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Published in: Aesthetic Plastic Surgery 4/2010

01-08-2010 | Original Article

Comprehensive Considerations in Blepharoplasty in an Asian Population: A 10-year Experience

Authors: Lingli Guo, Hongda Bi, Chunyu Xue, Junhui Li, Chao Yan, Jianxing Song, Mingli Zhang, Xin Xing

Published in: Aesthetic Plastic Surgery | Issue 4/2010

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Abstract

Background

This article discusses the effectiveness, patient selection criteria, complications, and the appropriate procedures for lower blepharoplasty in an Asian population.

Methods

During the past 10 years (1998–2008), a total of 2400 patients underwent lower blepharoplasty in our department. Four different types of lower-blepharoplasty procedures were performed, including the traditional transcutaneous skin flap procedure (n = 862), the transcutaneous skin-muscle flap procedure (n = 738), the transconjunctival procedure (n = 433), and Hamra’s procedure (septal reset and fat-replacing technique) (n = 367). Among these 2400 patients, 925 were available for follow-up. The length of follow-up ranged between 1 month and 10 years.

Results

Most of the patients were satisfied with the result, but 32 patients had some postoperative complications, including five patients with ectropion, five with hollow eyes, two with dry eyes, and 20 with retraction.

Conclusions

Transconjunctival blepharoplasty is the first choice for primary eyelid bags. Transcutaneous lower blepharoplasty (skin flap or skin-muscle flap procedures) is indicated for the senile eyelid with excess skin and muscles. If supporting structures (skin, muscle, and septum) show laxity and other aging stigma are present, including tear trough deformity and obvious skeleton rim, Hamra’s procedure (septal reset and fat-replacing technique) is performed.
Literature
1.
go back to reference Jordan DR, Anderson RL (1990) The tarsal tuck procedure: avoiding eyelid retraction after lower blepharoplasty. Plast Reconstr Surg 85:22–28CrossRefPubMed Jordan DR, Anderson RL (1990) The tarsal tuck procedure: avoiding eyelid retraction after lower blepharoplasty. Plast Reconstr Surg 85:22–28CrossRefPubMed
2.
go back to reference McCord CD, Boswell CB, Hester TR (2003) Lateral canthal anchoring. Plast Reconstr Surg 112:222–237CrossRefPubMed McCord CD, Boswell CB, Hester TR (2003) Lateral canthal anchoring. Plast Reconstr Surg 112:222–237CrossRefPubMed
3.
go back to reference Patel BCK, Patipa M, Anderson RL, McLeish W (1997) Management of postblepharoplasty lower eyelid retraction with hard palate grafts and lateral tarsal strip. Plast Reconstr Surg 99:1251–1260CrossRefPubMed Patel BCK, Patipa M, Anderson RL, McLeish W (1997) Management of postblepharoplasty lower eyelid retraction with hard palate grafts and lateral tarsal strip. Plast Reconstr Surg 99:1251–1260CrossRefPubMed
4.
go back to reference Sachs ME, Bosniak SL (1986) Correction of true periorbital fat herniation in cosmetic lower lid blepharoplasty. Aesthetic Plast Surg 10:111–114CrossRefPubMed Sachs ME, Bosniak SL (1986) Correction of true periorbital fat herniation in cosmetic lower lid blepharoplasty. Aesthetic Plast Surg 10:111–114CrossRefPubMed
5.
go back to reference Goldberg RA, McCann JD, Fiaschetti D, Ben Simon GJ (2005) What causes eyelid bags? Analysis of 114 consecutive patients. Plast Reconstr Surg 115:1395–1402CrossRefPubMed Goldberg RA, McCann JD, Fiaschetti D, Ben Simon GJ (2005) What causes eyelid bags? Analysis of 114 consecutive patients. Plast Reconstr Surg 115:1395–1402CrossRefPubMed
6.
go back to reference Camirand A, Doucet J, Harris J (1997) Anatomy, pathophysiology, and prevention of senile enophthalmia and associated herniated lower eye lid fat pads. Plast Reconstr Surg 100:1535–1546CrossRefPubMed Camirand A, Doucet J, Harris J (1997) Anatomy, pathophysiology, and prevention of senile enophthalmia and associated herniated lower eye lid fat pads. Plast Reconstr Surg 100:1535–1546CrossRefPubMed
7.
go back to reference Hamra ST (1995) Arcus marginalis release and orbital fat preservation in midface rejuvenation. Plast Reconstr Surg 96:354–362CrossRefPubMed Hamra ST (1995) Arcus marginalis release and orbital fat preservation in midface rejuvenation. Plast Reconstr Surg 96:354–362CrossRefPubMed
8.
go back to reference Tessier P (1973) The conjunctival approach to the orbital floor and maxilla in congenital malformation and trauma. J Maxillofac Surg 1:3–8CrossRefPubMed Tessier P (1973) The conjunctival approach to the orbital floor and maxilla in congenital malformation and trauma. J Maxillofac Surg 1:3–8CrossRefPubMed
9.
go back to reference Rizk SS, Matarasso A (2003) Lower eyelid blepharoplasty: analysis of indications and the treatment of 100 patients. Plast Resconstr Surg 111:1299–1306CrossRef Rizk SS, Matarasso A (2003) Lower eyelid blepharoplasty: analysis of indications and the treatment of 100 patients. Plast Resconstr Surg 111:1299–1306CrossRef
10.
go back to reference Seckel BR, Kovanda CJ, Cetrulo CL Jr, Passmore AK, Meneses PG, White T (2000) Laser blepharoplasty with transconjunctival orbicularis muscle/eptum tightening and periocular skin resurfacing: a safe and advantageous technique. Plast Resconstr Surg 106:1127–1141 (discussion 1142-1145)CrossRef Seckel BR, Kovanda CJ, Cetrulo CL Jr, Passmore AK, Meneses PG, White T (2000) Laser blepharoplasty with transconjunctival orbicularis muscle/eptum tightening and periocular skin resurfacing: a safe and advantageous technique. Plast Resconstr Surg 106:1127–1141 (discussion 1142-1145)CrossRef
11.
go back to reference Garcia RE, McCollough EG (2006) Transcutaneous lower eyelid blepharoplasty with fat excision: a shift-resisting paradigm. Arch Facial Plast Surg 8:374–384CrossRefPubMed Garcia RE, McCollough EG (2006) Transcutaneous lower eyelid blepharoplasty with fat excision: a shift-resisting paradigm. Arch Facial Plast Surg 8:374–384CrossRefPubMed
12.
go back to reference Lowe JB, Cohen M, Hunter DA, Mackinnon SE (2005) Analysis of the nerve branches to the orbicularis oculi muscle of the lower eyelid in fresh cadavers. Plast Reconstr Surg 116:1743–1749 (discussion 1750-1751)CrossRefPubMed Lowe JB, Cohen M, Hunter DA, Mackinnon SE (2005) Analysis of the nerve branches to the orbicularis oculi muscle of the lower eyelid in fresh cadavers. Plast Reconstr Surg 116:1743–1749 (discussion 1750-1751)CrossRefPubMed
13.
go back to reference Carraway JH, Mellow CG (1990) The prevention and treatment of lower lid ectropion following blepharoplasty. Plast Reconstr Surg 85:971–981CrossRefPubMed Carraway JH, Mellow CG (1990) The prevention and treatment of lower lid ectropion following blepharoplasty. Plast Reconstr Surg 85:971–981CrossRefPubMed
14.
go back to reference Hirmand H, Codner MA, McCord CD, Hester TR Jr, Nahai F (2002) Prominent eye: operative management in lower lid and midfacial rejuvenation and the morphologic classification system. Plast Reconstr Surg 110:620–628 (discussion 629-634)CrossRefPubMed Hirmand H, Codner MA, McCord CD, Hester TR Jr, Nahai F (2002) Prominent eye: operative management in lower lid and midfacial rejuvenation and the morphologic classification system. Plast Reconstr Surg 110:620–628 (discussion 629-634)CrossRefPubMed
15.
go back to reference Hamra ST (2004) The role of the septal reset in creating a youthful eyelid-cheek complex in facial rejuvenation. Plast Reconstr Surg 113:2124–2141 (discussion 2142-2144)PubMed Hamra ST (2004) The role of the septal reset in creating a youthful eyelid-cheek complex in facial rejuvenation. Plast Reconstr Surg 113:2124–2141 (discussion 2142-2144)PubMed
Metadata
Title
Comprehensive Considerations in Blepharoplasty in an Asian Population: A 10-year Experience
Authors
Lingli Guo
Hongda Bi
Chunyu Xue
Junhui Li
Chao Yan
Jianxing Song
Mingli Zhang
Xin Xing
Publication date
01-08-2010
Publisher
Springer-Verlag
Published in
Aesthetic Plastic Surgery / Issue 4/2010
Print ISSN: 0364-216X
Electronic ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-010-9478-x

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