Ординатура / Офтальмология / Английские материалы / Asian Blepharoplasty and the Eyelid Crease_Chen_2006
.pdf
Asian Blepharoplasty and the Eyelid Crease
198
Case 4 (Fig. 15-4 A–C)
Female university student who presented after lid crease placement. (A) She showed a high crease over the left upper lid and a segmented crease over the medial extent of the right upper lid and scar over the lateral half of the crease. I recommended enhancement and revision of the right upper crease, and repo-
sitioning to a lower level for the left upper crease. She elected to have only the right lid revised. A tarsal height-based Asian blepharoplasty was performed on the right upper lid, cicatrix was released from the lateral half (B).
(C) One week postoperative appearance.
A
B
C
Chapter 15 Suboptimal Results and Revision Operations
199
Case 5 (Fig. 15-5)
Incomplete and ‘bifid’ crease: the upper crease did not extend to the medial one-third of the fissure width.
The splitting of the crease is more noticeable over the right upper lid.
Asian Blepharoplasty and the Eyelid Crease
200
Case 6 (Fig. 15-6 A, B)
A patient with asymmetric creases. The right upper lid crease was too close to the lid margin, and is scarred down to the anterior surface of the upper tar-
sus. Left upper lid crease is high, harsh, and semilunar in shape.
A
B
Chapter 15 Suboptimal Results and Revision Operations
201
Case 7 (Fig. 15-7 A, B)
A patient had an asymmetric crease made more evident by the acquired ptosis of the right upper lid. This is an example of a static crease.
A
B
Asian Blepharoplasty and the Eyelid Crease
202
Case 8 (Fig. 15-8 A–C)
(A) A 30-year-old woman with multiple creases over the right upper lid (with one dominant and several less distinct creases over the medial half), and multiple indistinct high creases over the left upper lid. (B) Note the enhanced supratarsal sulcus on the left upper lid, probably due to excessive fat removal. (C) Correction of the left upper lid consisted of crease enhancement with excision of the small strip of skin
encompassing the multiple creases. No attempts were made to correct the supratarsal hollow because (a) this is a difficult procedure to perform, and placement of synthetic fillers frequently leads to complications; and (b) the conversion of several faint lines to a main crease often creates enough inward folding, especially on upgaze, to make the hollow less noticeable.
A
C
B
Chapter 15 Suboptimal Results and Revision Operations
203
Case 9 (Fig. 15-9)
A 50-year-old woman with high creases, some of which are bifid and multiple.
Asian Blepharoplasty and the Eyelid Crease
204
Case 10 (Fig. 15-10 A–D)
(A) A 30-year-old woman who had had two lid crease procedures in Asia. She complained that the crease tapered excessively towards the lateral canthi and of fullness in that area when she smiled. (B) Asian
blepharoplasty was performed laterally. Intraoperatively, scar tissues were excised until the underlying aponeurosis was clearly seen.
A
B
Chapter 15 Suboptimal Results and Revision Operations
205
Case 10 (Fig. 15-10 A–D)—cont’d
(C)Appearance immediately after the procedure.
(D)Appearance 1 month postoperatively. Some residual pretarsal edema can still be seen.
C
D
Asian Blepharoplasty and the Eyelid Crease
206
Case 11 (Fig. 15-11 A–E)
(A, B) A 25-year-old patient had undergone placement of a reddish tattoo line in an attempt to form a
pseudo-crease over the right upper lid. She had minimal ptosis of the same lid.
A
B
Chapter 15 Suboptimal Results and Revision Operations
207
Case 11 (Fig. 15-11 A–E)—cont’d
(C) The tattooed crease line, which measured less than 1mm wide, was excised. (D) A new crease was formed based on my technique.
C
D