Primary Transcutaneous Lower Blepharoplasty with Routine Lateral Canthal Support: A Comprehensive 10-Year Review

Codner, Mark A.; Wolfli, James; Anzarut, Alexander

doi:10.1097/01.prs.0000295377.03279.8d

Cited by 161 publications

(104 citation statements)

References 11 publications

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“…The rejuvenation effects of these surgeries are already well-known. Combining these with other procedures, such as fat reposition, SOOF suspension suture, lateral canthopexy, and/or midface lift for maximum results is popular [6,11,12]. However, currently, there is no report on changes in LCJ location induced by these two surgeries.…”

Section: Discussionmentioning

confidence: 99%

“…For the SOOF suspension suture, the orbital retaining ligament was divided along the inferolateral orbital rim, and the ligament, including SOOF, was resuspended superolaterally to the periosteum of the lateral orbital rim with three-point quilting sutures, made using 5-0 polydioxanone monofilament. To increase lid laxity, lateral retinacular canthopexy was performed, using the modified method of Codner MA et al [6]. A double-armed 4-0 Prolene ® (Ethicon, Somerville, NJ, USA) was used to suture the lateral retinaculum to the periosteum of the lateral orbital rim.…”

Section: Wwwjcosmetmedorgmentioning

confidence: 99%

“…TCLB is the simplest method to remove protruded orbital fat by transconjunctival approach [3]. TSIB is the more traditional method of removing protruded fat and excising the lax muscle and skin by the transcutaneous approach [4], which may be combined with additional surgical procedures, such as orbital fat transposition, lateral canthopexy, suborbicularis oculi fat (SOOF) suspension suture, or midface lift, depending on the patient's preoperative conditions [5,6].…”

Section: Introductionmentioning

confidence: 99%

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Assessment of rejuvenation by change of lid-cheek junction after transconjunctival and traditional subciliary incision blepharoplasty

Kang¹,

Yang²,

Chai

2017

J Cosmet Med

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Background: Transconjunctival lower blepharoplasty (TCLB) and traditional subciliary incision blepharoplasty (TSIB) are most commonly used to improve the appearance of an aged lower eyelid. The lid/cheek junction (LCJ) is located between the lower lid and midface, where structural changes caused by aging associated with both areas occur simultaneously. Thus, it may be a landmark that reflects the rejuvenation effects of lower blepharoplasty. However, there is no research-based proof yet.Objective: The purpose of this study was to investigate the rejuvenation effects of these two lower blepharoplasty procedures by observing changes in LCJ length and shape. Methods:The changes in LCJ length and shape in 32 patients with good follow-up among patients who underwent lower blepharoplasty between 2012 and 2016 were investigated. The patients were categorized as either TCLB (Group 1) or TSIB (Group 2) patients. Each group was further divided into the subgroups G1p, G1n, G2p, and G2n, according to the positive/negative globe-toskeletal relationship. Results:The shape of LCJ changed from a V-shape to a round shape, and its length decreased in G1p, G2p, and G2n, but increased in G1n. The pattern of LCJ was also affected, corresponding to the partial deformity of the zygomaticomaxillary bone. Aged lower lids were significantly improved in all groups, but infraorbital hollowness was not improved, and indeed was even worse, in G1n. Conclusion:Patients undergoing TCLB and TSIB surgeries significantly showed rejuvenation effects for fat protrusion, skin laxity, and wrinkles without any volume restoration, and particularly, G1n showed a worse result. Therefore, TCLB should not be recommended in G1n, and combination procedures that change a negative vector into a positive vector and improve infraorbital hollowness are necessary to achieve better outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Wwwjcosmetmedorgmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Assessment of rejuvenation by change of lid-cheek junction after transconjunctival and traditional subciliary incision blepharoplasty

Kang¹,

Yang²,

Chai

2017

J Cosmet Med

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“…This finding is not unexpected given that patients undergoing canthopexy likely had weaker eyelid support preoperatively. Some surgeons advocate routine canthal support 16,21 ; however, if further eyelid support is unneeded, the patient may assume unnecessary additional risks of canthoplasty or canthopexy. 22 Therefore, it is necessary to thoroughly examine each patient and selectively perform these procedures.…”

Section: Discussionmentioning

confidence: 99%

“…[8][9][10][11][12][13][14][15][16][17][18] Concerns have been raised regarding postoperative lower eyelid malposition with the transcutaneous approach, and a perception of a better safety profile with the transconjunctival approach has subsequently developed. 19,20 However, in the present study of 100 consecutive patients undergoing bilateral transcutaneous skin-muscle flap lower eyelid blepharoplasties with selective use of canthoplasty or canthopexy, only 2 patients required revision procedures because of eyelid malposition, and the change in eyelid position in all patients from baseline to final follow-up was less than 0.5 mm.…”

Section: Discussionmentioning

confidence: 99%

Measurement of Change in Lower Eyelid Position in Patients Undergoing Transcutaneous Skin-Muscle Flap Lower Eyelid Blepharoplasty

Sultan¹,

Genther

Perkins

2016

JAMA Facial Plast Surg

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IMPORTANCETranscutaneous lower eyelid blepharoplasty is a commonly performed procedure with a postoperative risk of eyelid malposition.OBJECTIVE To quantify the change in lower eyelid position after transcutaneous lower eyelid blepharoplasty. DESIGN, SETTING, AND PARTICIPANTSThis retrospective medical record review describes patients who underwent transcutaneous blepharoplasty at a private facial plastic surgery practice. Patients with less than 3 months of follow-up, a history of periocular trauma, and concurrent midface lift were excluded.INTERVENTIONS Bilateral skin-muscle flap lower eyelid blepharoplasties with possible tarsorrhaphy, canthopexy, or canthoplasty as indicated.MAIN OUTCOMES AND MEASURES Lower eyelid position determined by measurement of preoperative and postoperative pupil to eyelid and lateral limbus to eyelid distances.RESULTS Data from 100 consecutive patients (mean age, 56.7 years; 92 female [92.0%]) undergoing bilateral skin-muscle flap lower eyelid blepharoplasty were analyzed. The mean increase in distance was 0.33 mm (95% CI, 0.24-0.42 mm) from the pupil to the lower eyelid margin and 0.32 mm (95% CI, 0.23-0.41 mm) from the lateral limbus to the lower eyelid margin at final follow-up. For both measurements, patients undergoing concurrent canthopexy had a significantly greater change in eyelid position (P < .001). Men had a greater change in the distance of pupil to lower eyelid compared with women (0.76 mm; 95% CI, 0.44-1.08 mm, vs 0.30 mm; 95% CI, 0.20-0.39 mm, respectively; P = .008) at final follow-up. Two patients required revision procedures secondary to eyelid malposition, and 25 patients had new onset of dry eye symptoms.CONCLUSIONS AND RELEVANCE Transcutaneous skin-muscle lower eyelid blepharoplasty with selective performance of canthoplasty or canthopexy causes a small, predictable eyelid position change in this population with a low rate of revision procedures.LEVEL OF EVIDENCE 3.

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Dry Eye Symptoms and Chemosis Following Blepharoplasty

Prischmann¹,

Sufyan²,

Ting³

et al. 2013

JAMA Facial Plast Surg

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Primary Transcutaneous Lower Blepharoplasty with Routine Lateral Canthal Support: A Comprehensive 10-Year Review

Abstract: Lateral canthal support should be considered a routine component of lower transcutaneous blepharoplasty to obtain the desired aesthetic result and maintain the natural appearance of the eyelid shape. The associated complication rate is acceptable.

Cited by 161 publications

References 11 publications

Assessment of rejuvenation by change of lid-cheek junction after transconjunctival and traditional subciliary incision blepharoplasty

Assessment of rejuvenation by change of lid-cheek junction after transconjunctival and traditional subciliary incision blepharoplasty

Measurement of Change in Lower Eyelid Position in Patients Undergoing Transcutaneous Skin-Muscle Flap Lower Eyelid Blepharoplasty

Dry Eye Symptoms and Chemosis Following Blepharoplasty

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