Miotti Giovanni, Di Filippo Jacopo, Grando Martina, Salati Carlo, Parodi Pier Camillo, Spadea Leopoldo, Gagliano Caterina, Musa Mutali, Zeppieri Marco
Department of Plastic Surgery, University Hospital of Udine, Udine 33100, Italy.
Department of Internal Medicine, Azienda Sanitaria Friuli Occidentale, San Vito al Tagliamento 33078, Italy.
World J Clin Cases. 2024 Jun 6;12(16):2796-2802. doi: 10.12998/wjcc.v12.i16.2796.
As one of the most common aesthetic surgical procedures carried out today, blepharoplasty should be in the repertoire of every plastic surgeon. The term blepharoplasty encompasses a wide range of techniques and options that must be tailored to the specific defect and patient one has to treat. A sound knowledge of the upper and lower eyelids' anatomy is essential for proper surgical execution. Trends have shifted towards more conservative methods (especially of the fat compartment) and sometimes in combination with augmentation techniques, helping to reach a rejuvenated appearance.
To present an overview of the surgical techniques considered for upper lid blepharoplasty and fat pad management, in addition to information on how a surgeon may approach the best treatment for his patient based on current publications in literature.
We searched the literature published between 2013, to 2023 using Medline and Reference Citation Analysis. The database was searched using the keywords "upper blepharoplasty" AND "fat". Papers without full text/abstracts and reviews were excluded. The search strategy followed the PRISMA. The American Society of Plastic Surgeons guidelines for Therapeutic Studies checklist was used to assess all articles. Two authors individually reviewed each article and rated them for importance and relevance to the topic. A consensus was sought and the most relevant studies.
After the application of the selection criteria used in our review, 13 publications were found to address upper lid blepharoplasty specifically. Three of these studies were reviews and three were retrospective studies. Five publications were comparative studies and a further two were clinical trials.
The tendency of modern surgery is to be conservative, by removing adipose tissue only if strictly necessary and restoring the volume of the upper eyelid in a concept of beauty that espouses a "full" sight. There is no gold standard technique to achieve younger and enhanced eyelids. Long-term prospective comparative studies are fundamental in understanding which path is the best to follow.
作为当今最常见的美容外科手术之一，眼睑整形术应是每位整形外科医生必备的技能。眼睑整形术涵盖了广泛的技术和选择，必须根据具体的缺陷和要治疗的患者进行调整。对上睑和下睑解剖结构的扎实了解对于正确的手术操作至关重要。目前的趋势已转向更保守的方法（尤其是针对脂肪层），有时还会结合填充技术，以帮助实现年轻化的外观。
除了介绍基于当前文献中外科医生如何为患者选择最佳治疗方法的信息外，还概述上睑整形术和脂肪垫处理所考虑的手术技术。
我们使用Medline和参考文献引用分析检索了2013年至2023年发表的文献。使用关键词“上睑整形术”和“脂肪”对数据库进行搜索。排除没有全文/摘要和综述的论文。搜索策略遵循PRISMA。使用美国整形外科医生协会治疗研究清单指南对所有文章进行评估。两位作者分别审阅每篇文章，并对其与主题的重要性和相关性进行评分。寻求共识并选取最相关的研究。
在应用我们综述中使用的选择标准后，发现有13篇出版物专门论述上睑整形术。其中三项研究为综述，三项为回顾性研究。五项出版物为比较研究，另外两项为临床试验。
现代手术的趋势是保守，仅在严格必要时去除脂肪组织，并以上睑饱满为美的理念恢复上睑的容积。目前尚无实现更年轻、更美观眼睑的金标准技术。长期前瞻性比较研究对于理解哪种方法是最佳选择至关重要。
