Histopathological Characteristics of the Orbicularis Oculi Muscle After Lower Blepharoplasty With or Without Myotomy

Lessa, Sergio; Pontello, João; Wanick, R; Flores, Evelise; Costa, Waldemar S.; Sampaio, F.

doi:10.1007/s00266-018-01305-1

Cited by 6 publications

(1 citation statement)

References 24 publications

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“…Traditional skin-muscle flap resection increases the risk of middle lamellar scarring and denervation of the orbicularis oculi muscle as the branches of the zygomatic nerve run perpendicular to the surgical incision [27]. Histologically, Lessa et al [28] reinforced that myotomy increased collagen deposition and decreased nerve distribution, thus emphasizing the advantages of muscle preservation. Still, some regard the transcutaneous approach as safe and minimally denervate the muscles if the medial portion of the orbicularis oculi muscle is not violated [11,29].…”

Section: Discussionmentioning

confidence: 99%

A Combination of Three-Step Lower Blepharoplasty to Correct Four Types of Lower Eyelid Deformities in Asian People

et al. 2021

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Background This study aimed to propose a novel four-type deformity and treatment-oriented classification of the lower eyelids that directs the therapeutic combination of threestep lower blepharoplasty for Asian populations. Methods We reviewed 183 patients who underwent a therapeutic combination of three steps of lower blepharoplasty after being diagnosed with four types of lower eyelid deformities between July 2018 and April 2021. The threestep lower blepharoplasty includes: (1) mid-face and lower eyelid augmentation, (2) transconjunctival eye bag removal, and (3) skin pinch removal. Consecutive digital images, detailed fat graft volume, fat removal amount, skin pinch removal amount, complications, and patient's satisfaction and aesthetic improvement score were recorded. Results The overall patient's satisfy score is 91. Aesthetic improvement score is 80.2 and 83.3 among lay persons and experts, respectively. The volume of the fat graft ranges from 2 to 3 mL per orbit according to the severity of the deformity. The amount of fat removed was 0.53 ± 0.36 and 0.61 ± 0.40 mL per orbit in types II and III patients, respectively. There is no lower lid malposition. Eleven patients had over-correction of fat grafting, and they need steroid injection; 20 patients had under-correction of fat grafting, and they need secondary fat grafting. Ten patients need secondary skin pinch excision due to post-op skin redundancy. Two patients had conjunctiva wound granuloma. Conclusions The combination of three-step lower blepharoplasty according to the novel classification is a straightforward and effective method to correct lower eyelid deformities. The complication rate was low with high patient satisfaction.

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