Keyword(s):  
Behavioral Effect ◽  
Orbicularis Oculi Muscle ◽  
Upper Eyelid ◽  
Nerve Branch ◽  
Orbicularis Oculi ◽  
Eyelid Closure ◽  
Eye Blink ◽  
Eye Blinks ◽  
Dynamic Sensitivity ◽  
Stimulation Pattern

Objective. The authors are designing an implantable device that will electrically stimulate a paretic eyelid when electrodes implanted into the contralateral healthy orbicularis oculi muscle detect a spontaneous blink activity. As a novelty, the stimulation pattern includes the dynamic sensitivity of motor units, thus obtaining complete eyelid closure, tailored on the kinematics of the natural eye blink. Study Design. A preliminary study was performed on 10 healthy subjects, to observe, first, the kinematics of their natural eye blink and, second, the eye blink stimulated by a dynamic vs nondynamic pattern. Setting. A microaccelerometer taped onto the left upper eyelid detected its kinematics. A dedicated LabView software built up and triggered the stimulation pattern. A webcam recorded the behavioral effect. Subjects and Methods. The kinematics of spontaneous eye blinks was detected. Then, an epicutaneous stimulation of the facial nerve branch for the left orbicularis oculi muscle was performed on the same subjects. Muscle recruitment curves were studied, and acceleration of the bionic blink was measured and compared with the natural one. Results. Kinematics of the natural eyelid is highly variable within subjects. The stimulation pattern frequency was set case by case in order to obtain the desired eyelid acceleration of the contralateral eye. A custom-fit dynamic stimulation leads to a symmetrical natural-like eye blink. Conclusions. By adding the dynamic pulse, the authors were able to tailor a bionic eye blink, which was hardly distinguishable from the subject’s natural one.

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