Background: Nowadays, a sharp, well-defined supratarsal fold and appropriate fullness of the upper eyelid tissue are considered important features of beautiful and youthful eyes. Individuals with thin upper eyelid tissue are at high risk of developing multiple upper eyelid folds and/or sunken appearance after upper blepharoplasty. Innovatively, the authors propose the application of free orbital fat grafting to the postorbicularis oculi space during upper blepharoplasty in order to achieve better aesthetic results. Methods: Fifty Chinese patients with congenital single eyelids combined with mildly sunken upper eyelid tissue were operated on between June 2017 and October 2018. During blepharoplasty, the lateral portion of the orbital septum was dissected, and appropriate lateral orbital fat was harvested. When the double-eyelid fold was formed and skin was interruptedly sutured, the harvested fat was divided into several pieces each side according to the sunken depth, and they were used to replace a layer on two-thirds of the central region of the supraseptal skin-muscle flap through the zipping gaps. Results: Forty-five patients underwent the follow-up interview for 6 to 18 months with a mean period of 10 months. The satisfaction rate was 82%. No significant asymmetry, irregularities, and sunken upper eyelid and multiple upper eyelid folds occurred. Conclusion: The lateral orbital fat grafting to the central region of the supraseptal skin-muscle flap during upper blepharoplasty is an effective and simple method to correct or prevent multiple upper eyelid folds and/or sunken upper eyelid in Asians.

Introduction The anatomy of the arterial branches in the upper lip and their relationships to soft tissue are not well described in the literature. The purpose of this study was to explore a method for visualizing the microvessels and soft tissue three‐dimensionally to gain better understanding of the upper lip blood supply. Materials and Methods Seventeen stillborn fetuses were injected with lead oxide–gelatin and stained with iodine. Thirty‐four half upper lip specimens were obtained and scanned by micro‐computed tomography. The images were then examined and Inveon analysis software was used for three‐dimensional reconstructions. Results The main supplies to the upper lip were from the superior labial and inferior alar arteries. In some cases, the infraorbital and lateral nasal arteries also branched off to the upper lip. The anatomical variations were classified into six types on the basis of the observed vascular composition patterns. The skin was supplied by the subcutaneous vascular network, formed by the superficial ascending branches of the superior labial and inferior alar arteries. The mucosa was supplied by the submucosal vascular network, formed by the deep ascending branches of the superior labial artery and the labial branches of the infraorbital artery. The muscles were supplied by small vertical branches from the subcutaneous and submucosal vascular networks. Conclusion This study provides new anatomical insight into the upper lip by describing the microvessels and the relationship between the arteries and the soft tissue involved. This is important information for clinical applications in upper lip plastic surgery.

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Objective: To investigate the alveolar bone condition of mandibular molar distalization in skeletal Class III patients from buccolingual direction. Methods: 45 skeletal class III patients were recruited. The alveolar bone volume, buccal cortical bone thickness and lingual cortical bone thickness were measured in five planes from mesial to distal and at five depths from gingival to root. The effects of the gender of the patients, the second molar lingual inclination, and wisdom tooth on alveolar bone volume and cortical bone thickness were evaluated. To explore the effect of wisdom tooth extraction on alveolar bone condition, the measurements before and after wisdom tooth extraction were compared. Results: The impacted wisdom tooth had significantly greater alveolar bone volume and thicker buccal cortical bone at cervical third of molar, while the erupted wisdom tooth had greater alveolar bone volume at apical third. After wisdom tooth extraction, these advantages would weaken owing to the reconstruction of alveolar bone. Patients with lingual inclined molar were observed to own thicker lingual cortical bone. Male tended to have greater alveolar bone volume, but no significant differences were shown in this study. Conclusions: The growth of wisdom tooth and the second molar lingual inclination can effectively make the alveolar bone condition more favorable for mandibular molar distalization, but gender has trivial effects on alveolar bone condition. Shortly after the wisdom tooth extraction surgery, the better bone condition can be maintained.