The demand for procedures aiming to rejuvenate the upper third part of the face and the periocular region has increased in the past several years.Blepharoplasty is one of the most frequently performed procedures world...The demand for procedures aiming to rejuvenate the upper third part of the face and the periocular region has increased in the past several years.Blepharoplasty is one of the most frequently performed procedures worldwide to date.Surgery is currently the first choice in order to achieve permanent and effective results;however,it is burdened by potential surgical complications feared by patients.There is an increasing trend in individuals to request less invasive,non-surgical,effective,and safe procedures for eyelid treatment.The aim of this minireview is to present a brief overview of non-surgical blepharoplasty techniques that have been reported in the literature in the past 10 years.Numerous modern techniques that provide a rejuvenation of the entire area have been described.Numerous less invasive methods have been proposed in the current literature and in modern-day routine clinical settings.Dermal fillers are a commonly chosen option for providing enhanced aesthetic results,especially considering that volume loss can be one of the main underlying causes of facial and periorbital aging.Deoxycholic acid use may be considered when the problem is represented by periorbital excess fat deposits.The simultaneous excess and loss of elasticity of the skin can be assessed with techniques such as lasers and plasma exeresis.Furthermore,techniques such as platelet-rich plasma injections and the insertion of twisted polydioxanone threads are emerging as viable methods to rejuvenate the periorbital region.展开更多
Background: Asian Blepharoplasty (AB) is one of the most commonly performed aesthetic procedures today. Despite the increasing demand for AB and advancements in surgical techniques, creating an optimal upper eyelid cr...Background: Asian Blepharoplasty (AB) is one of the most commonly performed aesthetic procedures today. Despite the increasing demand for AB and advancements in surgical techniques, creating an optimal upper eyelid crease remains difficult. This study aimed to determine whether removing the preaponeurotic fat pad (PAF) had any effect on the revision surgery rates following primary Asian blepharoplasty. Methods: A retrospective comparative analysis was conducted on patients who underwent primary AB between January 2016 and December 2020. Patients were divided into PAF removed and PAF not removed groups. The outcomes in the groups were compared by the frequency of revision surgery following primary AB using the chi-square test (p Results: The study included 480 patients, 442 (92%) female and 38 (8%) male, and the final outcome was evaluated after 6 months postoperatively. 412 (86%) patients were observed to have PAF pads intraoperatively, while 68 (14%) had minimal/no PAF pads. In total, 115 (24%) patients underwent revision surgery, of whom 31 (27%) had PAF removed, 66 (57%) had PAF not removed, and 18 (16%) had minimal/no PAF noted. When compared to the PAF not removed group, the PAF removed group showed a significantly lower frequency of revision surgery between the two groups of patients (p = 0.0001). Conclusion: In the final outcome, not removing the PAF in primary AB indicated a strong association with an increase in revision surgery. The removal of PAF in primary AB showed a better overall outcome and patient satisfaction.展开更多
AIM: To evaluate the effect of releasing the orbicularis retaining ligament(ORL) complex of the tear trough combined with the transconjunctival blepharoplasty in the surgical management of tear trough deformity compar...AIM: To evaluate the effect of releasing the orbicularis retaining ligament(ORL) complex of the tear trough combined with the transconjunctival blepharoplasty in the surgical management of tear trough deformity compared with the effect of blepharoplasty alone. METHODS: A prospective, randomized(by closed envelope technique), controlled surgical trial which included 50 patients(100 eyes) with bilateral visible tear trough deformity and lower eyelid fat bulging, was divided into two groups where 25 patients(50 eyes) had tear trough-ORL release with blepharoplasty and 25 patients(50 eyes) didn't. Qualitative and quantitative assessments of tear trough deformity were done at 6 mo postoperatively, achieving grade 0 or 1 of Barton's classification was considered a success. Standardized photographic documentation of each patient was done pre and postoperatively, also assessment of the patients' satisfaction postoperatively was done and ranked as excellent, very good, good or fair. RESULTS: There was statistically significant difference between the two groups in the overall aesthetic results postoperatively regarding the qualitative and quantitative analysis of the tear trough deformity, where patients who had tear trough-ORL complex release had more successful outcomes than those of the second group. CONCLUSION: ORL release should be done in patients with tear trough deformity in order to release the tethering effect of this ligament which causes the prominence of the naso jugal groove.展开更多
AIM: To evaluate surgical outcomes of modified Z-epicanthoplasty with blepharoplasty that we previously reported from the patient's perspective using patient-reported outcome measures(PROMs) and patient satisfacti...AIM: To evaluate surgical outcomes of modified Z-epicanthoplasty with blepharoplasty that we previously reported from the patient's perspective using patient-reported outcome measures(PROMs) and patient satisfaction scores.METHODS: A total of patients(n=180) who underwent the surgery between January 2013 and June 2016 were randomly selected. Standardized patient satisfaction forms(total score, 40) and validated PROMs questionnaires(total score, 12) were sent to patients for completion. PROMs assesses the severity of scarring, pain and asymmetry, as well as functional and appearance issues.RESULTS: All patients were female, ranging from 18 to 35 years old(mean=24). The response rate was 73.3%(n=132). The majority of patients reported good or excellent outcomes based on PROM analysis. Patients reported minimum or non-visible scarring at both the double eyelid surgical scar(85.6%) and the inner canthus(80.3%). Issues concerning function and appearance were minimal as 80.3% reported satisfaction with both domains. Notably, the majority of patients reported either a high or very high satisfaction rate to yield a mean score of 104 out of 120(P<0.05).CONCLUSION: Integration of our modified Z-epicanthoplasty with blepharoplasty produces good outcomes based on PROM results, which shows a positive linear relationship with patient satisfaction scores.展开更多
Dry eye disease is a multifactorial disease of the ocular surface and can be caused by a variety of iatrogenic interventions,especially ophthalmic surgical procedures.This article reviews the incidence,clinical manife...Dry eye disease is a multifactorial disease of the ocular surface and can be caused by a variety of iatrogenic interventions,especially ophthalmic surgical procedures.This article reviews the incidence,clinical manifestations,mechanisms and prevention of dry eye disease caused or worsened by cosmetic blepharoplasty,and focus on how to reduce and prevent the occurrence of postoperative dry eye disease and provide the basis for the selection of operation methods and the rational drug during the perioperative period.展开更多
AIM:To assess the effects of upper lid blepharoplasty on visual quality.METHODS:Seventy-three eyelids of 39 patients were subjected to upper lid blepharoplasty.Pre- and postoperative contrast sensitivity,visual acuity...AIM:To assess the effects of upper lid blepharoplasty on visual quality.METHODS:Seventy-three eyelids of 39 patients were subjected to upper lid blepharoplasty.Pre- and postoperative contrast sensitivity,visual acuity,vertical palpebral aperture and the degree of lash ptosis were measured.RESULTS:The mean log contrast sensitivities under photopic(P =0.017) and scotopic conditions(P =0.009)were improved after surgery,and these differences were significant.The degree of lash ptosis was also decreased after blepharoplasty(P<0.001).CONCLUSION:In our study,a significant increase in contrast sensitivity was found after surgery.These results suggest that upper lid blepharoplasty can be helpful for improving visual quality.展开更多
<strong>Background: </strong>Eyes are one of the most important facial features, their appearance being associated with state of mind, age and beauty. Therefore, upper blepharoplasty is one of the most com...<strong>Background: </strong>Eyes are one of the most important facial features, their appearance being associated with state of mind, age and beauty. Therefore, upper blepharoplasty is one of the most common procedures performed in plastic surgery. Standardized tools allow for measurement of outcomes through patient satisfaction and surgeon experience. <strong>Objectives: </strong>Our objective was to measure the satisfaction index and scar quality of patients who underwent upper blepharoplasty using the Patient-reported Outcome Measure Questionnaire (PROM-Q) and Patient and Observer Scar Assessment Scale (POSAS). <strong>Methods: </strong>A retrospective review of patients that underwent upper blepharoplasty in our institution was performed. We included those with a preoperative anthropometric analysis, standardized incision markings (developed in our center), same operative technique and a 3-month postoperative evaluation with PROM-Q and POSAS. The sample for this study consists of 67 patients, all of them operated between January 1 2019 and June 30 2019 at the Department of Plastic Surgery, South Central High Specialty Hospital, Pemex, Mexico City, Mexico. <strong>Results: </strong>A total of 67 patients were included, 73% female and 27% male. The most frequent indication for surgery was functional visual symptoms. The index of PROM-Q at 3 months demonstrated an increased satisfaction above 90%, and the evaluation with POSAS reported an almost imperceptible scar. <strong>Conclusion:</strong> Evaluating outcomes with objective tools provides data useful to improve the surgical protocols of patients subjecting to aesthetic procedures.展开更多
Currently in lower blepharoplasty, the transconjunctival approach indication has been limited to young patients without skin excess and prominence of bags;in our practice this access has become the preferred technique...Currently in lower blepharoplasty, the transconjunctival approach indication has been limited to young patients without skin excess and prominence of bags;in our practice this access has become the preferred technique in most of our cases because it is simpler, faster, prevents bad scarring, produces less orbicularis muscle trauma, and decreases postoperative edema and possible retractions (ectropion) in patients with decreased lower palpebral tone. Objective: To identify important concepts when deciding this approach. Material and Methods: Retrospective review of 177 patients who underwent lower blepharoplasty by a single surgical group. Regarding techniques, the transconjunctival approach was selected in 42% of patients while the transcutaneous technique was preferred in 58%. Results: A lower rate of complications was observed by the transconjunctival approach, with greater patient satisfaction. Conclusions: In our experience, due to its simplicity and less traumatic effect on the patient, the transconjunctival approach is an ideal technique, except in cases where there is lower eyelid weakness and surgical resolution is needed.展开更多
A blepharoplasty flap has been previously reported as a useful reconstruction approach for anterior lamellar defects lying between the lash line and the eyelid crease.We herein describe a variation of the blepharoplas...A blepharoplasty flap has been previously reported as a useful reconstruction approach for anterior lamellar defects lying between the lash line and the eyelid crease.We herein describe a variation of the blepharoplasty flap and suggest its use as an adjunct in the reconstruction of full-thickness lateral upper eyelid defects.Technique description and retrospective interventional case series.The reconstruction technique was used by an experienced oculoplastics surgeon(ASL)in 3 adults with malignant lesions involving the lateral upper eyelid margin,resulting in a post-excision 50%full-thickness defect between November 2017 and June 2020.The posterior lamella was reconstructed using an ipsilateral free tarsal graft and an inferiorly hinged transposition periosteal flap.The anterior lamella reconstruction was then performed using a local advancement flap utilizing the principles of upper blepharoplasty and Burow’s triangle.Almost full eyelid excursion and full gentle closure were evident at 1–2 weeks follow-up in all three cases.One case later developed 1–2 mm of gentle closure lagophthalmos and was managed successfully with topical lubricants.In all patients,the final eyelid contour and symmetry were adequate,with only minimal scarring,evident already 3 to 4 months postoperative.There were no major complications or need for revisions.The technique described herein highlights the utility of the blepharoplasty flap for lateral,full-thickness upper eyelid defects.This logical variation enables the reconstruction of significant defects using only local tissue,obeying the“like with like”principle,and helps avoid the need for a bridging flap.We provide preliminary evidence of the potential of a good cosmetic outcome of upper lid appearance and contour,together with a fast recovery of appropriate eyelid function.展开更多
Background:Upper blepharoplasty is one of the most commonly performed esthetic surgeries,but injection pain during local anesthesia often disturbs patients.The objective of this study was to identify the pain levels a...Background:Upper blepharoplasty is one of the most commonly performed esthetic surgeries,but injection pain during local anesthesia often disturbs patients.The objective of this study was to identify the pain levels associated with anesthetizing the upper eyelids in blepharoplasty and determine whether injection with thin needles is associated with less pain and bleeding than injection with thick needles.Methods:The study included 50 patients who underwent bilateral upper blepharoplasty.The eyelids were anesthetized using 2%lidocaine with 1:100000 epinephrine.One upper eyelid was randomly injected with a thin needle(26G)and the other with a thick needle(22G).The pain level was scored by patients immediately after the injection of each eyelid using a visual analog scale(VAS)ranging from 0 to 10.The incidence of eyelid hematomas caused by the anesthetic injection was also recorded.Results:The VAS scores in eyelids injected with thin needles were not significantly lower than those in eyelids injected with thick needles(4.0 vs.4.0,P=0.393).The formation of eyelid bruises caused by thin-needle injection was less frequent than that caused by thick-needle injection(16%vs.26%),but there was no significant difference between the two groups(P=0.326).Conclusion:Using thin needles for local anesthesia during upper blepharoplasty could not significantly decrease injection pain or hematoma occurrence compared with that associated with using thick needles.展开更多
Background: Traditional full-incision double eyelid blepharoplasty has several significant disadvantages, including slow recovery and bilateral asymmetry, which results in high rates of patient dissatisfaction. These ...Background: Traditional full-incision double eyelid blepharoplasty has several significant disadvantages, including slow recovery and bilateral asymmetry, which results in high rates of patient dissatisfaction. These problems can be minimized using improved surgical techniques aimed at reducing tissue damage and bleeding, decreasing operation time, and especially at protecting the subcutaneous capillary network during the operation. We therefore aimed to guard the capillary network and reduce intraoperative bleeding using the practical technique of reverse orbicularis oculi muscle resection.Methods: Fifty cases of double eyelid blepharoplasty with traditional full-incision(group A) and 61 cases of reverse double eyelid blepharoplasty with a preserved capillary network(group B) were divided into two groups from October 1 to December 31, 2021 and from March 1 to May 31, 2022, respectively. The orbicularis oculi muscle was removed reversely from the front of the tarsal plate using double eyelid blepharoplasty, and the muscular membrane and subcutaneous capillary network were preserved. The operation time recorded in previous medical records was checked and compared with that of our novel technique. The recovery of double eyelid blepharoplasty was determined at 1, 4, and 12 weeks after the operation and patient satisfaction was also compared with that in previous medical records of patients in group A.Results: The reverse double eyelid blepharoplasty procedure was less complicated and easier to control than the traditional full-incision double eyelid blepharoplasty methodology. The average operation time of the double eyelid blepharoplasty cases with traditional full-incision was significantly greater than that of the cases of reverse double eyelid blepharoplasty with the capillary network preserved(45.68 ± 5.27 min and 31.11 ± 5.58 min,respectively;t=14.018 9, P=0.000 0). Patient satisfaction was 42% and 78.69%, respectively, at 1 week postoperation(χ~2=15.724 8, P=0.000 1), 62% and 90.16% at 4 weeks post-operation(χ~2=12.490 2, P=0.000 4),and 90% and 95.08%, at 12 weeks post-operation(χ~2=1.061 1, P=0.303 0).Conclusion: Reverse double eyelid blepharoplasty with preserved subcutaneous capillary network effectively decreases the operation time and improves post-operative patient satisfaction. It is a double eyelid blepharoplasty method worthy of popularization.展开更多
<strong>Background:</strong> Aging changes to the lower eyelids and midface include all but not only these changes: pseudoherniated orbital fat, tear trough deformity, lid laxity, and dermatochalasis. Surg...<strong>Background:</strong> Aging changes to the lower eyelids and midface include all but not only these changes: pseudoherniated orbital fat, tear trough deformity, lid laxity, and dermatochalasis. Surgical repair often aims at treating redundant skin or orbital fat malposition with a lower eyelid blepharoplasty. In manipulating the inferior orbital fat pads, a surgeon has many options including excision, repositioning, or augmentation with synthetic dermal filler, autologous fat grafts, or acellular dermal allografts <a href="#ref1">[1]</a>. The aim of this study is to find the best approach in preventing fat herniation reccurnce in lower lid blepharoplasty. <strong>Methods: </strong>The patients in study were classified into three groups depending on the used surgical technique, to test the most effective technique associated with minimal rate of lower fat pad recurrence after surgery. Two of these techniques include a muscular flap suspension from the orbicularis oculae muscle. <strong>Results: </strong>The two surgical techniques that include orbicularis oculi muscle suspension are associated with no recurrence of lower herniated fat pads after blepharoplasty. <strong>Conclusions:</strong> The suspension of orbicularis oculi muscle has an important role in enhancing the lower orbital septum and prevents the recurrence of the lower herniated fat pads.展开更多
Aim: Aging affects the appearance of the eyelids and the surrounding malar region. Blepharoplasty improves the aesthetic appearance of this region, and multiple variants of the procedure have been reported. We here re...Aim: Aging affects the appearance of the eyelids and the surrounding malar region. Blepharoplasty improves the aesthetic appearance of this region, and multiple variants of the procedure have been reported. We here report our technique for modified lower lid blepharoplasty and cheek lift for patients with hypoplastic malar regions, which was introduced after observing prominent lower orbital rims in patients with flat malar prominences after blepharoplasty. Methods: This technique combines standard canthopexy and cheek-lift for rejuvenation of the mid-face with redraping of orbital fat and concurrent sub orbicularis oculi fat pad (SOOF) lift to 'double-breast' the lower orbital margin. Data on 33 patients who had undergone this modified lower lid blepharoplasty was collected retrospectively. Results: Thirty-three patients underwent the modified lower lid blepharoplasty resulting in smooth and youthful appearance of the malar region that was consistent and sustained. No recurrence of V-deformity was observed on a median follow-up of 14 months. twenty-two (66.6%) and 11 (33.3%) patients were pleased and satisfied with postoperative outcomes respectively. Three (9.1%) patients experienced minor postoperative complications and no major complication was observed. Conclusion: The proposed modified lower lid blepharoplasty is a safe and effective alternative to the existing technique with improved aesthetic outcomes and therefore is recommended in patients with flat malar prominences.展开更多
目的:观察眉下缘切口提升术联合重睑成形治疗中重度上睑皮肤松弛的美学效果。方法:回顾性分析2020年10月-2022年10月在笔者医院治疗的62例上睑皮肤松弛患者临床资料,根据治疗方法不同分为联合治疗组(n=32)和眉下切口组(n=30),联合治疗...目的:观察眉下缘切口提升术联合重睑成形治疗中重度上睑皮肤松弛的美学效果。方法:回顾性分析2020年10月-2022年10月在笔者医院治疗的62例上睑皮肤松弛患者临床资料,根据治疗方法不同分为联合治疗组(n=32)和眉下切口组(n=30),联合治疗组行眉下缘切口提升术联合重睑术,眉下切口组行眉下缘切口提升术,术后对患者进行随访,比较两组术后矫治效果,上睑缘至眉距离(The distance between the upper eyelid margin and the eyebrow,DEE)、睑裂宽度(The height of the palpebral fissure,HPF)、瞳孔中点睑缘与重睑距离(Middle pupil margin-fold distance,MPMFD)、角膜内侧睑缘与重睑距离(Medial corneal margin-fold distance,MCMFD)以及外眦处睑缘与重睑距离(Lateral canthus margin-fold distance,LCMFD)、上睑皱纹改善效果(Lemperle评分)、术后外观满意度、术后并发症发生率。结果:治疗后,联合治疗组DEE、HPF、MPMFD、MCMFD、LCMFD均高于对照组(P<0.05);治疗后,两组患者Lemperle评分均有所降低,但联合治疗组低于眉下切口组(P<0.05);治疗后,联合治疗组术后外观满意度96.88%高于眉下切口组76.67%(P<0.05);治疗后,联合治疗组与眉下切口组并发症发生率比较,差异无统计学意义(P>0.05)。结论:眉下缘切口提升术联合重睑成形治疗中重度上睑皮肤松弛,能够有效改善上睑松弛情况,减少上睑皱纹,且患者外观满意度较高。展开更多
文摘The demand for procedures aiming to rejuvenate the upper third part of the face and the periocular region has increased in the past several years.Blepharoplasty is one of the most frequently performed procedures worldwide to date.Surgery is currently the first choice in order to achieve permanent and effective results;however,it is burdened by potential surgical complications feared by patients.There is an increasing trend in individuals to request less invasive,non-surgical,effective,and safe procedures for eyelid treatment.The aim of this minireview is to present a brief overview of non-surgical blepharoplasty techniques that have been reported in the literature in the past 10 years.Numerous modern techniques that provide a rejuvenation of the entire area have been described.Numerous less invasive methods have been proposed in the current literature and in modern-day routine clinical settings.Dermal fillers are a commonly chosen option for providing enhanced aesthetic results,especially considering that volume loss can be one of the main underlying causes of facial and periorbital aging.Deoxycholic acid use may be considered when the problem is represented by periorbital excess fat deposits.The simultaneous excess and loss of elasticity of the skin can be assessed with techniques such as lasers and plasma exeresis.Furthermore,techniques such as platelet-rich plasma injections and the insertion of twisted polydioxanone threads are emerging as viable methods to rejuvenate the periorbital region.
文摘Background: Asian Blepharoplasty (AB) is one of the most commonly performed aesthetic procedures today. Despite the increasing demand for AB and advancements in surgical techniques, creating an optimal upper eyelid crease remains difficult. This study aimed to determine whether removing the preaponeurotic fat pad (PAF) had any effect on the revision surgery rates following primary Asian blepharoplasty. Methods: A retrospective comparative analysis was conducted on patients who underwent primary AB between January 2016 and December 2020. Patients were divided into PAF removed and PAF not removed groups. The outcomes in the groups were compared by the frequency of revision surgery following primary AB using the chi-square test (p Results: The study included 480 patients, 442 (92%) female and 38 (8%) male, and the final outcome was evaluated after 6 months postoperatively. 412 (86%) patients were observed to have PAF pads intraoperatively, while 68 (14%) had minimal/no PAF pads. In total, 115 (24%) patients underwent revision surgery, of whom 31 (27%) had PAF removed, 66 (57%) had PAF not removed, and 18 (16%) had minimal/no PAF noted. When compared to the PAF not removed group, the PAF removed group showed a significantly lower frequency of revision surgery between the two groups of patients (p = 0.0001). Conclusion: In the final outcome, not removing the PAF in primary AB indicated a strong association with an increase in revision surgery. The removal of PAF in primary AB showed a better overall outcome and patient satisfaction.
文摘AIM: To evaluate the effect of releasing the orbicularis retaining ligament(ORL) complex of the tear trough combined with the transconjunctival blepharoplasty in the surgical management of tear trough deformity compared with the effect of blepharoplasty alone. METHODS: A prospective, randomized(by closed envelope technique), controlled surgical trial which included 50 patients(100 eyes) with bilateral visible tear trough deformity and lower eyelid fat bulging, was divided into two groups where 25 patients(50 eyes) had tear trough-ORL release with blepharoplasty and 25 patients(50 eyes) didn't. Qualitative and quantitative assessments of tear trough deformity were done at 6 mo postoperatively, achieving grade 0 or 1 of Barton's classification was considered a success. Standardized photographic documentation of each patient was done pre and postoperatively, also assessment of the patients' satisfaction postoperatively was done and ranked as excellent, very good, good or fair. RESULTS: There was statistically significant difference between the two groups in the overall aesthetic results postoperatively regarding the qualitative and quantitative analysis of the tear trough deformity, where patients who had tear trough-ORL complex release had more successful outcomes than those of the second group. CONCLUSION: ORL release should be done in patients with tear trough deformity in order to release the tethering effect of this ligament which causes the prominence of the naso jugal groove.
文摘AIM: To evaluate surgical outcomes of modified Z-epicanthoplasty with blepharoplasty that we previously reported from the patient's perspective using patient-reported outcome measures(PROMs) and patient satisfaction scores.METHODS: A total of patients(n=180) who underwent the surgery between January 2013 and June 2016 were randomly selected. Standardized patient satisfaction forms(total score, 40) and validated PROMs questionnaires(total score, 12) were sent to patients for completion. PROMs assesses the severity of scarring, pain and asymmetry, as well as functional and appearance issues.RESULTS: All patients were female, ranging from 18 to 35 years old(mean=24). The response rate was 73.3%(n=132). The majority of patients reported good or excellent outcomes based on PROM analysis. Patients reported minimum or non-visible scarring at both the double eyelid surgical scar(85.6%) and the inner canthus(80.3%). Issues concerning function and appearance were minimal as 80.3% reported satisfaction with both domains. Notably, the majority of patients reported either a high or very high satisfaction rate to yield a mean score of 104 out of 120(P<0.05).CONCLUSION: Integration of our modified Z-epicanthoplasty with blepharoplasty produces good outcomes based on PROM results, which shows a positive linear relationship with patient satisfaction scores.
基金Supported by the National Natural Science Foundation of China(No.81770888,No.81800873)Shanghai Science and Technology Development Funds(No.17411963800)Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant Support(No.20161421).
文摘Dry eye disease is a multifactorial disease of the ocular surface and can be caused by a variety of iatrogenic interventions,especially ophthalmic surgical procedures.This article reviews the incidence,clinical manifestations,mechanisms and prevention of dry eye disease caused or worsened by cosmetic blepharoplasty,and focus on how to reduce and prevent the occurrence of postoperative dry eye disease and provide the basis for the selection of operation methods and the rational drug during the perioperative period.
文摘AIM:To assess the effects of upper lid blepharoplasty on visual quality.METHODS:Seventy-three eyelids of 39 patients were subjected to upper lid blepharoplasty.Pre- and postoperative contrast sensitivity,visual acuity,vertical palpebral aperture and the degree of lash ptosis were measured.RESULTS:The mean log contrast sensitivities under photopic(P =0.017) and scotopic conditions(P =0.009)were improved after surgery,and these differences were significant.The degree of lash ptosis was also decreased after blepharoplasty(P<0.001).CONCLUSION:In our study,a significant increase in contrast sensitivity was found after surgery.These results suggest that upper lid blepharoplasty can be helpful for improving visual quality.
文摘<strong>Background: </strong>Eyes are one of the most important facial features, their appearance being associated with state of mind, age and beauty. Therefore, upper blepharoplasty is one of the most common procedures performed in plastic surgery. Standardized tools allow for measurement of outcomes through patient satisfaction and surgeon experience. <strong>Objectives: </strong>Our objective was to measure the satisfaction index and scar quality of patients who underwent upper blepharoplasty using the Patient-reported Outcome Measure Questionnaire (PROM-Q) and Patient and Observer Scar Assessment Scale (POSAS). <strong>Methods: </strong>A retrospective review of patients that underwent upper blepharoplasty in our institution was performed. We included those with a preoperative anthropometric analysis, standardized incision markings (developed in our center), same operative technique and a 3-month postoperative evaluation with PROM-Q and POSAS. The sample for this study consists of 67 patients, all of them operated between January 1 2019 and June 30 2019 at the Department of Plastic Surgery, South Central High Specialty Hospital, Pemex, Mexico City, Mexico. <strong>Results: </strong>A total of 67 patients were included, 73% female and 27% male. The most frequent indication for surgery was functional visual symptoms. The index of PROM-Q at 3 months demonstrated an increased satisfaction above 90%, and the evaluation with POSAS reported an almost imperceptible scar. <strong>Conclusion:</strong> Evaluating outcomes with objective tools provides data useful to improve the surgical protocols of patients subjecting to aesthetic procedures.
文摘Currently in lower blepharoplasty, the transconjunctival approach indication has been limited to young patients without skin excess and prominence of bags;in our practice this access has become the preferred technique in most of our cases because it is simpler, faster, prevents bad scarring, produces less orbicularis muscle trauma, and decreases postoperative edema and possible retractions (ectropion) in patients with decreased lower palpebral tone. Objective: To identify important concepts when deciding this approach. Material and Methods: Retrospective review of 177 patients who underwent lower blepharoplasty by a single surgical group. Regarding techniques, the transconjunctival approach was selected in 42% of patients while the transcutaneous technique was preferred in 58%. Results: A lower rate of complications was observed by the transconjunctival approach, with greater patient satisfaction. Conclusions: In our experience, due to its simplicity and less traumatic effect on the patient, the transconjunctival approach is an ideal technique, except in cases where there is lower eyelid weakness and surgical resolution is needed.
文摘A blepharoplasty flap has been previously reported as a useful reconstruction approach for anterior lamellar defects lying between the lash line and the eyelid crease.We herein describe a variation of the blepharoplasty flap and suggest its use as an adjunct in the reconstruction of full-thickness lateral upper eyelid defects.Technique description and retrospective interventional case series.The reconstruction technique was used by an experienced oculoplastics surgeon(ASL)in 3 adults with malignant lesions involving the lateral upper eyelid margin,resulting in a post-excision 50%full-thickness defect between November 2017 and June 2020.The posterior lamella was reconstructed using an ipsilateral free tarsal graft and an inferiorly hinged transposition periosteal flap.The anterior lamella reconstruction was then performed using a local advancement flap utilizing the principles of upper blepharoplasty and Burow’s triangle.Almost full eyelid excursion and full gentle closure were evident at 1–2 weeks follow-up in all three cases.One case later developed 1–2 mm of gentle closure lagophthalmos and was managed successfully with topical lubricants.In all patients,the final eyelid contour and symmetry were adequate,with only minimal scarring,evident already 3 to 4 months postoperative.There were no major complications or need for revisions.The technique described herein highlights the utility of the blepharoplasty flap for lateral,full-thickness upper eyelid defects.This logical variation enables the reconstruction of significant defects using only local tissue,obeying the“like with like”principle,and helps avoid the need for a bridging flap.We provide preliminary evidence of the potential of a good cosmetic outcome of upper lid appearance and contour,together with a fast recovery of appropriate eyelid function.
基金the National Natural Science Foundation of China(grant no.31870974).
文摘Background:Upper blepharoplasty is one of the most commonly performed esthetic surgeries,but injection pain during local anesthesia often disturbs patients.The objective of this study was to identify the pain levels associated with anesthetizing the upper eyelids in blepharoplasty and determine whether injection with thin needles is associated with less pain and bleeding than injection with thick needles.Methods:The study included 50 patients who underwent bilateral upper blepharoplasty.The eyelids were anesthetized using 2%lidocaine with 1:100000 epinephrine.One upper eyelid was randomly injected with a thin needle(26G)and the other with a thick needle(22G).The pain level was scored by patients immediately after the injection of each eyelid using a visual analog scale(VAS)ranging from 0 to 10.The incidence of eyelid hematomas caused by the anesthetic injection was also recorded.Results:The VAS scores in eyelids injected with thin needles were not significantly lower than those in eyelids injected with thick needles(4.0 vs.4.0,P=0.393).The formation of eyelid bruises caused by thin-needle injection was less frequent than that caused by thick-needle injection(16%vs.26%),but there was no significant difference between the two groups(P=0.326).Conclusion:Using thin needles for local anesthesia during upper blepharoplasty could not significantly decrease injection pain or hematoma occurrence compared with that associated with using thick needles.
文摘Background: Traditional full-incision double eyelid blepharoplasty has several significant disadvantages, including slow recovery and bilateral asymmetry, which results in high rates of patient dissatisfaction. These problems can be minimized using improved surgical techniques aimed at reducing tissue damage and bleeding, decreasing operation time, and especially at protecting the subcutaneous capillary network during the operation. We therefore aimed to guard the capillary network and reduce intraoperative bleeding using the practical technique of reverse orbicularis oculi muscle resection.Methods: Fifty cases of double eyelid blepharoplasty with traditional full-incision(group A) and 61 cases of reverse double eyelid blepharoplasty with a preserved capillary network(group B) were divided into two groups from October 1 to December 31, 2021 and from March 1 to May 31, 2022, respectively. The orbicularis oculi muscle was removed reversely from the front of the tarsal plate using double eyelid blepharoplasty, and the muscular membrane and subcutaneous capillary network were preserved. The operation time recorded in previous medical records was checked and compared with that of our novel technique. The recovery of double eyelid blepharoplasty was determined at 1, 4, and 12 weeks after the operation and patient satisfaction was also compared with that in previous medical records of patients in group A.Results: The reverse double eyelid blepharoplasty procedure was less complicated and easier to control than the traditional full-incision double eyelid blepharoplasty methodology. The average operation time of the double eyelid blepharoplasty cases with traditional full-incision was significantly greater than that of the cases of reverse double eyelid blepharoplasty with the capillary network preserved(45.68 ± 5.27 min and 31.11 ± 5.58 min,respectively;t=14.018 9, P=0.000 0). Patient satisfaction was 42% and 78.69%, respectively, at 1 week postoperation(χ~2=15.724 8, P=0.000 1), 62% and 90.16% at 4 weeks post-operation(χ~2=12.490 2, P=0.000 4),and 90% and 95.08%, at 12 weeks post-operation(χ~2=1.061 1, P=0.303 0).Conclusion: Reverse double eyelid blepharoplasty with preserved subcutaneous capillary network effectively decreases the operation time and improves post-operative patient satisfaction. It is a double eyelid blepharoplasty method worthy of popularization.
文摘<strong>Background:</strong> Aging changes to the lower eyelids and midface include all but not only these changes: pseudoherniated orbital fat, tear trough deformity, lid laxity, and dermatochalasis. Surgical repair often aims at treating redundant skin or orbital fat malposition with a lower eyelid blepharoplasty. In manipulating the inferior orbital fat pads, a surgeon has many options including excision, repositioning, or augmentation with synthetic dermal filler, autologous fat grafts, or acellular dermal allografts <a href="#ref1">[1]</a>. The aim of this study is to find the best approach in preventing fat herniation reccurnce in lower lid blepharoplasty. <strong>Methods: </strong>The patients in study were classified into three groups depending on the used surgical technique, to test the most effective technique associated with minimal rate of lower fat pad recurrence after surgery. Two of these techniques include a muscular flap suspension from the orbicularis oculae muscle. <strong>Results: </strong>The two surgical techniques that include orbicularis oculi muscle suspension are associated with no recurrence of lower herniated fat pads after blepharoplasty. <strong>Conclusions:</strong> The suspension of orbicularis oculi muscle has an important role in enhancing the lower orbital septum and prevents the recurrence of the lower herniated fat pads.
文摘Aim: Aging affects the appearance of the eyelids and the surrounding malar region. Blepharoplasty improves the aesthetic appearance of this region, and multiple variants of the procedure have been reported. We here report our technique for modified lower lid blepharoplasty and cheek lift for patients with hypoplastic malar regions, which was introduced after observing prominent lower orbital rims in patients with flat malar prominences after blepharoplasty. Methods: This technique combines standard canthopexy and cheek-lift for rejuvenation of the mid-face with redraping of orbital fat and concurrent sub orbicularis oculi fat pad (SOOF) lift to 'double-breast' the lower orbital margin. Data on 33 patients who had undergone this modified lower lid blepharoplasty was collected retrospectively. Results: Thirty-three patients underwent the modified lower lid blepharoplasty resulting in smooth and youthful appearance of the malar region that was consistent and sustained. No recurrence of V-deformity was observed on a median follow-up of 14 months. twenty-two (66.6%) and 11 (33.3%) patients were pleased and satisfied with postoperative outcomes respectively. Three (9.1%) patients experienced minor postoperative complications and no major complication was observed. Conclusion: The proposed modified lower lid blepharoplasty is a safe and effective alternative to the existing technique with improved aesthetic outcomes and therefore is recommended in patients with flat malar prominences.
文摘目的:观察眉下缘切口提升术联合重睑成形治疗中重度上睑皮肤松弛的美学效果。方法:回顾性分析2020年10月-2022年10月在笔者医院治疗的62例上睑皮肤松弛患者临床资料,根据治疗方法不同分为联合治疗组(n=32)和眉下切口组(n=30),联合治疗组行眉下缘切口提升术联合重睑术,眉下切口组行眉下缘切口提升术,术后对患者进行随访,比较两组术后矫治效果,上睑缘至眉距离(The distance between the upper eyelid margin and the eyebrow,DEE)、睑裂宽度(The height of the palpebral fissure,HPF)、瞳孔中点睑缘与重睑距离(Middle pupil margin-fold distance,MPMFD)、角膜内侧睑缘与重睑距离(Medial corneal margin-fold distance,MCMFD)以及外眦处睑缘与重睑距离(Lateral canthus margin-fold distance,LCMFD)、上睑皱纹改善效果(Lemperle评分)、术后外观满意度、术后并发症发生率。结果:治疗后,联合治疗组DEE、HPF、MPMFD、MCMFD、LCMFD均高于对照组(P<0.05);治疗后,两组患者Lemperle评分均有所降低,但联合治疗组低于眉下切口组(P<0.05);治疗后,联合治疗组术后外观满意度96.88%高于眉下切口组76.67%(P<0.05);治疗后,联合治疗组与眉下切口组并发症发生率比较,差异无统计学意义(P>0.05)。结论:眉下缘切口提升术联合重睑成形治疗中重度上睑皮肤松弛,能够有效改善上睑松弛情况,减少上睑皱纹,且患者外观满意度较高。
