scholarly journals Lower Eyelid Blepharoplasty

2019 ◽  
Vol 3 (1) ◽  
Keyword(s):  
Side Effects ◽  
Surgical Approach ◽  
Lower Eyelid ◽  
Facial Rejuvenation ◽  
Steady Increase ◽  
Operative Techniques ◽  
Lower Blepharoplasty ◽  
Midface Lift ◽  
Lower Lid Blepharoplasty

The eyelids and periorbital tissues undergo significant changes with aging and often constitute a major concern for those seeking facial rejuvenation. Over the last decade, there has been a steady increase in the demand for lower eyelid rejuvenation. Many techniques and approaches exist to address these concerns, including both noninvasive (filler, lasers, or chemical resurfacing) and invasive (Blepharoplasty or midface lift) procedures. The danger of side effects when performing lower blepharoplasty has kept many patients and physicians away from the surgery, yet advances in lower eyelid blepharoplasty techniques made this procedure more relevant. The exact surgical approach remains controversial and is largely dependent upon surgeon preference and a patient’s cosmetic desire. Here we review the aging changes in the lower lid, indications, preoperative considerations, operative techniques, and complications of lower lid blepharoplasty.

Observations on the Tear Trough

2019 ◽  
Vol 40 (9) ◽  
pp. 938-947 ◽  
Author(s):  
Sathyadeepak Ramesh ◽  
Robert Alan Goldberg ◽  
Allan Edward Wulc ◽  
Alan Bart Brackup
Keyword(s):  
Lower Eyelid ◽  
Surgical Patients ◽  
Level Of Evidence ◽  
Erbium Laser ◽  
Laser Resurfacing ◽  
Men And Women ◽  
Lower Blepharoplasty ◽  
Tear Trough ◽  
Midface Lift ◽  
Topographic Structure

Abstract Background The tear trough is a prominent structure of the midface. Many surgical and nonsurgical techniques have been devised to efface this feature. Objectives The aim of this study was to define an aesthetically pleasing tear trough and understand the effect of various surgical procedures on its appearance. Methods We undertook a retrospective review of “ideal” subjects (ie, young men and women as well as male and female models) as well as surgical patients undergoing lower blepharoplasty with fat excision, fat transposition, erbium laser resurfacing of the eyelids and midface, or endoscopic midface lifting. Marginal reflex distance-2, lower eyelid length, and nasojugal fold depth were measured and analyzed for all patients. Results The nasojugal fold was significantly less prominent in ideal female models than in all other groups (P < 0.0001). Lower eyelid length was significantly shorter after fat excisional lower blepharoplasty, laser resurfacing, and midface lift (P < 0.0001), and did not change after fat transpositional lower blepharoplasty. Postsurgical reduction in lower eyelid length was significantly less with fat transpositional lower blepharoplasty than in all other groups (P < 0.0001). The nasojugal fold was significantly effaced after all types of procedures (P < 0.0001), but was significantly more effaced after fat transpositional lower blepharoplasty (P < 0.01) than after all other procedures. Conclusions A slight, medial tear trough is present in youth in many patients. The clinical tear trough is a virtual topographic structure distinct from the anatomic tear trough ligament and can be altered in a variety of ways. Level of Evidence: 4

Safety and Efficacy of a Trans-Eyelid Facial Rejuvenation Surgery Combining Partial Repositioning of Orbital Fat and Midface Lift in Chinese Patients: A Prospective Case Series

2019 ◽  
Vol 128 (10) ◽  
pp. 970-977
Author(s):  
Yin Liu ◽  
Minqin Xiao ◽  
Yanan Zhao ◽  
Wei Qiu ◽  
Hong Xiao
Keyword(s):  
Case Series ◽  
Lower Eyelid ◽  
Facial Rejuvenation ◽  
Chinese Patients ◽  
Minor Trauma ◽  
Orbital Fat ◽  
Aesthetic Results ◽  
Procedural Complications ◽  
Midface Lift ◽  
Prospective Case Series

Objective:To describe the combined technique of midface lift and partial release of orbital fat for facial rejuvenation and evaluate the safety and aesthetic results.Methods:This was a single-center study that included patients who underwent facial rejuvenation from January 2010 to December 2016. The orbital fat was partially removed, and the cheek fat pads were repositioned to exfoliate the myocutaneous flaps of the lower eyelids and midface through a sub-ciliary incision. The cheek soft tissue pads and orbital fat were restored and sutured to the periorbital membranes and orbital margins. Postoperatively, the patients were examined at 6 and 18 months for changes in the shapes of cheeks, eyelid joints, sunken eyepit, and nasolabial sulcus along with procedural complications.Results:A total of 179 (177 women; 2 men) eligible patients with a mean age of 47.17 years underwent the procedure. The shapes of cheeks and eyelid joints of all patients improved, along with shallowing of the sunken eyepit and nasolabial sulcus at 6- and 18-month follow-up. The surgical procedure involved minor trauma without facial scarring, lower eyelid flinch, and dislocation. None of the patients reported complications of nerve injuries, long-term chemosis conjunctiva, periocular swelling, or dislocation of the lower eyelids. Only 2 patients who underwent subsequent pouch surgeries had slight ectropion, which was restored within 4 months of surgery.Conclusion:To conclude, the combined partial orbital fat repositioning and midface lift via sub-ciliary approach is a successful treatment option for facial rejuvenation with no major complications.

Subperiosteal Midface Lift: Its Role in Static Lower Eyelid Reconstruction after Chronic Facial Nerve Palsy

Orbit ◽  
2011 ◽  
Vol 30 (3) ◽  
pp. 140-144 ◽  
Author(s):  
Carlo Graziani ◽  
Claudio Panico ◽  
Giovanni Botti ◽  
Richard J. Collin
Keyword(s):  
Facial Nerve ◽  
Nerve Palsy ◽  
Facial Nerve Palsy ◽  
Lower Eyelid ◽  
Eyelid Reconstruction ◽  
Lower Eyelid Reconstruction ◽  
Midface Lift

Lower Eyelid Retraction: A Minimal Incision Surgical Approach to Retractor Lysis

1990 ◽  
Vol 21 (11) ◽  
pp. 767-771 ◽  
Author(s):  
John B Holds ◽  
Richard L Anderson ◽  
Steven M Thiese
Keyword(s):  
Surgical Approach ◽  
Lower Eyelid ◽  
Eyelid Retraction ◽  
Minimal Incision

Lateral Pull Lower Lid Blepharoplasty

1987 ◽  
Vol 4 (3) ◽  
pp. 225-229
Author(s):  
Julius Newman ◽  
John R. Fetzek ◽  
Abram Nguyen
Keyword(s):  
Surgical Procedure ◽  
Postoperative Morbidity ◽  
Operating Time ◽  
Muscle Flap ◽  
Lower Eyelid ◽  
Cosmetic Results ◽  
Preoperative Marking ◽  
Orbital Hematoma ◽  
Lower Lid Blepharoplasty

The lateral pull lower lid blepharoplasty with steri-strip closure has proved to be a safe, reliable, and aesthetically pleasing procedure. This technique offers multiple benefits, including decreased operating time, simplified the surgical procedure, and decreased postoperative morbidity. Preoperative marking and evaluation of lower lid laxity has been eliminated. Precision tailoring of the skin muscle flap decreases the risk of ectropion or scleral show. Appropriate muscle excision improves the contour of the lower eyelid, particularly in the area of the incision, and relieves tension from the lateral pull. The steri-strip closure decreases operating time, eliminates the usual problems associated with conventional suture, and may decrease the risk of orbital hematoma. We have used this steri-strip lower lid blepharoplasty procedure in 397 patients seen over the previous 38 months and found it to be an effective and safe blepharoplasty technique. We have had no permanent complications and have had excellent cosmetic results with this procedure.

scholarly journals Objective Comparison of Nasojugal Fold Depth and Lower Eyelid Length After Fat Excision Versus Fat Transpositional Lower Blepharoplasty

2019 ◽  
Vol 39 (10) ◽  
pp. 1048-1054 ◽  
Author(s):  
Sathyadeepak Ramesh ◽  
Robert A Goldberg ◽  
Allan E Wulc ◽  
Alan B Brackup
Keyword(s):  
Retrospective Review ◽  
Lower Eyelid ◽  
Level Of Evidence ◽  
Aesthetic Result ◽  
Lower Blepharoplasty ◽  
The World ◽  
Aesthetic Results ◽  
Compare And Contrast

AbstractBackgroundLower blepharoplasty is one of the most commonly performed aesthetic surgeries in the world. However, there are no studies to directly compare patients who had fat excision vs fat transposition.ObjectivesThe authors sought to compare and contrast aesthetic results of fat excisional and fat transpositional lower blepharoplasty.MethodsA retrospective review was conducted of 60 patients (120 eyelids) who underwent transconjunctival lower blepharoplasty, either with fat excision or fat transposition into a preperiosteal plane. Marginal reflex distance-2, lower eyelid length, nasojugal fold depth, and pretarsal orbicularis definition were measured.ResultsMean follow-up was 5.6 months. Mean marginal reflex distance-2 did not significantly differ after either fat excision or fat transposition. Mean lower lid length decreased after fat excision only (P < 0.001), and postoperative fat excision patients had a shorter lower eyelid length than patients who underwent fat transposition (13.5 ± 2.1 mm vs 16.1 ± 1.9 mm, P < 0.0001). Pretarsal orbicularis definition increased after both surgeries (P < 0.001), and the groups did not differ (1.0 ± 0.8 vs 1.1 ± 0.9, not significant). Mean nasojugal fold depth was effaced after surgery in both groups (P < 0.001), although the nasojugal fold was significantly more effaced after fat transposition (1.5 ± 0.7 vs 0.48 ± 0.6, P < 0.001).ConclusionsIn lower blepharoplasty, fat excision resulted in a shorter lower eyelid, and fat transposition resulted in a more effaced lid-cheek junction. Surgeons should be able to balance both techniques to deliver a customized aesthetic result.Level of Evidence: 3

Achieving a Youthful Midface: Examination of Midface Anatomy Improvement Following Lower Blepharoplasty With Fat Transposition and Transtemporal Midface Lift With Lower Lid Skin Pinch

2019 ◽  
Vol 39 (10) ◽  
pp. NP416-NP428 ◽  
Author(s):  
Catherine Weng ◽  
Vito Quatela
Keyword(s):  
Retrospective Cohort ◽  
Senior Author ◽  
Level Of Evidence ◽  
Lower Blepharoplasty ◽  
Surgical Methods ◽  
Significant Difference ◽  
Before And After ◽  
Midface Lift ◽  
Orbital Rim ◽  
Surgical Group

Abstract Background Numerous methods have been described to treat midfacial aging. The authors compared 2 surgical methods aimed to improve the appearance of midface aging via their ability to improve midface contour: the transtemporal midface lift (with lower lid skin pinch) and lower blepharoplasty with fat transposition. Objectives The authors conducted a retrospective cohort study of all patients who underwent transtemporal midface lift and lower blepharoplasty with fat transposition performed by the senior author (V.Q.) from January 2014 to December 2015. Preoperative and 6-month postoperative profile photos were objectively examined for both surgical groups and compared. A total of 16 patients underwent lower blepharoplasty with fat transposition and 15 patients underwent trans temporal midface lift. Methods For comparison 1, the authors compared the angle at the orbital rim within each surgical group before and after surgery. For comparison 2, the degree of improvement in the midfacial contour was quantitatively compared between the 2 surgical groups. Results This study demonstrated that both procedures achieved a statistically significant improvement in the midfacial contour. There was no statistically significant difference between groups in severity of deformity preoperatively (mean preoperative orbital rim angle 131.5° for lower blepharoplasty group and 132.2° for transtemporal midface lift group, P = 0.90). Degree of improvement between the groups also did not significantly differ (P = 0.28). Conclusions Both approaches (transtemporal midface lift and lower blepharoplasty with fat transposition) can successfully improve the lower lid midface contour, as the authors demonstrated statistically significant improvement at 6 months postoperatively. Level of Evidence: 4

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