Evolution of Blepharoplasty

Hicks, Katherine; Sclafani, Anthony P.; Thomas, J. Regan

doi:10.1055/s-0039-1693437

Cited by 7 publications

(6 citation statements)

References 110 publications

(121 reference statements)

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Section: Discussionmentioning

confidence: 99%

“…The periorbital region is not only the earliest aging part of the face, but also the most exposed area of the human body, especially during the pandemic due to the use of surgical masks due to viral infection. 9 The increasing demand and popularity of treatment of the periorbital area have been observed among patients, especially in the inferior orbital rim, due to the aging effect resulting in a loss of the suborbicularis oculi fat pads, since hollow eyes give the appearance of tiredness. HA fillers were FDA approved in 2003 and have been preferred by those looking for a quick, temporary, nonsurgical procedure with minimal side effects.…”

Section: Discussionmentioning

confidence: 99%

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Infraorbital mass long after dermal filler injection: A report of two cases

Arıcı

Tosuner

2023

J of Cosmetic Dermatology

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Hyaluronic acid (HA) fillers are commonly used for aesthetic purposes. HA filler injections are the second most frequently used nonsurgical aesthetic procedure in the world, following botulinum toxin injections. 1 Limited allergic reactivity, the availability of an antidote, rapid recovery, and a wide selection of products fulfilling different aesthetic goals make HA fillers popular. Despite their popularity, the tear trough has been considered the most challenging area to treat with HA. [2][3][4] HA is a naturally occurring glycosaminoglycan in living organisms that is one of the basic components of the dermis and all connective tissue. 5 Although HA fillers have been thought to be relatively safe, adverse effects can occur, ranging from mild to severe in intensity. Dermal filler complications can be categorized according to the time of appearance (early, late, and delayed onset). Early onset complications include temporary bruising, edema, erythema at the injection site, and vascular compromise (retinal artery occlusion, tissue necrosis, ischemic changes) which is a major complication. Late-onset complications include atypical infections and inflammation, migration of implant material, persistent discoloration and scarring, and foreignbody granuloma formation. 6,7 All injectable dermal fillers may cause foreign-body granulomas whose incidence is 0.01% to 1%. 7,8 To our knowledge, there has been no study reporting very lateterm orbital mass formation secondary to HA filler injection into the inferior eyelid. We report two cases of right infraorbital palpable mass 10 years after filler injection in patients who underwent orbitotomy due to the concern of a potential orbital tumor according to the clinical examination and magnetic resonance imaging (MRI)

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Infraorbital mass long after dermal filler injection: A report of two cases

Arıcı

Tosuner

2023

J of Cosmetic Dermatology

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“…With a deeper understanding of aesthetics, an increasing number of studies on facial proportional aesthetics have been reported. 3 , 4 Plastic surgeons increasingly declare that the upper part of the face should be considered an extended aesthetic unit, and all patients who present for blepharoplasty should undergo an evaluation of their forehead and eyelids. 17 In our study, the complete design of the palpebral crease line was based on the evaluation of patients’ periorbital region ratio.…”

Section: Discussionmentioning

confidence: 99%

“… 2 However, a recent cadaveric study of Asian eyelids showed that distinctions in the volume and configuration of upper eyelid fat probably lead to differences in the appearance. 3 Generally speaking, orbital fullness is a symbol of youth, but orbital swelling is undesirable. Excessive orbital fat can even affect the height of the marginal reflex distance (MRD1) when the eyelids are open.…”

Section: Introductionmentioning

confidence: 99%

Upper Eyelid Blepharoplasty Improved the Overall Periorbital Aesthetics Ratio by Enhancing Harmony Between the Eyes and Eyebrows

Zhang¹,

Xiao²

2022

CCID

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Purpose In upper eyelid blepharoplasty, most aesthetic surgeons and patients focus on improvements in the appearance of the upper eyelids, such as changing the vertical dimension of the palpebral fissure and the width of the pretarsal crease. Nevertheless, appropriately balanced periorbital aesthetics stemming from harmony between the eyelids and eyebrows is often ignored. The aim of this study was to explore the use of upper eyelid blepharoplasty to improve the overall periorbital aesthetics by enhancing the harmony between the eyes and eyebrows in young Asian women. Patients and Methods From December 2019 to December 2020, 45 young Asian female patients underwent external incision upper eyelidplasty without ptosis repair or brow lift at The Second Affiliated Hospital of Harbin Medical University. The pre- and 6-month post-operative follow-up changes in the overall periorbital aesthetics were studied retrospectively. Results The vertical position of the eyebrows in the upper face and shape of the brow apex were significantly improved after surgery. As a result, the height of the upper face was increased. Furthermore, the facial width proportion and midface ratio were closer to the ideal aesthetic golden ratio due to changes in the size of the periorbital area. All patients were satisfied with the result, and they achieved excellent surgical outcomes for not only the upper eyelids but also the overall periorbital region. Conclusion This study revealed that upper eyelid blepharoplasty, which enhances the appearance of the upper eyelids while regulating the eyelid position and shape of the eyebrows by considering the eye to eyebrow ratio, optimizes the proportion of the periorbital area and improves the overall periorbital aesthetics.

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“…T he upper eyelid is the earliest and most obvious area of aging due to long-term sunlight exposure, thin skin, and frequent muscle activity. 1 In aging, some senile patients experience upper-eyelid depression, ptosis, and higher eyelid crease, which show the appearance of fatigue and block vision, seriously affecting daily life. A sunken upper eyelid refers to a depressed area between the tarsus and supraorbital rim, imparting a tired and aging appearance.…”

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confidence: 99%

Anatomic and Magnetic Resonance Imaging-Based Correction of Upper-Eyelid Depression and Blepharoptosis in Senile Patients

et al. 2023

Journal of Craniofacial Surgery

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In senile patients with sunken superior sulcus, involutional ptosis, and higher eyelid crease, a single operation to correct depression or ptosis cannot achieve good results. We demonstrated the anatomy of periorbital septum fibers, which may contribute to the levator muscle's volume depletion and dynamic power transmission disorder, and described a procedure for correcting upper-eyelid depression and blepharoptosis in senile patients. The fibrous webs in these patients connected the posterior aspect of the orbicularis and the orbital septum and extended to the orbital fat and levator aponeurosis. These fibers were dissected to release the periorbital septal fibers, and the orbital septal fat flap was transferred to the depressed region. Advancement or plication of the levator aponeurosis was performed in patients with uncorrected blepharoptosis after the procedures described above. The technique was applied to 13 Chinese patients (25 eyes) between May 2021 and April 2022. Postoperative magnetic resonance imaging revealed that the preaponeurotic fat was displaced forward and down to the upper margin of the tarsus, and the curvature of the upper-eyelid depression was significantly improved. Moreover, the superior sulcus deformity improved, the ptosis was corrected, and the uppermost crease decreased in all patients. No recurrence of ptosis or abnormal adhesion was observed. We believe this is the first study using magnetic resonance imaging to evaluate eyelid anatomy and the effects of surgery in this patient group. Releasing periorbital septum fibers is crucial for correcting a portion of the sunken eyelid and ptosis in Asians.

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Evolution of Blepharoplasty

Cited by 7 publications

References 110 publications

Infraorbital mass long after dermal filler injection: A report of two cases

Infraorbital mass long after dermal filler injection: A report of two cases

Upper Eyelid Blepharoplasty Improved the Overall Periorbital Aesthetics Ratio by Enhancing Harmony Between the Eyes and Eyebrows

Anatomic and Magnetic Resonance Imaging-Based Correction of Upper-Eyelid Depression and Blepharoptosis in Senile Patients

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