Background: Pretarsal atrophy is not uncommonly found in patients who have undergone a transcutaneous or transconjunctival lower blepharoplasty because of intraoperative denervation of the pretarsal orbicularis oculi. The motor-supplying concept to the lower eyelid was recently updated; however, there have not yet been any guidelines to preserve motor nerves in lower blepharoplasty incisions based on the refined knowledge.
Methods: Forty-six fresh cadaveric hemifaces were examined to find a safe zone for a lower blepharoplasty muscle incision and a danger zone for an infraorbital incision in the transblepharoplasty midface approach. In addition, practical anatomy about the pretarsal motor supply was also investigated in detail.
Results: The medial, lateral, superior, and inferior borders of the safe zone for a lower blepharoplasty muscle incision were 9.4 mm from the medial canthus line, 3 mm from the lateral canthal crease, and 6.0 and 6.5 mm from the eyelid margin, respectively. The danger zone for an infraorbital incision ranged from 9.4 mm medial to the midpupillary line to 9.7 mm lateral to the midpupillary line. The motor nerve in the danger zone abutted the distal roof of the preseptal pocket, making it vulnerable to electrocautery heat. Motor nerve distribution of the lower pretarsal orbicularis oculi was fully identified.
Conclusions: There is a safe zone for the lower blepharoplasty muscle incision which, if adhered to, will preserve the pretarsal motor supply and prevent muscle atrophy. There is an infraorbital danger zone, where surgeons should pay special attention to avoid electrocautery heat injury.
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http://dx.doi.org/10.1097/PRS.0000000000010901 | DOI Listing |
Int Ophthalmol
December 2024
Department of Ophthalmology, Ankara Training and Research Hospital, University of Health Sciences, Ankara, Turkey.
Purpose: To investigate the efficacy of a comprehensive surgical approach for rejuvenation of the aging lower periorbita.
Methods: Between February 2018 and January 2023, 80 eyes of 40 patients with lower lid dermatochalasis (LLD), lower lid laxity (LLL) or orbicularis laxity of the lower lid (OL) admitted to the oculoplastic surgery department of our clinic were included in the study. 18 eyes had LLD, 14 eyes had LLL, 18 eyes had LLD and LLL, and 30 eyes had LLD, LLL and OL.
J Craniofac Surg
December 2024
Department of Plastic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou.
Objective: The infrabrow blepharoplasty is a common surgical operation indicated in Asians for periorbital rejuvenation. This operation alone is difficult to achieve the correction of crow's feet. Therefore, the authors elucidate the authors' experiences of applying infrabrow blepharoplasty combined with the subcutaneous undermining of the lateral periorbital region to treat upper eyelid dermatochalasis with lateral hooding deformity and alleviate crow's feet, including its indications, operative procedures, and postoperative outcomes.
View Article and Find Full Text PDFBMC Ophthalmol
December 2024
Department of Ophthalmology, The Second Hospital of Dalian Medical University, Dalian, Liaoning Province, China.
Background: The injection of local anesthetics, an extremely painful procedure, leads to a reduction of patients' acceptance.
Objective: To investigate the efficacy and adverse reactions of 4% tetracaine gel (TG) and lidocaine-prilocaine cream (LPC) on reducing the local anesthetic injection pain for upper eyelid blepharoplasty.
Methods: Sixty participants were equally divided into three groups.
BMC Ophthalmol
December 2024
The Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, 526601, Israel.
Purpose: Frontalis sling surgery is a common method for ptosis correction for both pediatric and adult populations. This study aims to compare the characteristics and outcomes of this surgery in these two populations.
Methods: A retrospective cohort study.
Med J Islam Repub Iran
July 2024
Department of Plastic Surgery, Faculty of Medicine, Port Said University, Port Said, Egypt.
Background: The anatomy of the eyelid changes with age. Multiple changes were observed in the eyelids and the surrounding structures including the malar region. Aging affects the appearance of eyelids and midface by the formation of tear trough deformity and malar flattening and ptosis.
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