Upper blepharoplasty revision technique: Correction of the high eyelid fold using the pretarsal orbicularis oculi flap

Liu, Haipeng; Shao, Ying; Li, Bing; Sun, M. J.; Yu, Xiaojie; Zhang, Duo

doi:10.1016/j.bjps.2018.08.013

Cited by 9 publications

(15 citation statements)

References 14 publications

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“…Local tissues are the first choice for correcting upper eyelid depression and should be preserved as much as possible 18. The muscle flap has a good vascular supply and provides tissue volume without displacement or absorption 23. During the follow-up period, there was no irregularity on the upper eyelid, and the eyelid movement was normal without major complications.…”

Section: Discussionmentioning

confidence: 99%

Sunken Upper Eyelid Deformity Correction by Orbital Fat Pad Repositioning and Orbicularis Oculi Muscle Folding in Blepharoplasty

Lin²,

Li³

2023

Journal of Craniofacial Surgery

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Background: Sunken upper eyelid deformity results in an aged and unnatural appearance and is common among Asians along with the single eyelid. The upper eyelid volume restoration is as important as the creation of a supratarsal fold for patients with sunken eyelids. In the present study, the combination of orbital fat pad repositioning and orbicularis oculi muscle flap folding was established to correct the upper eyelid depression during blepharoplasty. Methods: A retrospective study was conducted on patients who underwent the orbital fat pad repositioning and orbicularis oculi muscle flap folding to correct the upper eyelid depression between July 2020 and October 2021. The preoperative and postoperative sunken depths were calculated and compared, and overall patient satisfaction was performed to evaluate the operation efficiency. Results: There were 40 patients, including 39 females and 1 male, who underwent surgery with an average age of 25.4 years. During the mean follow-up period of 12.7 months, the sunken depth improved from 3.2 mm preoperatively to 1.5 mm postoperatively with a statistical significance. Satisfactory results were achieved without major complication. Conclusions: For patients with mild to moderate sunken upper eyelids, the combination of orbital fat pad repositioning and orbicularis oculi muscle folding has been proved efficient and consistent to restore the upper eyelid volume and helpful to build esthetic double eyelids.

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Section: Discussionmentioning

confidence: 99%

Sunken Upper Eyelid Deformity Correction by Orbital Fat Pad Repositioning and Orbicularis Oculi Muscle Folding in Blepharoplasty

Lin²,

Li³

2023

Journal of Craniofacial Surgery

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“…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. Successful correction of high eyelid folds among Asians remains one of the most challenging procedures for plastic surgeons.…”

Section: Discussionmentioning

confidence: 99%

“…Abnormally high eyelid fold can be caused by the following factors. 3,[5][6][7][8][9]13 First, high double eyelid crease incision design and high fixation from the previous operation are the most common causes. Improper fixation that is set too high may lead to eyelash eversion or unesthetic showing of the red tarsal margin.…”

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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“…Another technique was presented by a Chinese group. 10 They used a pretarsal orbicularis oculi muscle flap with meticulous dissections of the lower and upper flap. They then transposed the flap upward and fixed it to the upper orbicularis oculi muscle.…”

Section: Management Of Asymmetrical Double Eyelidsmentioning

confidence: 99%

“…Using both of these techniques, the incision scar is excised, and any scar tissue overlying the aponeurotic attachment is removed to allow for new crease formation. 6,9,10 Hyaluronic acid filler can be also used, especially in patients with upper eyelid hollowing. Volume replacement and fullness lower the surgically created eyelid crease.…”

Section: Management Of Asymmetrical Double Eyelidsmentioning

confidence: 99%

The Causes and Management of Asymmetrical Double Eyelids

Kim

Jang

2020

Facial Plast Surg

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Blepharoplasty is a commonly performed aesthetic surgery, especially in Asians. Nevertheless, as in all surgeries, postoperative complications still occur. Asymmetry is the most common complication after double eyelid surgery. Preexisting asymmetries in patient appearance and technical faults during surgery are associated with postoperative asymmetrical double eyelids. In this review, we discuss how to prevent unfavorable outcomes after this procedure and how to manage asymmetrical double eyelids when they do occur.

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Upper blepharoplasty revision technique: Correction of the high eyelid fold using the pretarsal orbicularis oculi flap

Cited by 9 publications

References 14 publications

Sunken Upper Eyelid Deformity Correction by Orbital Fat Pad Repositioning and Orbicularis Oculi Muscle Folding in Blepharoplasty

Sunken Upper Eyelid Deformity Correction by Orbital Fat Pad Repositioning and Orbicularis Oculi Muscle Folding in Blepharoplasty

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

The Causes and Management of Asymmetrical Double Eyelids

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