Effectiveness of transcutaneous lower eyelid blepharoplasty with a skin flap reserving the pretarsal fullness
10.3760/cma.j.cn114453-20221013-00315
- VernacularTitle:保留眼台的皮瓣法外路眼袋整复术效果观察
- Author:
Jianwu CHEN
1
;
Yuzhi WANG
;
Xiaoyu CHENG
;
Liming ZHANG
;
Qi LI
;
Zhixiang CHEN
;
Yanhong WU
Author Information
1. 南部战区总医院烧伤整形科，广州 510010
- Keywords:
Eyelids;
Pretarsal fullness;
Lower eyelid blepharoplasty;
Transcutaneous;
Retrospective studies
- From:
Chinese Journal of Plastic Surgery
2023;39(10):1088-1093
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effectiveness of transcutaneous lower eyelid blepharoplasty with a skin flap reserving the pretarsal fullness.Methods:From November 2017 to April 2022, a retrospective analysis was performed to assess the reserving of pretarsal fullness after the transcutaneous lower blepharoplasty with a skin flap in the Department of Burn and Plastic Surgery, General Hospital of Southern Theater Command, PLA. A subciliary incision was made below the ciliary margin and a skin flap was elevated at the surface of pretarsal orbicularis. The muscle was partially split at the position of pretarsal crease, leaving the pretarsal orbicularis oculi muscle and the pretarsal crease intact. Preseptal dissection was proceeded down to the level of arcus marginalis, exposing the orbital fat pads. For patient with tear trough deformity or volume deficiency in the medial cheek, retaining ligament laxity and fat repositioning were routinely performed. The muscle wound was closed edge to edge and the excess skin was excised conservatively. Postoperative complications were recorded. Face-Q scale was used for surgical decision and postoperative satisfaction evaluation. The scores range from 0 to 100, with higher scores indicating less regret the operation or greater satisfaction. The preoperative and postoperative digital photographs were used to evaluate the change of pretarsal fullness.Results:256 patients were included, of whom 233 cases were women and 23 cases were men. The age was (43.0±10.2) years. 24 cases had concomitant lateral canthoplasty due to hypotonia of lower eyelid, 22 had concomitant upper blepharoplasty, and 21 cases had brow lift surgery to correct upper eyelid relaxation. All patients had follow-up for (3.7±4.1) months, most patients were satisfied with the operation results. A total of 211 patients maintained a natural pretarsal fullness postoperatively, with the rate of 82.4%. The Face-Q satisfaction score was (75.8±18.6) and the surgical decision score was (80.3±15.4), indicating that most patients did not regret the operation. Postoperative complications included 8 cases of eyelid bags undercorrection, of whom 4 patients underwent secondary resection. 7 patients experienced infraorbital bulge for the uneven placement of the fat pad, 2 of them required revision surgery. Hematoma occurred in 4 cases and was resolved by hematoma clearance. Other complications included 3 cases of ectropion and 2 cases of minimal tear trough correction. Lower eyelid ectropion was corrected in one case.Conclusion:Reserving the pretarsal fullness in transcutaneous lower eyelid blepharoplasty with a skin flap provides excellent aesthetic results and high patient satisfaction. This technique is simple and effective.
