Ординатура / Офтальмология / Английские материалы / Asian Blepharoplasty and the Eyelid Crease_Chen_2006
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Asian Blepharoplasty and the Eyelid Crease
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Case 11 (Fig. 15-11 A–E)—cont’d
(E) Closure of wound over right upper lid.
E
Case 12 (Fig. 15-12)
A 55-year-old woman with a high, harsh, incomplete crease. The crease spanned only 60% of the width of the fissure.
Chapter 15 Suboptimal Results and Revision Operations
209
Case 13 (Fig. 15-13 A–C)
(A) This patient had a crease deformity of the right upper lid due to laceration by broken windshield glass during an automobile accident with embedded glass
fragments. The left upper lid had a ‘shielded’ crease. (B, C) Postoperative views after crease revision.
A
B
Asian Blepharoplasty and the Eyelid Crease
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Case 13 (Fig. 15-13 A–C)—cont’d
C
Chapter 15 Suboptimal Results and Revision Operations
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Case 14 (Fig. 15-14 A–D)
(A)A 28-year-old patient before Asian blepharoplasty.
(B)Immediately after the procedure.
A
B
Asian Blepharoplasty and the Eyelid Crease
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Case 14 (Fig. 15-14 A–D)—cont’d
(C) Six months after the operation the patient reported a 30% weight gain (from 90 to 120lb) and obliteration of the left upper lid crease. (D) Surgical
exploration showed hypertrophy of the suborbicularis (preseptal) fat pads, which may have obliterated previous crease-forming attachment.
C
D
Chapter 15 Suboptimal Results and Revision Operations
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Case 15 (Fig. 15-15 A–I)
(A)A 19-year-old woman with absence of lid crease.
(B)Design of a nasally tapered crease over the right upper lid. (C) Opening of the orbital septum and exci-
sion of some preaponeurotic fat pads. (D) Eyelid before surgical closure.
A
C
B
D
Asian Blepharoplasty and the Eyelid Crease
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Case 15 (Fig. 15-15 A–I)—cont’d
(E) Closure with both interrupted and continuous 6/0 nylon. (F) Three months postoperatively the crease appeared shallow over the right upper lid, and was incomplete over the lateral portion of the left upper lid. Retrospectively, the patient informed me that because of her anxiety and intolerance to pain she
never looked up during the first week after the surgery ‘for fear of scarring’. It is most likely that the surgical adhesions did not form adequately during the first week, as the levator muscle was not actively contracted in any way. (G) I performed a revisional Asian blepharoplasty over the right upper lid.
E
G
F
Chapter 15 Suboptimal Results and Revision Operations
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Case 15 (Fig. 15-15 A–I)—cont’d
(H) Enhancement was performed segmentally over the lateral one-third of the left upper lid. (I) Appearance immediately after the operation.
H
I
Asian Blepharoplasty and the Eyelid Crease
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Case 16 (Fig. 15-16 A–E)
(A)A 50-year-old woman had previously undergone blepharoplasty and presented with a high parallel crease and some residual hooding of the upper lids.
(B)Upper and lower lines of incision during revision, the design of the crease allowed for excision of the
area of the previous crease incision (dotted line outlined with methylene blue ink) to remove some redundant skin and reposition the crease closer to the lid margin, based on the tarsal height.
A
B
Chapter 15 Suboptimal Results and Revision Operations
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Case 16 (Fig. 15-16 A–E)—cont’d
(C) The orbital septum was opened superiorly, revealing minimal preaponeurotic fat pads, which I did not remove. (D) Excision of skin and redundant underlying preseptal orbicularis muscles. The methylene blue tip points to a previously buried 6/0 Prolene suture that had functioned as a levator aponeurosis–inferior subcutaneous fixation suture. (E) Closure of wound following revision.
C
E
D