Haefliger I O, Pimentel de Figueiredo A R
Holbein-PraxisKLINIK, Basel, Switzerland.
Department of Oculoplastic Surgery, São Geraldo Hospital, Federal University of Minas Gerais, Santa Efigênia Belo Horizonte - MG, Brazil (Chairman: Ana Rosa Pimentel de Figueiredo).
Klin Monbl Augenheilkd. 2015 Apr;232(4):493-6. doi: 10.1055/s-0035-1545773. Epub 2015 Apr 22.
The purpose of this study was to report a transcutaneous lower eyelid blepharoplasty procedure where different amounts of skin and orbicularis oculi muscle are excised and where skin and muscle are redraped (tightened) separately.
A retrospective non-consecutive small case-series of patients undergoing lower eyelid blepharoplasty is described. In a nutshell, during this procedure a skin flap was fashioned (caudal to the sub-ciliary pre-tarsal excess of skin to be excised), some pre-septal orbicularis oculi muscle fibers were excised (in regard of the skin flap), muscle and then skin were redraped, separately. In addition to these surgical steps conducted on each patient, when required, orbital fat prolapse was reduced, orbital retaining ligament was detached, and/or a canthopexie/plasty was performed. Assessment of surgical outcome was made by providing, for comparison, pictures taken before and after the procedure.
No major intra- or postoperative complications were recorded and overall postoperative outcome was judged satisfactory by both surgeons and patients.
In contrast to a conventional skin-muscle lower blepharoplasty approach where, in a block, pre-tarsal skin and muscle are excised and then pre-septal skin and muscle are redraped, the technique described in the present paper allows us to excise different amounts of skin and orbicularis muscle and to redrape them separately. Among several potential advantages, this approach preserves pre-tarsal orbicularis muscle function, allows us to apply more tension on the redraped muscle and less on the redraped skin, and avoids redraping of a relatively thick per-septal orbicularis oculi muscle over the tarsus (like it is in the case of a conventional skin-muscle technique).
本研究的目的是报告一种经皮下睑成形术，该手术切除不同量的皮肤和眼轮匝肌，并分别对皮肤和肌肉进行重新铺展（收紧）。
描述了一组接受下睑成形术患者的回顾性非连续性小病例系列。简而言之，在此手术过程中，制作了一个皮瓣（在待切除的睑缘前睑板前多余皮肤的尾侧），切除了一些眶隔前眼轮匝肌纤维（相对于皮瓣而言），然后分别对肌肉和皮肤进行重新铺展。除了对每位患者进行的这些手术步骤外，必要时还减少了眶脂肪脱垂，分离了眶隔韧带，和/或进行了眦固定术/成形术。通过提供手术前后的照片进行对比来评估手术效果。
未记录到重大的术中或术后并发症，外科医生和患者均认为总体术后效果令人满意。
与传统的皮肤 - 肌肉下睑成形术方法不同，传统方法是整块切除睑缘前皮肤和肌肉，然后重新铺展眶隔前皮肤和肌肉，本文所述技术使我们能够切除不同量的皮肤和眼轮匝肌，并分别对它们进行重新铺展。在几个潜在优势中，这种方法保留了睑缘前眼轮匝肌的功能，使我们能够在重新铺展的肌肉上施加更大的张力，而在重新铺展的皮肤上施加较小的张力，并且避免了相对较厚的眶隔前眼轮匝肌在睑板上重新铺展（就像传统皮肤 - 肌肉技术那样）。
