Update on Upper Lid Blepharoplasty

Pfeiffer, Markus J.

doi:10.1007/3-540-29969-6_11

Cited by 5 publications

(3 citation statements)

References 25 publications

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“…11,12 Its strength and laxity vary between patients and divides the lid into anterior lamella (skin and orbicularis), middle lamella (OS, orbital fat, and suborbicularis fibroadipose tissue), and posterior lamella (tarsus, conjunctiva, and lid retractors). 3,13,14 It also acts as a diaphragm holding orbital contents in place. 15 The arcus marginalis is a thick whitish fibrous band fusing with the periosteum of the orbital rim.…”

Section: Anatomy Of the Lower Eyelidmentioning

confidence: 99%

Lower Eyelid Transcutaneous Blepharoplasty, Minimizing Complications and Correction of Lower Eyelid Malposition

Joshi

Sobti

2022

Facial Plast Surg

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Lid retraction is a feared complication of lower blepharoplasty. Anatomical variations like negative orbital vector, horizontal lid laxity and pre-existing lid retraction are more prone to lid malpositions. Meticulous and precise execution of a series of surgical steps is key to preventing complications. This includes minimising surgical trauma, meticulous hemostasis, preserving innervation to the medial lid and pretarsal orbicularis, safe method of fat excision, septal tightening while maintaining lid traction and conservative and titrated skin excision. Canthal fixation addresses lid laxity and maintains the lid stretched vertically while post-operative healing and fibrosis are taking place. Post-blepharoplasty lid retraction may occur due to failure to address lid laxity and the occurrence of middle lamellar fibrosis. Excessive skin excision may also result in anterior lamellar deficiency. The “sag and drag” concept is useful to evaluate the post-blepharoplasty retracted lid. The treatment of the retracted lid includes lid massage, replacing the anterior lamella or releasing the middle lamellar fibrosis or a combination of techniques. In conclusion, understanding the mechanisms of lid retraction, careful pre-operative assessment and surgical precision will help surgeons to prevent and manage this complication.

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Section: Anatomy Of the Lower Eyelidmentioning

confidence: 99%

Lower Eyelid Transcutaneous Blepharoplasty, Minimizing Complications and Correction of Lower Eyelid Malposition

Joshi

Sobti

2022

Facial Plast Surg

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“…The eyelid consists of an anterior and posterior lamella. The anterior portion of the lid is composed of skin and orbicularis muscles, while the posterior portion includes the posterior tarsal plate, retractors (in the lower eyelid), and conjunctiva[ 2 ]. In most eyelid reconstruction surgical procedures, both lamellae need to be replaced.…”

Section: Introductionmentioning

confidence: 99%

How and when of eyelid reconstruction using autologous transplantation

Miotti¹,

Zeppieri²,

Rodda³

et al. 2022

WJT

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Reconstructive surgery of the eyelid after tumor excision, trauma or other causes can be challenging, especially due to the complexities of the anatomic structures and to the necessity of both functional and aesthetic successful outcomes. The aim of this minireview was to investigate the use of tissue transplantation in eyelid reconstruction. Surgical procedures are various, based on the use of both flaps, pedicled or free, and grafts, in order to guarantee adequate tissue reconstruction and blood supply, which are necessary for correct healing. Common techniques normally include the use of local tissues, combining non-vascularized grafts with a vascularized flap for the two lamellae repair, to attempt a reconstruction similar to the original anatomy. When defects are too wide, vast, deep, and complex or when no adjacent healthy tissues are available, distant area tissues need to be recruited as free flaps or grafts and paired with mucosal layer reconstruction. With regards to the anterior lamella, full thickness skin grafts are commonly preferred. With regards to the reconstruction of posterior lamella, there are different graft options, which include conjunctival or tarsoconjunctival, mucosal or palatal or cartilaginous grafts usually combined with local flaps. Free flap transplantation, normally reserved for rare select cases, include the use of the radial forearm and anterolateral flaps combined with mucosal grafts, which are surgical options currently reported in the literature.

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“…Blepharoplasty can be performed by many operative approaches and an almost uncountable number of different techniques have been published [1,9,13,14,18].…”

Section: Introductionmentioning

confidence: 99%