Department of Facial Plastic Surgery, Faceistanbul, Istanbul, Turkey.
Department of Otorhinolaryngology, Acibadem University, Halkali Merkez Mahallesi Turgut Ozal Bulvari, Istanbul, Turkey.
Facial Plast Surg. 2021 Apr;37(2):198-204. doi: 10.1055/s-0041-1724112. Epub 2021 Feb 25.
The subciliary lower eyelid blepharoplasty has evolved considerably to create a more harmonious natural appearance with a fuller and unoperated look and also to minimize the complications. While lower eyelid malposition was very common in the past, now this complication is significantly reduced by attention to preoperative evaluation, meticulous surgical planning, precise surgical technique, and postoperative care. Various prophylactic maneuvers maintaining/strengthening lower lid support can be utilized to prevent lower lid malposition including preservation of the pretarsal orbicularis oculi muscle, conservative resection of skin and muscle, and suspension of the orbicularis oculi muscle and/or tarsus to the periosteum of the lateral orbital rim. The release of the orbicularis retaining ligament and surgical transposition of orbital fat over the rim rather than excision allows for smoothing of the lid-cheek junction, filling the tear trough deformity, and reducing the appearance of bulging fat in the lower eyelid. In this article the reader will find a comprehensive approach for achieving a smooth contour with gradual blending at the lower eyelid-cheek junction while maintaining/restoring normal lower lid support. A descriptive outline of postoperative care is also provided to help in optimal healing for the patient.
眉下眼睑下睑成形术有了很大的发展，旨在通过创造更和谐的自然外观，使下睑看起来更饱满、未经手术，并尽量减少并发症。虽然过去下睑位置异常很常见，但现在通过术前评估、精细的手术计划、精确的手术技术和术后护理，可以显著减少这种并发症。可以利用各种预防性操作来维持/加强下睑支撑，以防止下睑位置异常，包括保留眼轮匝肌前部、皮肤和肌肉的保守切除，以及将眼轮匝肌和/或睑板悬吊到眶外侧缘的骨膜上。释放眼轮匝肌保留韧带，并将眶隔脂肪越过眶缘而不是切除，可以使睑颊交界处平滑，填充泪槽畸形，并减少下睑膨出脂肪的外观。在本文中，读者将找到一种全面的方法，在保持/恢复正常下睑支撑的同时，在下睑-颊交界处实现平滑的轮廓，逐渐融合。还提供了术后护理的描述性大纲，以帮助患者实现最佳愈合。
