Murri Michael, Hamill Eric B, Hauck Matthew J, Marx Douglas P
Cullen Eye Institute, Baylor College of Medicine, Houston, Texas.
Medical Eye Center, Medford, Oregon.
Semin Plast Surg. 2017 Feb;31(1):46-50. doi: 10.1055/s-0037-1598632.
Aging changes to the lower eyelids and midface include pseudoherniated orbital fat, tear trough deformity, lid laxity, and dermatochalasis. Surgical repair often aims at treating redundant skin or orbital fat malposition with a lower eyelid blepharoplasty. Either a transcutaneous or transconjunctival approach may be used, though recent trends have favored the transconjunctival technique if procedures require more than simple skin excision. In manipulating the inferior orbital fat pads, a surgeon has many options including excision, repositioning, or augmentation with synthetic dermal filler, autologous fat grafts, or acellular dermal allografts. The authors review and detail indications, preoperative evaluation, techniques, and complications of lower lid blepharoplasty.
下眼睑和中面部的衰老变化包括眶脂肪假性疝出、泪沟畸形、眼睑松弛和皮肤松弛。手术修复通常旨在通过下睑成形术治疗多余的皮肤或眶脂肪位置异常。可以采用经皮肤或经结膜入路，不过如果手术需要的不仅仅是简单的皮肤切除，最近的趋势更倾向于经结膜技术。在处理眶下脂肪垫时，外科医生有多种选择，包括切除、重新定位或用合成真皮填充剂、自体脂肪移植或脱细胞真皮同种异体移植物进行填充。作者回顾并详细阐述了下睑成形术的适应症、术前评估、技术和并发症。
