Secondary Blepharoplasty: Correction of the High Fold

Wattanakrai, Kamol; Chiemchaisri, Nattawut; Wattanakrai, Penpun

doi:10.1007/s00266-016-0713-y

Cited by 11 publications

(17 citation statements)

References 10 publications

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“…Free fat graft is recommended by previous articles but was not applied in our series due to its lower ability for surgical fixation, possibility to induce more adhesion, and unpredictable resorption rates. 5-7 The overall success rate in our series was 83.6% which was lower than other series of secondary revision. 4-10 However, severity of the eyelid deformity and surgical scar height was lesser in other series and most did not involve patients from surgically induced levator compromised or ptosis group.…”

Section: Discussioncontrasting

confidence: 62%

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High Eyelid Crease Deformity in Asians: A Clinical Evaluation and Corrective Strategies

Saonanon

2021

Am J Cosmet Surg

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The aim of this study was to describe the manifestations of post-blepharoplasty high eyelid crease patients and to propose steps of clinical evaluation and corrective operations. High eyelid crease patients were categorized into 3 groups, including pre-existing ptosis (PP), surgical induced levator compromised (SI), and high eyelid crease alone (HC), based on their MRD1 and signs of compromised levator muscle. The primary outcomes were the type and success rate of the operative techniques. The secondary outcomes were the complications. A total of 131 patients were enrolled, 7 males and 124 females, with an average age of 39.7 years. The mean scar height in the HC, SI, and PP groups were 10.4 ± 2.2, 12.8 ± 2.6, and 9.0 ± 2.0 mm, respectively. The scar height in the SI group was statistically differently higher than the other groups (mean: 1.7 mm, 95% CI: [0.91, 2.43]; P < 0.001). In total, 117 eyes of 67 patients underwent corrective operations with significant lower eyelid fold height and an 83.6% success rate. There were 6 re-operation eyes, 5 in the SI group and 1 in the PP group. High blepharoplasty incision scar can lead to surgical induced levator compromise and ptosis. Systematical evaluation and optimal corrective operations are needed to achieve targeted outcome.

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Section: Discussioncontrasting

confidence: 62%

“…5-7 The overall success rate in our series was 83.6% which was lower than other series of secondary revision. 4-10 However, severity of the eyelid deformity and surgical scar height was lesser in other series and most did not involve patients from surgically induced levator compromised or ptosis group.…”

Section: Discussioncontrasting

confidence: 62%

High Eyelid Crease Deformity in Asians: A Clinical Evaluation and Corrective Strategies

Saonanon

2021

Am J Cosmet Surg

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“…Although most patients acquired beautiful double eyelid folds after double eyelid blepharoplasty, the number of people who got unsatisfactory outcomes even severe complications was also increasing year by year. Among these unacceptable results, abnormally high lid fold is a common complaint and the main cause of patients requiring revision operation 3,6,7,9,11. However, few papers published on Asian eyelid complications of high eyelid folds and their corrections.…”

Section: Discussionmentioning

confidence: 99%

“…Abnormally high eyelid fold can be caused by the following factors 3,5–9,13. First, high double eyelid crease incision design and high fixation from the previous operation are the most common causes.…”

Section: Discussionmentioning

confidence: 99%

Revisional Asian Blepharoplasty of the High Eyelid Fold: Tarsus-Orbicularis Fixation Combined With Orbital Fat Repositioning Technique

H¹,

Liu

Wen³

et al. 2022

Journal of Craniofacial Surgery

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Background: Abnormally high eyelid fold is a common unsatisfactory esthetic outcome after double eyelid surgery. At present, successful correction of high eyelid fold among Asians remains one of the most challenging procedures for eyelid plastic surgeons. Objectives: This article aims to propose a novel technique for correcting high eyelid fold to improve the cosmetic outcomes and patient satisfaction. Materials and Methods: This is a retrospective study of 86 patients (154 eyelids) with high eyelid folds who underwent revision blepharoplasty. A new proper height incision line was designed during the operation, and the adhesion between skin and levator aponeurosis was fully released. The residual orbital fat was adequately separated. If necessary, orbital fat from lower eyelid will be harvested for free fat grafting. The tarsus-orbicularis fixation combined with orbital fat repositioning technique was used to create a double eyelid fold and reconstruct the gliding zone. The surgical outcome and patient satisfaction are reviewed. Results: Among the 154 eyelids with high eyelid fold, mean lid crease height decreased from 9.8 mm preoperation to 6.8 mm (P < 0.001) and mean pretarsal show decreased from 3.5 mm preoperation to 1.9 mm 6 months postoperation (P <0.001). The esthetic outcome was fully satisfied in 78 patients (90.7%) and basically satisfied in 6 patients (7.0%). Two patients (2.3%) were unsatisfied because of ptosis undercorrection in 1 patient and asymmetry in the other. They both got satisfied results after reoperation. Conclusions: The tarsus-orbicularis fixation combined orbital fat repositioning technique is a simple and effective method to correct high eyelid folds with high satisfaction and rare complications.

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“…The adhesion of the high fold to the levator aponeurosis or muscle might compromise normal upward movement of the tarsus, causing ptosis despite a normal levator function. 3,15,17 Therefore, we could not advance the levator as much as we did in patients requesting ptosis correction. The primary purpose of advancement was to bring down the adhesion point on the levator aponeurosis away from the corresponding point underneath the skin.…”

Section: Methodsmentioning

confidence: 99%

Algorithm for Correction of Unaesthetic High Eyelid Folds

Wattanakrai

Chiemchaisri

Wattanakrai

2023

Plastic &Amp; Reconstructive Surgery

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Secondary Blepharoplasty: Correction of the High Fold

Abstract: This journal requires the authors to assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors. www.springer.com/00266 .

Cited by 11 publications

References 10 publications

High Eyelid Crease Deformity in Asians: A Clinical Evaluation and Corrective Strategies

High Eyelid Crease Deformity in Asians: A Clinical Evaluation and Corrective Strategies

Revisional Asian Blepharoplasty of the High Eyelid Fold: Tarsus-Orbicularis Fixation Combined With Orbital Fat Repositioning Technique

Algorithm for Correction of Unaesthetic High Eyelid Folds

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