Surgical Correction of Tear Trough Deformity (TTD) with Orbicularis Retaining Ligament Release and Volume Augmentation for Periorbital Rejuvenation: Review of the Literature

Atiyeh, Bishara S.; Hakim, Christopher-Roland; Oneisi, Ahmad; Ghieh, Fadi; Chahine, Fadel

doi:10.1007/s00266-022-03183-0

Cited by 11 publications

(3 citation statements)

References 92 publications

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“…14,15 This surgical operation inevitably damages the fibrous connective tissues, which includes the arcuate expansion and the fascia of inferior oblique muscle, as well as the orbicularis retaining ligament. 16,17 We do not advocate the destruction of these reinforcing structures. Although it may yield immediate surgical results, the likelihood of recurrent herniation significantly increases.…”

Section: Discussionmentioning

confidence: 99%

“…When a tear trough is present, some pedicled orbital fat is replaced in the prezygomatic space or the premaxillary space 14,15 . This surgical operation inevitably damages the fibrous connective tissues, which includes the arcuate expansion and the fascia of inferior oblique muscle, as well as the orbicularis retaining ligament 16,17 . We do not advocate the destruction of these reinforcing structures.…”

Section: Discussionmentioning

confidence: 99%

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The Experience in Lower Eyelid Blepharoplasty

Yang,

2024

Ann Plast Surg

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Objective This study characterizes the appearance changes associated with aging of the human lower eyelid, grounded in its anatomical basis. Tailored approaches to lower eyelid bag are performed by these anatomical manifestations. Methods From January 2017 to January 2023, lower eyelid blepharoplasty was performed on 137 patients, aged 20 to 60 years. These patients were divided into 3 groups according to the periorbital aging appearance, primarily characterized by the presence and location of the “bag” bulge of the lower eyelid. We analyzed the corresponding changes in anatomical structures for each type, which included a weakened fibrous orbital support system, reduced muscle tone, and increased orbital fat. Patients were treated with tailored blepharoplasty techniques according to their classification. All patients in this study ranged in follow-up from 1 to 12 months. With patients' permit, photographs and clinical information were taken to evaluate the preoperative and postoperative outcome. Results Our study identified 3 morphologies of the lower eyelid. Type 1 presents a “bubble bag” in the medial and inferior aspect of the lower eyelid. Type 2 features a double convexity contour, with separate fat pad herniations demarcated by fibrous connective tissue. Type 3 exhibits a single convexity with a uniform herniation of fat pads across the entire lower eyelid. We have delineated the anatomical changes associated with each morphology type. With an approach grounded in “remodeling” and “recovery,” the surgical treatment targets the fibrous support tissue to improve the outcomes of lower eyelid rejuvenation. No complications occurred. All postoperative results reached both surgeon's and patient's expectations. Conclusions Surgeons must recognize the pivotal role of fibrous connective tissues—including the arcuate expansion, fascia of the inferior oblique muscle, and the orbicularis retaining ligament—and endeavor to preserve or reinforce these structures during surgical procedures. An anatomically based surgical approach would more effectively and safely to resist the facial aging process.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Experience in Lower Eyelid Blepharoplasty

Yang,

2024

Ann Plast Surg

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“…It can give the orbital regions a more relaxed appearance, as evidenced by a wider palpebral aperture, increased symmetry, and smoother eyelids 4 . Different techniques have been proposed during the years, 5–9 sometimes in combination with other facial and skin rejuvenation procedures such as brow or mid‐face lift, lasers, or chemical skin resurfacing 10 . Eyelid anatomy is complex and intricate, so there are some complications, but they are typically mild and temporary 8…”

Section: Introductionmentioning

confidence: 99%

Laser‐assisted blepharoplasty: An innovative safe and effective technique

Bonan¹,

Fusco

Bruscino³

et al. 2023

Skin Research and Technology

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Background: Blepharoplasty is one of the most popular esthetic procedures with an acceptable risk profile and a relatively quick procedure. Methods:The aim was to evaluate the efficacy and safety of a new CO 2 and 1540-nm laser-assisted blepharoplasty technique applied to the upper and lower eyelids. A total of 38 patients were enrolled. Photographs were taken before the treatment and at 6month follow-up. One "blind" observer assessed the performance of this technique by ranking the results in four categories of eyelid esthetic: 1 = no or poor results (0%-25%), 2 = slight improvement (25%-50%), 3 = moderate improvement (50%-75%) and 4 = marked improvement (75%-100%). All possible complications were monitored.Results: Thirty-two patients (84 %) achieved marked improvement, four patients (11%) moderate improvement, two patients (5 %) slight improvement, while zero subjects (0%) poor or no improvement. No serious adverse effects were observed. Conclusions:Our results from clinical evaluations suggest that the CO 2 and 1540-nm laser assisted blepharoplasty is proved to be a sophisticate intervention efficacious in improving the treatment of patients with various degrees of eyelid and periocular aging and also in reducing downtime.

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