Asian Upper Blepharoplasty in Women: A Comprehensive Approach for a Natural and Aesthetically Pleasing Outcome

2021 ◽  
Author(s):  
Chunmei Wang ◽  
Xiaoxia Mei ◽  
Lee L Q Pu
Keyword(s):  
Skin Incision ◽  
Comprehensive Approach ◽  
Asian Women ◽  
Orbicularis Oculi Muscle ◽  
Upper Eyelid ◽  
Cosmetic Procedure ◽  
Eyelid Skin ◽  
Upper Blepharoplasty ◽  
Levator Aponeurosis

Abstract Background Asian upper blepharoplasty is the most popular cosmetic procedure for Asian women. However, there is lack of standardized approach to this procedure and less than optimal results are still common. Objectives In this article, we introduce our comprehensive approach to Asian upper blepharoplasty in women and report our clinical outcomes with this approach. Methods Our comprehensive approach for Asian upper blepharoplasty in women includes: (1) To determine the height and length of the upper eyelid skin crease; (2) To create a more optimal anatomy of the upper eyelid by removing excess eyelid skin, a portion of the orbicularis oculi muscle and septal fat; (3) To reconstruct the desired anatomic structures of the upper eyelid skin crease through plication of the levator aponeurosis, if necessary, and closure of the upper eyelid skin incision through the septum and the mobile portion of the levator aponeurosis; (4) To add a medial epicanthoplasty if needed to enhance final cosmetic results. Results Over a 5-year period, 332 Asian women underwent upper blepharoplasty for creation of double eyelids, or conversion from less visible to more ideal double eyelids, by the authors with the above comprehensive approach. There were no surgical complications postoperatively and 326 patients (98.2%) rated satisfactory for their outcome during 5-year’s follow-up. Only 6 patients (1.8%) required surgical revision for asymmetry or less optimal shape of the upper eyelid. Conclusions Our comprehensive approach to Asian upper blepharoplasty can be used for Asian women with a natural and aesthetically pleasing outcome and low revision rates.

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.

scholarly journals Complex Intratarsal Cyst with a Mixed Ciliated Respiratory-Type and Squamous Epithelial Lining

2019 ◽  
Vol 6 (3) ◽  
pp. 151-158
Author(s):  
Frederick A. Jakobiec ◽  
Paula Cortes Barrantes ◽  
Lina Ma ◽  
Nahyoung Grace Lee
Keyword(s):  
Epithelial Cell ◽  
Epithelial Cells ◽  
Staining Pattern ◽  
Epithelial Lining ◽  
Full Thickness ◽  
Upper Eyelid ◽  
Eyelid Skin ◽  
Eyelid Swelling

A 55-year-old woman developed a painless, non-ulcerated left upper eyelid swelling over 6 months. Examination disclosed a fluctuant mass that permitted movement of the eyelid skin over the lesion. A full-thickness eyelid resection contained a well-encapsulated cyst with milky contents that was predominantly located in the tarsus. The cyst’s lining was partially composed of segments of ciliated respiratory-type and non-keratinizing squamous epithelia. Immunohistochemical evaluation with cytokeratins 17, 18, and 19 confirmed the staining pattern of a respiratory-type epithelial cell (whether or not cilia were present in the non-squamous epithelial zones). In the squamous region, entirely different cytokeratin results were obtained vis-a-vis the non-squamous regions of the lining. The current lesion is interpreted as congenital and representing an in situ persistence of embryonic ciliated glandular epithelium that normally exists only transitorily. A more remote possibility is that the lesion was the result of ectopic epithelial cells displaced from an adjacent sinus. A recurrence has not developed during 6 months of follow-up.

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.

scholarly journals A Rare Case of Palpebral Cellulitis, a Variation of Pott’s Puffy Tumor

2020 ◽  
Vol 11 (1) ◽  
pp. 106-111
Author(s):  
Marina Yamamoto ◽  
Nozomu Wakayama ◽  
Yuki Hamajima ◽  
Kohei Miyata ◽  
Hiroshi Takahashi ◽  
...  
Keyword(s):  
Frontal Sinus ◽  
Rare Case ◽  
Maxillary Sinusitis ◽  
Skin Incision ◽  
Sinus Surgery ◽  
Inferior Wall ◽  
Upper Eyelid ◽  
Eyelid Skin ◽  
Pott’S Puffy Tumor ◽  
Eyelid Swelling

A rare case of palpebral cellulitis with simultaneous frontal sinusitis and osteomyelitis is reported. A healthy 45-year-old man presented with left upper eyelid swelling. He was given intravenous meropenem at the local hospital, but he failed to improve. Magnetic resonance imaging showed left frontal and maxillary sinusitis and upper palpebral cellulitis with an abscess. His temperature was 37.6°C, C-reactive protein was 1.36 mg/dL, thyroid hormone was elevated, left best-corrected visual activity was 1.2, and intraocular pressure was 25 mm Hg. He was then given cefazolin intravenously for 3 days but with no improvement. Therefore, the eyelid skin was incised. Postoperatively, the swelling improved significantly. Computed tomography demonstrated osteomyelitis of the left frontal sinus and osteolysis of the inferior wall. This case was considered a variation of Pott’s puffy tumor. Bacterial cultures from the cellulitis abscess and sinusitis were negative. As for sinusitis, endoscopic sinusitis surgery (frontal sinus single sinus surgery [Draf III] and Kilian surgery) was performed. During 10 months of follow-up after the skin incision, no signs of recurrent eyelid swelling were observed.

Lateral Orbitotomy for Removal of Sphenoid Wing Meningiomas Invading the Orbit

2010 ◽  
Vol 66 (suppl_2) ◽  
pp. ons287-ons292 ◽  
Author(s):  
Giuseppe Mariniello ◽  
Francesco Maiuri ◽  
Enrico de Divitiis ◽  
Giulio Bonavolontà ◽  
Fausto Tranfa ◽  
...  
Keyword(s):  
Skin Incision ◽  
Tumor Extension ◽  
Orbital Cavity ◽  
Upper Eyelid ◽  
Anterior Clinoid Process ◽  
Select Group ◽  
Lateral Orbitotomy ◽  
Orbital Wall ◽  
Transcranial Approach

Abstract OBJECTIVE This study defines the indications, results, and limits of lateral orbitotomy coupled with resection of the sphenoid wing for removing lateral sphenoid wing meningiomas with intraorbital extension. METHODS Eighteen patients with lateral sphenoid wing meningiomas and tumor extension into the lateral or superolateral compartments of the orbital cavity were treated by microsurgical lateral orbitotomy and resection of the sphenoid wing without craniotomy. The approach consisted of a linear skin incision along the upper eyelid crease extending to 2 cm from the canthal angle and resection of the lateral orbital rim, lateral orbital wall, and infiltrated sphenoid wing. RESULTS A complete resection (Simpson I), including the infiltrated bone, dura, and periorbita, was obtained in 13 patients (72%); in the other 5 cases (28%), the tumor mass and most infiltrated dura were removed, but the entity of dural resection up to the normal tissue could not be exactly defined (Simpson II). Follow-up ranged from 5 to 17 years (mean 9.7 years). CONCLUSION A select group of lateral sphenoid wing meningiomas with tumor extension in the lateral or superolateral compartments of the orbital cavity may be successfully approached and removed through a lateral orbitotomy with resection of the sphenoid wing and without craniotomy. Cases with tumor extension to the anterior clinoid process and superior orbital fissure and those with extension medial to the axis of the optic nerve require a transcranial approach.

Combined Upper Blepharoplasty With Upper Eyelid Filler Injection

2021 ◽  
pp. 074880682098533
Author(s):  
Mehryar Ray Taban
Keyword(s):  
Hyaluronic Acid ◽  
Phone Call ◽  
Upper Eyelid ◽  
Skin Laxity ◽  
Filler Injection ◽  
Skin Removal ◽  
Acid Gel ◽  
Upper Blepharoplasty ◽  
Hyaluronic Acid Gel

To describe our experience with treating upper eyelid aging with combined upper blepharoplasty and upper eyelid hyaluronic acid gel filler injection. Retrospective analysis of patients with upper eyelid aging (including skin laxity/excess and fat deflation) undergoing combined upper blepharoplasty and upper eyelid hyaluronic acid gel filler injection by one surgeon. Minimum follow-up time was 3 months. Preoperative and postoperative photographs at longest follow-up visit were evaluated by blind observers. Patient satisfaction was recorded using questionnaire and phone call. A total of 40 patients (34 females, 6 males) underwent combined upper blepharoplasty with upper eyelid hyaluronic acid gel filler injection. Mean age was 43 years old (range: 26-75). All patients reported satisfaction with the surgical outcome, with no complications. 6 patients received additional touch-up filler injection postoperatively. One patient underwent additional skin removal. Upper blepharoplasty and upper eyelid hyaluronic acid gel filler injection can be safely and effectively combined together to treat upper eyelid aging for more youthful results.

Eyelid Reconstruction: Pediculated versus Non-Pediculated

2018 ◽  
Vol 235 (04) ◽  
pp. 398-403
Author(s):  
Sonja Frimmel ◽  
Christoph Kniestedt ◽  
Karla Chaloupka
Keyword(s):  
Skin Flap ◽  
Upper Eyelid ◽  
One Stage ◽  
Eyelid Skin ◽  
Free Grafts ◽  
The Mean ◽  
Pediculated Flap ◽  
Mean Time ◽  
Tarsoconjunctival Flap

Abstract Background To compare the functional and cosmetic outcome of pediculated versus free anterior and posterior lamella reconstruction after large eyelid defects due to malignancy excision. Patients and Methods A retrospective study over 2 years with 12 patients matching the criterion of pediculated versus non-pediculated transplants out of a cohort of 124 tumor excisions. The mean age was 76 ± 8 years of the 7 male and 5 female patients. In the majority of cases, more than half of the eyelid was excised. The posterior lamella was always reconstructed with tarsal tissue, and the anterior lamella mostly with an upper eyelid skin graft. The postoperative follow-up time was between 2 months and 1 year. Results Nodular basal cell carcinoma was the prevailing histology (6 patients). The reconstruction techniques included a Hughes procedure (four patients) or a free tarsal graft with a pediculated skin flap (four patients), respectively. In the remaining four patients, a combination of pediculated/free anterior AND posterior lamellae was performed. Four patients had a one-stage and eight patients a 2nd stage procedure with a mean time until tarsoconjunctival flap reopening of 16 ± 2 days. Conclusions No difference was found in the final functional outcome in pediculted versus free grafts. The cosmetic result was better in anterior lamella reconstructions with a pediculated flap, which usually allows a one-stage procedure. The 2nd stage procedure could be performed after 2 weeks without any complications.

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.

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