Rejuvenation of the deep superior sulcus in the eyelid

Moon, Hichan; Ahn, Byungjoon; Lee, Jun Hee; Rah, Dong Kyun; Park, Tae Hwan

doi:10.1111/jocd.12221

Cited by 19 publications

(23 citation statements)

References 40 publications

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“…In addition, if the patient has a supraorbital sunken eyelid deformity, then it may become more visible postoperatively because redundant tissue over the sunken area is replaced by thinner tissue. A sunken deformity is defined as a depression between the eye brow and the upper border of the globe [13]. With aging, sunken upper eyelids can develop due to skin laxity and atrophy of orbital fat and subcutaneous tissue.…”

Section: Discussionmentioning

confidence: 99%

“…However, it is difficult to accurately predict the degree of atrophy when using transplanted fat; there fore, the outcomes of surgery may not be consistent, and unsatis factory results are possible, such as contour irregularity. In addition, the risk of fat embolism, which can lead to stroke or blindness, can not be completely ruled out [13,21]. To overcome these limitations, several studies utilized dermofat grafting and reported good results [19,20].…”

Section: Discussionmentioning

confidence: 99%

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Feasibility of a de-epithelialized orbicularis oculi musculocutaneous flap for subbrow blepharoplasty

Kim

Ahn

Suh

et al. 2019

Arch Aesthetic Plast Surg

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Background Subbrow blepharoplasty (SBB) has advantages over traditional blepharoplasty in that it results in more natural-looking creases and contours and is more effective for lateral periorbital rejuvenation. However, in older patients with sunken upper eyelid, this procedure might make the superior eyelid sulcus appear worse because the thicker upper eyelid tissue in the subbrow area is replaced by thinner tissue. To overcome this limitation, we developed a de-epithelialized musculocutaneous flap for SBB. Methods From August 2016 to January 2018, 13 patients with sunken upper eyelid deformity underwent SBB. For each of these patients, a typical SBB incision was made, but the tissue usually removed in SBB was dissected as a flap based on the branch of the ophthalmic vessel. After elevation, the flap was transposed or folded to correct the sunken deformity. The results were assessed by the patients themselves and by three plastic surgeons at 6 months postoperatively. Results The mean age of the patients was 63 years (range, 47-81 years). There were no postoperative complications related to wound dehiscence, hypertrophic scarring, or sensory changes. All patients and plastic surgeons provided scores indicating good to excellent results and were satisfied with the cosmetic outcomes. All patients reported improved functional visual acuity after surgery. Conclusions Our technique is simple and effectively addresses both sunken upper eyelid deformity and dermatochalasis. Unlike fat or dermofat grafting, our new technique does not require an additional donor site, and it is more reliable in terms of vascularity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Feasibility of a de-epithelialized orbicularis oculi musculocutaneous flap for subbrow blepharoplasty

Kim

Ahn

Suh

et al. 2019

Arch Aesthetic Plast Surg

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show abstract

“…Most notably, the sunken upper eyelid is often associated with an aged appearance, and has been the trigger for cosmetic surgical treatments. 225,226 The eyelashes may also decrease in length, thickness and darkness (pigmentation) with age, which may be 'treated' by prostaglandin treatment; 227 for some patients there may therefore be a perceived cosmetic benefit to prostaglandin use. 228 However, some patients may also develop poliosis of the eyelashes and hair growth elsewhere on the face, [229][230][231] which are conversely cosmetically undesirable.…”

Section: Patient Agementioning

confidence: 99%

Management of open‐angle glaucoma by primary eye‐care practitioners: toward a personalised medicine approach

Phu

Agar

Wang

et al. 2021

Clinical and Experimental Optometry

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Glaucoma is the leading cause of irreversible blindness worldwide. As a chronic disease, glaucoma presents a significant burden to the individual, health-care provider and the health-care system. Currently, strategies for treating glaucoma are focused on lowering intraocular pressure, which is aimed at slowing or arresting disease progression over time. This is the only current accepted therapeutic strategy for glaucoma, and can be achieved using topical drugs, laser trabeculoplasty, filtration surgery or cyclodestructive techniques. The lowering of intraocular pressure has been wellsupported by numerous large-scale seminal clinical trials in primary open-angle glaucoma, in both its early and advanced stages. Although such guidance remains current, in the last 10-years, there has been a significant evolution in preferred first-line therapies in the treatment of open-angle glaucoma with a resultant shift in practice patterns, particularly early in the course of the disease. These changes reflect both from the perspective of the doctor -in titrating the most effective and least risky treatment modality -and the perspective of the patient, in consenting to a treatment that preserves vision and results in minimal negative impact on quality of life. In this review, the most recent evidence regarding treatment modalities for early primary open-angle glaucoma is presented and an updated framework for management guidance is proposed.

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“…The areas with a higher degree of bony resorption are illustrated with larger arrows. Reproduced with permission from Mendelson and Wong [3] orbital rim (orbital retaining ligament) loosen with age, further accentuating this hollow [15,16] . These changes contribute to the classic "double convexity deformity" at the lid-cheek complex.…”

Section: Fat Padsmentioning

confidence: 99%

Periocular rejuvenation using hyaluronic acid fillers

Ziai¹,

Lighthall²

2020

PAR

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The eyes and periocular region are critical for emotive display and play a key role in social interactions. This region includes the upper and lower eyelids, brow-lid complex, and lid-cheek complex. Perturbances in this area can lead to a prematurely aged appearance and patients complain of emotive misinterpretation. It often shows the earliest signs of facial aging, leading to a tired, sad, or angry appearance. With the evolution of medical and surgical knowledge on facial aging, there has been a shift from isolated volume reducing interventions for periorbital aging to volume replacement techniques. The treatment of periocular aging is multifactorial and often includes resurfacing, chemodenervation, surgical interventions, and volumization. The minimally-invasive, office-based nature of fillers has resulted in their increased popularity and filler placement has become one of the most commonly performed cosmetic oculoplastic interventions. With a multitude of fillers emerging over the past decade or so, facial plastic surgeons have been equipped with the means to address age-related periorbital hollowing and skeletonization in an outpatient setting. An appropriate knowledge of periocular anatomy, types of fillers, proper injection technique, and management of potential complications is required for safe injection and to achieve optimal aesthetic outcomes. This paper reviews the use of hyaluronic acid fillers for periocular rejuvenation.

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Rejuvenation of the deep superior sulcus in the eyelid

Abstract: By careful identification of the clinical features and proper classification of the types of sunken superior sulcus, the treatment plan can be specified.

Cited by 19 publications

References 40 publications

Feasibility of a de-epithelialized orbicularis oculi musculocutaneous flap for subbrow blepharoplasty

Feasibility of a de-epithelialized orbicularis oculi musculocutaneous flap for subbrow blepharoplasty

Management of open‐angle glaucoma by primary eye‐care practitioners: toward a personalised medicine approach

Periocular rejuvenation using hyaluronic acid fillers

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