- •Foreword
- •Foreword
- •Preface
- •Contents
- •Contributors
- •1.1 Introduction
- •1.2 Blepharoplasty
- •1.3 Forehead Lift
- •1.4 Midface
- •1.5 Conclusion
- •References
- •2.1 Introduction
- •2.2 Facial Proportions
- •2.3 Forehead
- •2.4 Eyebrows
- •2.5 Eyelid
- •2.5.1 Topography
- •2.5.2 Lamellae
- •2.5.3 Upper Eyelid Retractors
- •2.5.4 Tarsus
- •2.5.5 Lower Eyelid
- •2.6 Midface
- •2.6.1 Topography
- •2.6.2 Soft Tissue Lamellae
- •2.6.3 Nasojugal Groove
- •2.6.4 Malar Region
- •2.6.5 Nasolabial Region
- •2.7 Facial Vasculature, Innervation, and Lymphatic Drainage
- •2.8 Conclusion
- •References
- •3.1 Introduction
- •3.2 Specific Anatomic Subunits
- •3.3 Conclusion
- •References
- •4.1 Introduction
- •4.3 Examination of the Brow and Upper Eyelid Continuum
- •4.4 Examination of the Lower Eyelid and Cheek Continuum
- •4.5 Conclusion
- •References
- •5: Oculofacial Anesthesia
- •5.1 Introduction
- •5.2 Topical Anesthesia
- •5.2.1 Eye Drops
- •5.2.2 Topical Skin Creams
- •5.3 Local Injectable Anesthesia
- •5.4 Tumescent Anesthesia
- •5.5 Oral Sedation
- •5.6 Monitored Anesthesia Care
- •5.7 General Anesthesia
- •5.8 Issues for Consideration
- •5.9 Postoperative Care
- •5.10 Regional Nerve Blocks
- •5.11 Sensory Blocks
- •5.12 Conclusion
- •References
- •6: The Open Approach to Forehead Lifting
- •6.1 Introduction
- •6.2 Background
- •6.3 Anatomy
- •6.4 Preoperative Assessment
- •6.5 Technique
- •6.6 Postoperative Care
- •6.7 Complications
- •6.8 Conclusion
- •References
- •7.1 Introduction
- •7.2 Forehead and Temporal Anatomy
- •7.3 Aesthetics and Aging
- •7.4 Patient Selection
- •7.5 Instrumentation
- •7.5.1 Technique
- •7.5.2 Complications
- •7.6 Conclusion
- •References
- •8: Direct Brow Lift: An Aesthetic Approach
- •8.1 Introduction
- •8.2 Direct Eyebrow Lift
- •8.3 The Limited Lateral Supraciliary Eyebrow Lift Procedure
- •8.5 Scar Management
- •8.6 Conclusion
- •References
- •9: Upper Eyelid Blepharoplasty
- •9.1 Introduction
- •9.2 Anatomic Eyelid and Periorbital Considerations
- •9.3 Assessing Patients’ Concerns
- •9.4 Patient History
- •9.5 Patient Examination
- •9.6 Preparation for Surgery
- •9.7 Anesthesia
- •9.8 The Surgical Prep
- •9.9 The Surgery
- •9.10 Postoperative Management
- •9.11 Complications
- •9.12 Conclusion
- •References
- •10.1 Introduction
- •10.2 Anatomical Considerations and Preoperative Evaluation
- •10.3 Internal Brow Fat Sculpting and Elevation
- •10.3.1 Surgical Technique
- •10.4 Glabellar Myectomy
- •10.4.1 Surgical Technique
- •10.5 Lacrimal Gland Prolapse
- •10.5.1 Surgical Technique
- •10.6 Conclusion
- •References
- •11.1 Introduction
- •11.2 Complications
- •11.2.1 Hemorrhage
- •11.2.1.1 Eyelid Hematoma
- •Medical Management
- •Surgical Management
- •11.2.1.2 Retrobulbar/Intraorbital Hemorrhage
- •Medical Management
- •Surgical Management
- •11.2.2 Vision Loss
- •11.2.2.1 Orbital Compartment Syndrome
- •11.2.2.2 Globe Rupture/Perforation
- •Medical Management
- •Surgical Management
- •11.2.2.3 Corneal Abrasion
- •Medical Management
- •Surgical Management
- •11.2.3 Infection
- •11.2.3.1 Medical Management
- •11.2.3.2 Surgical Management
- •11.3 Surgical Complications
- •11.3.1 Lagophthalmos
- •11.3.1.1 Medical Management
- •11.3.1.2 Surgical Management
- •11.3.2 Dry Eye Syndrome
- •11.3.2.1 Medical Management
- •11.3.2.2 Surgical Management
- •11.3.3 Lacrimal Gland Injury
- •11.3.3.1 Medical Management
- •11.3.3.2 Surgical Management
- •11.3.4 Ptosis
- •11.3.4.1 Medical Management
- •11.3.4.2 Surgical Management
- •11.3.5 Diplopia
- •11.3.5.1 Medical Management
- •11.3.5.2 Surgical Management
- •11.3.6 Sulcus Deformity
- •11.3.6.1 Medical Management
- •11.3.6.2 Surgical Management
- •11.4 Incision Irregularities
- •11.4.1 Canthal Webbing
- •11.4.1.1 Medical Management
- •11.4.1.2 Surgical Management
- •11.4.2 Scarring
- •11.4.2.1 Medical Management
- •11.4.2.2 Surgical Management
- •11.4.3 Suture Milia
- •11.4.3.1 Medical Management
- •11.4.3.2 Surgical Management
- •11.5 Asymmetry
- •11.5.1 Lid Crease and Fold
- •11.5.1.1 Medical Management
- •11.5.1.2 Surgical Management
- •11.5.2 Skin
- •11.5.2.1 Medical Management
- •11.5.2.2 Surgical Correction
- •11.5.3.1 Medical Management
- •11.5.3.2 Surgical Management
- •11.5.4 Brow Position
- •11.5.4.1 Medical Management
- •11.5.4.2 Surgical Treatment
- •11.5.5 Undercorrection/Overcorrection
- •11.5.5.1 Medical Management
- •11.5.5.2 Surgical Management
- •11.6 Unrealized Patient Expectations
- •11.7 Conclusion
- •References
- •12.1 Introduction
- •12.2 Ptosis Repair: Which Approach?
- •12.3 Patient Evaluation
- •12.4 Anatomy
- •12.5 Procedure
- •12.6 Complications
- •12.7 Conclusion
- •References
- •13.1 Introduction
- •13.2 Preoperative Evaluation
- •13.2.1 Degree of Eyelid Ptosis
- •13.2.2 Levator Muscle Function
- •13.2.3 Phenylephrine Test
- •13.3 Anesthesia
- •13.4 Surgical Technique
- •13.4.1 Step 1: Eyelid Marking for Upper Blepharoplasty
- •13.4.2 Step 2: Instilling Local Anesthetic for Upper Blepharoplasty
- •13.4.3 Step 3: Performing the Frontal Block
- •13.4.4 Step 4: Placement of the Traction Suture
- •13.4.5 Step 5: Measuring Amount of Resection
- •13.4.6 Step 6: Separation of Conjunctiva and Müller’s Muscle
- •13.4.7 Step 7: Placement of the Ptosis Clamp
- •13.4.8 Step 8: Preventing Inappropriate Ptosis Clamp Placement
- •13.4.9 Step 9: Passage of Suture
- •13.4.10 Step 10: Excision of Conjunctiva and Müller’s Muscle
- •13.4.11 Step 11: Closure of Conjunctival Wound
- •13.4.12 Step 12: Burying the Suture Knot
- •13.4.13 Step 13: Completion of Upper Blepharoplasty
- •13.5 Postoperative Management
- •13.6 Complications
- •13.7 Conclusion
- •References
- •14.1 Introduction
- •14.2 Anatomic Considerations of the Asian Upper Eyelid
- •14.2.1 Musculature
- •14.2.2 Orbital Septum
- •14.2.3 Orbital Fat
- •14.2.4 Levator Palpebrae Superioris
- •14.3 Modern Management of the Upper Eyelid
- •14.5 Strategies for the Aging Asian Eyelid
- •14.5.1 Asians with a Natural Crease
- •14.5.2 Asians Without a Crease
- •14.5.3 Asians with Prior Surgery for Supratarsal Crease Formation
- •14.6 Eyelid Crease Formation
- •14.6.1 Preoperative Eye Evaluation and Crease Positioning
- •14.6.2 Surgical Marking
- •14.6.3 Anesthesia
- •14.6.4 Surgical Technique
- •14.6.4.1 Levator-to-Skin Fixation
- •14.6.5 Postoperative Care
- •14.7 Conclusion
- •References
- •15.1 Introduction
- •15.2 Patient Selection
- •15.3 Patient Examination
- •15.4 Eyelid Position and Laxity
- •15.5 Revision Patients
- •15.6 Festoons and Malar Edema
- •15.7 Patient Expectations and Psychology
- •15.8 Important Surgical Anatomy
- •15.9 Operative Technique
- •15.10 Fat Transposition
- •15.11 Lower Eyelid Tightening
- •15.12 Skin Resurfacing
- •15.13 Postoperative Care
- •15.14 Complications and Management
- •15.14.1 Milia
- •15.14.2 Dry Eye/Chemosis
- •15.14.3 Hematoma
- •15.14.4 Eyelid Malposition/Ectropion
- •15.15 Conclusion
- •References
- •16.1 Introduction
- •16.2 Lower Eyelid Anatomy
- •16.3 Eyelid Analysis/Preoperative Evaluation
- •16.5 Postoperative Care
- •16.6 Complications
- •16.7 Conclusion
- •References
- •17.1 Introduction
- •17.2 Canthal Anatomy
- •17.3 Patient Evaluation for Canthal Surgery
- •17.4 Surgical Techniques
- •17.4.1 Canthoplasty (Lateral Tarsal Strip)
- •17.4.2 Modified Canthoplasty
- •17.4.3 Canthopexy (Muscle suspension)
- •17.4.4 The Prominent Globe
- •17.5 Postoperative Care
- •17.6 Complications
- •17.7 Conclusion
- •References
- •18.1 Introduction
- •18.2 Anatomy of the Eyelid and Cheek
- •18.4 Presentation
- •18.5 Preoperative Evaluation
- •18.6 Surgical Procedures
- •18.7 Surgical Technique
- •18.7.1 Scar Lysis and Mobilization
- •18.7.2 Midface Elevation
- •18.7.3 Graft Placement
- •18.7.4 Lateral Canthal Resuspension
- •18.7.5 Eyelid Splinting and Casting
- •18.8 Conclusion
- •References
- •19: Laser Management of Festoons
- •19.1 Introduction
- •19.2 Laser Tissue Interactions
- •19.4 Treatment Protocols
- •19.5 Complications
- •19.6 Conclusion
- •References
- •20: Midface and Lower Eyelid Rejuvenation
- •20.1 Introduction
- •20.2 The Midface
- •20.3 Why I Prefer the Subperiosteal Face Lift
- •20.4 Patient Selection
- •20.5 Indications
- •20.6 Preoperative Preparation
- •20.7 Aesthetic Considerations
- •20.8 Technique
- •20.9 Lower Eyelid Blepharoplasty
- •20.10 Fat Grafting
- •20.12 Summary
- •References
- •21: Face Implants in Aesthetic Surgery
- •21.1 Introduction
- •21.2 Midface Treatment Options
- •21.3 Diagnosis and Implant Selection
- •21.4 Surgical Procedure
- •21.5 Postoperative Care and Healing
- •21.6 Implant Complications
- •21.7 Conclusion
- •21.8 Case Presentations
- •References
- •22: Periorbital Fat Grafting
- •22.1 Introduction
- •22.2 Analysis
- •22.2.1 Lower Eyelid
- •22.2.2 Upper Eyelid
- •22.3 Volume Source: Fat Versus Filler
- •22.4 Surgical Technique
- •22.4.1 General Considerations
- •22.4.2 Fat Harvest
- •22.4.3 Fat Processing
- •22.4.4 Fat Injection
- •22.5 Postoperative Considerations
- •22.6 Complications
- •22.7 Conclusion
- •References
- •23: Periorbital Laser Resurfacing
- •23.1 Introduction
- •23.2 History
- •23.3 Use of Resurfacing Lasers for Periorbital Resurfacing
- •23.4 Traditional Ablative Laser Resurfacing
- •23.7 Fractionated Laser Resurfacing
- •23.8 Technical Considerations: Nonablative Fractionated Laser
- •23.9 Posttreatment Care for Nonablative Fractionated Laser
- •23.10 Conclusion
- •24: Laser Incisional Eyelid Surgery
- •24.1 Introduction
- •24.2 History
- •24.3 Laser Incisions
- •24.4 Laser Safety
- •24.5 Upper Blepharoplasty
- •24.6 Lower Lid Transconjunctival Blepharoplasty
- •24.7 Ptosis Repair
- •24.8 Direct Brow Lift
- •24.10 Conclusion
- •References
- •25.1 Introduction
- •25.2 Review of Neuromodulators and Fillers: The Products
- •25.3 Treatments
- •25.3.1 Lateral Orbital Rhytids (Crow’s Feet)
- •25.3.2 Glabellar Complex
- •25.3.3 Frontalis Muscle
- •25.3.4 Nasojugal Groove/Tear Trough
- •25.4 Avoiding and Managing Complications
- •25.5 Conclusion
- •References
- •26: Management of the Prominent Eye
- •26.1 Introduction
- •26.2 Anatomic Associations of the Prominent Eye
- •26.3 Surgical Treatment of the Prominent Eye
- •26.3.1 Orbital Decompression Surgery
- •26.3.2 Cheek/Orbital Rim Implants
- •26.3.3 Repair of Eyelid Retraction
- •26.3.4 Upper Lid Retraction
- •26.3.5 Lower Lid Retraction
- •26.4 Cosmetic Treatment of the Tear Trough in the Prominent Eye
- •26.7 Conclusion
- •References
- •27.1 Introduction
- •27.2 Anti-metabolites
- •27.3 5-Fluorouracil
- •27.3.1 Mechanism of Action
- •27.3.2 Management
- •27.3.3 Safety
- •27.4 Corticosteroids
- •27.4.1 Mechanism of Action
- •27.4.2 Management
- •27.4.3 Safety
- •27.5 Fillers
- •27.5.1 Safety
- •27.6 Conclusions
- •References
- •28.1 History
- •28.3 Key Anatomic Features
- •28.4 Preoperative Assessment
- •28.5 Preoperative Care
- •28.6 Surgical Preparation and Technique
- •28.7 Postoperative Care
- •28.8 Potential Complications
- •28.9 Future Considerations
- •References
- •Index
7 Endoscopic Brow and Forehead Rejuvenation |
77 |
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Fig. 7.8 Frontal and oblique preand postoperative views of two patients who underwent endoscopic brow lift and
conservative upper blepharoplasty
7.6Conclusion
The human experience is garnered and conveyed through the window of the eyes.
With the wear of age though, this window becomes erroneously reflective rather than transparent. Rejuvenation of the periorbita then not only restores cosmesis and self-image
but also facilitates improved personal interactions and ensures the communication of one’s true emotions to others. While many techniques exist to aid in this, the restorative process, none is as comprehensive and relatively free of morbidity as the endoscopic brow lift. It remains our operation of choice to return aesthetics to this area of the aging face (Fig. 7.8).
78 |
C.L. Stallworth and T.D. Wang |
|
|
Fig. 7.8 (continued)
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