The Pinch Blepharoplasty Revisited

Rosenfield, Lorne K.

doi:10.1097/01.prs.0000157020.67216.31

Cited by 38 publications

(24 citation statements)

References 3 publications

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“…The evolution of this procedure has resulted in divergent concepts. Some authors favor the maintenance of the fat bags, others are against touching the orbicularis oculi muscle, and still others recommend muscle cutaneous flaps and ample undermining of the orbicularis oculi muscle [2,4,12,[14][15][16][17][18][19][20][21].…”

Section: Discussionmentioning

confidence: 99%

Comparison between two surgical techniques for lower eyelid rejuvenation: safety analysis and outcomes

Viana

Osaki

Nishi

2010

Graefes Arch Clin Exp Ophthalmol

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Section: Discussionmentioning

confidence: 99%

Comparison between two surgical techniques for lower eyelid rejuvenation: safety analysis and outcomes

Viana

Osaki

Nishi

2010

Graefes Arch Clin Exp Ophthalmol

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“…In the lower lid, conservative removal of a pinch of skin is more appropriate as excessive skin removal leads to undesirable scleral show (Level IV Evidence). 15 Lateral removal of lower eyelid skin, however, can be more aggressive.…”

Section: Evidence On Surgical Treatment Planmentioning

confidence: 99%

An Evidence-Based Approach to Blepharoplasty

Friedland

Lalonde

Rohrich

2010

Plastic and Reconstructive Surgery

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The Maintenance of Certification module series is designed to help the clinician structure his or her study in specific areas appropriate to his or her clinical practice. This article is prepared to accompany practice-based assessment of preoperative assessment, anesthesia, surgical treatment plan, perioperative management, and outcomes. In this format, the clinician is invited to compare his or her methods of patient assessment and treatment, outcomes, and complications, with authoritative, information-based references.This information base is then used for self-assessment and benchmarking in parts II and IV of the Maintenance of Certification process of the American Board of Plastic Surgery. This article is not intended to be an exhaustive treatise on the subject. Rather, it is designed to serve as a reference point for further in-depth study by review of the reference articles presented. (Plast. Reconstr. Surg. 126: 2222 CLINICAL SCENARIOA 56-year-old woman requests improvement in the appearance of her upper and lower eyelids. She had LASIK surgery 3 months earlier. She has ptosis of her left upper eyelid. What is the best evidence to guide you in the management of her condition? There is very little high level evidence in the blepharoplasty literature at this time. The age of evidence is just upon us, and objective measurement in aesthetic surgery is in its infancy. This article is a starting point where most of the evidence is level IV (case series) and level V (case reports or expert opinion). There is almost no level III evidence (retrospective comparative case series) and virtually no level II evidence (prospective comparative studies). It will be very difficult to create level I studies that are prospective randomized blinded controlled studies. Nevertheless, we have to start somewhere. One hundred years from now, there will be serious useful evidence-based studies in cosmetic plastic surgery, like looking from the top of a sky scraper. This is the first step at examining where we are in the basement of evidence based medicine in aesthetic blepharoplasty. METHODS FOR IDENTIFYING EVIDENCEA literature search of PubMed, Cumulative Index to Nursing and Allied Health Literature, and the Cochrane Library was performed to obtain the best available evidence on blepharoplasty, with emphasis on preoperative assessment, treatment, and outcomes. The following search terms were combined as appropriate, and PubMed MeSH terms were used when available: blepharoplasty, eyelid surgery, diagnosis, preoperative assessment, risk factors, smoking, diabetes mellitus, pulmonary embolism, venous thrombosis, dry eye syndromes, anticoagulants, DVT prophylaxis, antibiotic prophylaxis, anesthetics, premedication, surgical treatment plan, treatment, surgery, outcome, complications, postoperative complications, pain management, and analgesia. The initial search was limited to human studies that were published from 1999 to 2009 and indexed as metaanalyses, randomized controlled trials, clinical trials, or comparative studies. Very fe...

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“…If there is moderate excess skin present after a volume preservation lower lid blepharoplasty, a skin pinch can be performed at the same time in select cases. 48,[60][61][62] More severe skin excess may benefit from skin flap elevation and excision, particularly to address skin excess that extends along the entire length of the lower lid.…”

Section: Amount Of Skin Excessmentioning

confidence: 99%

Simplifying Blepharoplasty

Zoumalan

Roostaeian

2016

Plastic and Reconstructive Surgery

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Blepharoplasty remains one of the most common aesthetic procedures performed today. Its popularity stems partly from the ability to consistently make significant improvements in facial aesthetics with a relatively short operation that carries an acceptable risk profile. In this article, the authors attempt to simplify the approach to both upper and lower lid blepharoplasty and provide an algorithm based on the individual findings for any given patient. The recent trend with both upper and lower lid blepharoplasty has been toward greater volume preservation and at times volume augmentation. A simplified approach to upper lid blepharoplasty focuses on removal of excess skin and judicious removal of periorbital fat. Avoidance of a hollow upper sulcus has been emphasized and the addition of volume with either fat grafting or fillers can be considered. Lower lid blepharoplasty can use a transcutaneous or a transconjunctival approach to address herniated fat pads while blending the lid-cheek junction through release of the orbitomalar ligament and volume augmentation with fat (by repositioning and/or grafting) or injectable fillers. Complications with upper lid blepharoplasty are typically minimal, particularly with conservative skin removal and volume preservation techniques. Lower lid blepharoplasty, conversely, can lead to more serious complications, including lid malposition, and therefore should be approached with great caution. Nevertheless, through an algorithmic approach that meets the needs of each individual patient, the approach to blepharoplasty may be simplified with consistent and predictable results.

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The Pinch Blepharoplasty Revisited

Abstract: The pinch blepharoplasty has proved to be a superior approach to lower eyelid rejuvenation. This series suggests that with this technique significantly more crepe-like skin can be removed with reliably less chance of scleral show.

Cited by 38 publications

References 3 publications

Comparison between two surgical techniques for lower eyelid rejuvenation: safety analysis and outcomes

Comparison between two surgical techniques for lower eyelid rejuvenation: safety analysis and outcomes

An Evidence-Based Approach to Blepharoplasty

Simplifying Blepharoplasty

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