Periorbital Rejuvenation Surgery in the Geriatric Population

Chuang, Ann Yi-Chiun; Liao, Shu‐Lang

doi:10.1016/s1873-9598(10)70033-8

Cited by 5 publications

(13 citation statements)

References 37 publications

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“…The use of CPF repair, or the combination of fat repositioning with elevation of the midface cheek fat (SOOF and descended malar fat pad) and/ or lipo-sculpturing to volume deficient areas, especially in older patients, can be beneficial to restore a smooth lid-cheek junction, regardless of tear trough deformity in some patients [2,13,30,35,36].…”

Section: Discussionmentioning

confidence: 99%

“…There have been a number of modifications made to the "intra-SOOF" procedure whereby the fat pads are temporarily secured internally or externally with matrix sutures through cheek skin [2,29]. There are centers which support the use of lower eyelid fat repositioning alone; others may combine lower eyelid fat repositioning with a mid-face lift, regardless of the condition of the tear-trough [2,13,30].…”

Section: Palpebral Bagsmentioning

confidence: 99%

“…There are centers which support the use of lower eyelid fat repositioning alone; others may combine lower eyelid fat repositioning with a mid-face lift, regardless of the condition of the tear-trough [2,13,30]. The utilization of fat repositioning (i.e.…”

Section: Palpebral Bagsmentioning

confidence: 99%

“…This, however, is insufficient to address all of these anatomical changes and to restore a youthful smooth lid cheek junction. Furthermore, most elderly Asian patients are not interested in a complicated surgical procedure for periorbital rejuvenation, particularly if it is uncomfortable to go through with a long period of recovery time [2].…”

Section: Introductionmentioning

confidence: 99%

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The troublesome triad: festoons, malar mounds, and palpebral bags

Phoebe¹

2017

J Cosmet Med

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The ill-defined lid-cheek junction continues to be one of the most challenging regions for rejuvenation. Malar mounds, festoons or palpebral bags, may occur alone, or in combination, in the infraorbital area. These pathological variants are distinctly different and may contribute to patients' perception of their eyebags. Traditional lower blepharoplasty (fat repositioning/ removal) with skin adjustment alone may be insufficient in addressing all of these pathologies, and recurrence may occur. This literature review aims to look at current definitions and treatment of festoons, malar mounds, and palpebral bags in Asian blepharoplasty. A Medline literature search for articles with anatomic descriptions of malar mounds, palpebral bags and festoons, particularly in Asian eyelids, was performed. This was supplemented by a manual search of the references of articles obtained. The details of all of the different surgical options for eyelid rejuvenation are beyond the scope of this review article. Thus, only the basic concepts that illustrate the anatomical relationship and the natural progression of malar mounds, festoons, and palpebral bags will be discussed in this article. Some of the treatment options, both invasive and non-invasive, will also be reviewed. There is no singular treatment for malar mounds, festoons, and palpebral bags. Standard lower blepharoplasty with skin excision is ineffective to lift and re-drape malar mounds or festoons. Repositioning of the malar septum, on the other hand, allows for resolution of the edema (malar festoons) above its cutaneous insertion. A number of liposculpturing techniques to volumize deficient areas, such as fat repositioning (cheek, suborbicularis and descended malar fat pad) with lifting of the midface, can be beneficial to restore a smooth lid-cheek junction.Non-invasive techniques like laser resurfacing and Ultherapy ® (Ulthera, Inc., Meza, AZ, USA) may be useful in periorbital rejuvenation in selected cases.

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Section: Discussionmentioning

confidence: 99%

Section: Palpebral Bagsmentioning

confidence: 99%

Section: Palpebral Bagsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The troublesome triad: festoons, malar mounds, and palpebral bags

Phoebe¹

2017

J Cosmet Med

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“…We developed a unique procedure for combined MMCR and tarsectomy with no reference to the phenylephrine response [28]. Due to our previous surgical experience, MMCR alone without tarsectomy did not achieve satisfactory results in our Asian patients.…”

Section: Liao's Modification Of Mmcrmentioning

confidence: 99%

Various Modifications of Müller's Muscle-Conjunctival Resection for Ptosis Repair

Liao

Chuang

2015

Arch Aesthetic Plast Surg

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Background The posterior approach for ptosis, including the Fasanella-Servat procedure and Müller's muscle-conjunctival resection (MMCR), has been proven effective for mild-to moderately affected patients whose levator muscle function remains relatively intact. Traditionally, MMCR was reserved for phenylephrine test-positive patients for whom various modifications and several nomograms have been developed. Methods We reviewed the literature for the Fasanella-Servat procedure and MMCR. The methods and results of the different modifications were analyzed and compared. Nomograms of these two procedures were summarized. Results MMCR mainly involved resection of Müller's muscle and conjunctiva in the original design by Putterman and co-workers. The suggested resection ranged from 8 to 9 mm for the achievement of the maximal effect produced by topical epinephrine. Perry included tarsectomy in his procedure and developed a new nomogram that included a 1:1 ratio of the ptosis correction to the amount of tarsus resection. The effect of tarsectomy for the Fasanella-Servat procedure in terms of eyelid elevation was approximately one-half the value seen in phenylephrine test-negative patients. We've performed MMCR with tarsectomy regardless of the response to phenylephrine with similar results to Perry. Surgical indications and possible complications of MMCR with tarsectomy for Asian patients are discussed. Conclusions MMCR is an effective and simple method for the correction of ptosis. With baseline MMCR, the additional tarsectomy has proven to be a powerful tool for ptosis correction irrespective of phenylephrine test results.

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