Maione Luca, Vinci Valeriano, Costanzo Domenico, Battistini Andrea, Lisa Andrea, Di Maria Alessandra
Plastic Surgery Unit, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
Department of Medical Biotechnology and Translational Medicine BIOMETRA, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Rozzano, Milan, Italy.
J Med Case Rep. 2021 Apr 29;15(1):248. doi: 10.1186/s13256-020-02641-0.
Dermatochalasis of the upper eyelids (blepharochalasis) is a typical age-related change in the upper third of the face and a major concern for facial aesthetics. Nowadays both surgical and nonsurgical interventions are available for patients complaining of upper eyelid dermatochalasis. Although nonsurgical treatments are often easier to perform, if they are not performed correctly, complications may ensue and worsen the condition.
We describe the case of a Caucasian patient presenting with bilateral upper eyelid dermatochalasis, previously treated with multiple injections of hyaluronic acid filler. Following these procedures, the patient reported nonspecific eye symptoms (such as a sense of heaviness and asthenopia) and cosmetic concerns. We decided to perform an upper eyelid blepharoplasty. During the procedure we found a ribbon of hard, fibrous material, which was carefully removed. The patient reported resolution of functional eye symptoms owing to the reduction of upper lid heaviness, which also resulted in subjective improvement of the visual field. Patient satisfaction was assessed preoperatively and 3 months postoperatively using the Blepharoplasty Outcomes Evaluation (BOE), which showed an overall satisfaction rate of 95.8 %.
Blepharoplasty not only treated the patient's blepharochalasis but also allowed us to correct the previous nonsurgical intervention by removing the excessive amount of injected hyaluronic acid. Both aesthetic and functional results were successfully achieved.
上睑皮肤松弛症是面部上三分之一典型的与年龄相关的变化，也是面部美学的主要关注点。如今，对于抱怨上睑皮肤松弛的患者，手术和非手术干预方法均有。尽管非手术治疗通常更容易实施，但如果操作不当，可能会引发并发症并使病情恶化。
我们描述了一名白人患者的病例，该患者患有双侧上睑皮肤松弛症，此前曾多次注射透明质酸填充剂进行治疗。经过这些治疗后，患者报告了非特异性眼部症状（如沉重感和眼疲劳）以及美容方面的问题。我们决定进行上睑成形术。在手术过程中，我们发现了一条坚硬的纤维状物质带，并小心地将其取出。患者报告称，由于上睑沉重感减轻，功能性眼部症状得到缓解，这也使视野在主观上得到改善。术前和术后3个月使用上睑成形术效果评估（BOE）对患者满意度进行评估，结果显示总体满意率为95.8%。
上睑成形术不仅治疗了患者的上睑皮肤松弛症，还通过去除过量注射的透明质酸纠正了之前的非手术干预。美学和功能效果均得以成功实现
