OBJECTIVETo explore the reasonable therapeutic strategy for different types of epicanthus.

METHODSPatients with epicanthus were classificated according to the shape, extent and inner canthal distance and treated with different methods appropriately. Modified asymmetric Z plasty with two curve method was used in lower eyelid type epicanthus, inner canthus type epicanthus and severe upper eyelid type epicanthus. Moderate upper epicanthus underwent '-' shape method. Mild Upper epicanthus in two conditions which underwent nasal augumentation and double eyelid formation with normal inner canthal distance need no correction surgery. The other mild epicanthus underwent '-' shape method.

RESULTSA total of 66 cases underwent the classification and the appropriate treatment. All wounds healed well. During 3 to 12 months follow-up period, all epicanthus were corrected completely with natural contour and unconspicuous scars. All patients were satisfied with the results.

CONCLUSIONSClassification of epicanthus hosed on the shape, extent and inner canthal distance and correction with appropriate methods is a reasonable therapeutic strategy.

Blepharoplasty ; methods ; Cicatrix ; Eyelids ; anatomy & histology ; surgery ; Humans ; Nose ; surgery

BACKGROUND: The double fold operation is one of the most common aesthetic surgeries in Korea. There are many methods to make double fold using non-incision, incision and partial incision. Patients seeking double folds prefer natural appearance, less downtime, minimal scarring technique. The most favorable method is the minimal invasive but long-lasting fold formation technique. METHODS: From October 2003 to September 2016, this procedure was applied in 7,963 patients who worried about surgical scar or preferred non-incision method with puffy eyelids. Five stab incisions including two small incisions were taken in the upper eyelid. Through the small incision lines, the pretarsal muscle and the orbital fat were removed to facilitate tissue adhesion. The double fold line was made with the continuous buried suture. The suture was tied in the fifth stab incision site and the knot was placed deeply to prevent granuloma formation. RESULTS: This method was performed in all patients. The complications were asymmetry (52 cases), fold loosening (43 cases), granuloma (12 cases), conjunctival hemorrhage (5 cases), and scar (4 cases). Especially 74% of fold loosening cases were developed in mild ptotic patients. CONCLUSIONS: This method achieves good cosmetic result, shorter operation time, less morbidity, faster recovery in puffy eyelids than the other method.
Blepharoplasty ; Cicatrix ; Eyelids ; Granuloma ; Hemorrhage ; Humans ; Korea ; Methods ; Orbit ; Suture Techniques ; Sutures* ; Tissue Adhesions

PURPOSE: To introduce and evaluate the long-term effectiveness of interrupted buried suture using non-absorbable material in involutional lower lid entropion. METHODS: A total of 105 adult involutional lower lid entropion patients (135 eyes) from January 2010 to January 2015 with or without the horizontal laxity, and without a history of previous surgical treatment were included. Exclusion criteria included patients with cicatricial entropion, epiblepharon, history of previous lower lid surgery, and follow-up period less than 3 months. The central and lateral areas below the lower lid margin and below the inferior tarsal margin were connected by non-absorbable interrupted buried suture. Results were analyzed by objective outcome using measurements from clinical photographs, subjective outcome using improvements of patients' symptom and cosmetic satisfactions. RESULTS: This study included 135 eyelids. Pre-operative distraction test revealed horizontal laxity in 37 eyes (27.4%). The mean age was 79.50 years and the mean period of follow-up was 34.51 ± 3.8 months. In 133 eyelids (98.5%), post-operative lid positions have everted. Score of symptom improvements were 9.44 (0 to 10 scale). 99 patients (94.3%) were cosmetically satisfied. No surgical complications were observed. Although we had two recurred cases (1.5%), one with horizontal laxity (2.7%) and one without horizontal laxity (1.0%), reoperation was not performed due to mild subjective discomfort. CONCLUSIONS: For patients with involutional entropion regardless of horizontal laxity, a simple interrupted buried suture method using non-absorbable suture material showed excellent long term results in very low recurrence rate and high cosmetic satisfaction.
Adult ; Blepharoplasty ; Entropion* ; Eyelids ; Follow-Up Studies ; Humans ; Methods* ; Recurrence ; Reoperation ; Sutures*

OBJECTIVETo introduce the experience in the treatment of lower eyelid pouches orbital rim.

METHODSAn incision was made along the margin of lower eyelid and dissection was performed under the orbicularis muscle to expose the orbital septum and periosteum of lower orbital rim. The fat released from orbital septum was transposed just below the lower orbital rim and fixed on the periosteum. If lacrimal groove deformity was not corrected completely, the musculocutaneous flap, which may be excised beside the incision, was kept to correct the deformities further with only the muscle portion.

RESULTS72 cases with lower eyelid pouches complicated with lacrimal groove deformities were treated with transposition of orbital fat and orbicularis muscular flaps. Satisfactory results were achieved in all the patients after a follow-up period of 3-6 months.

CONCLUSIONIt is an effective and feasible technique to correct lacrimal groove deformities with transposition of orbital fat and orbicularis muscular flaps.

Adipose Tissue ; transplantation ; Aged ; Blepharoplasty ; methods ; Eyelids ; surgery ; Humans ; Orbit ; Periosteum ; surgery

OBJECTIVETo investigate the technique and therapeutic effect for correction of sunken eyes combined with ptosis.

METHODSIn order to adjust the levator muscle tension and the relationship between levator aponeurosis and tarsus plate, multiple individualized treatment was selected, including levator aponeurosis restoration, levator aponeurosis plication, or shorten, or combination. Then the orbital fat was transferred to the depressed area, or autologous fat particles were collected and injected into the depressed area within the orbital fat fascia. After the orbital septum fascia was restored, the incision was closed primarily.

RESULTS15 cases (30 eyes) were treated. 11 cases were followed up for 6-40 months (average, 9.5 months) with satisfactory cosmetic and functional result. No recurrence of ptosis happened.

CONCLUSIONSOne-stage correction of sunken eyes combined with ptosis can be achieved with autologous fat injection or orbital fat transposition. Good cosmetic and functional result can be achieved.

Adipose Tissue ; transplantation ; Aged ; Blepharoplasty ; methods ; Blepharoptosis ; surgery ; Eyelids ; Fasciotomy ; Humans ; Oculomotor Muscles ; surgery ; Orbit

OBJECTIVETo evaluate the role of undermining orbicularis oculi muscle from Orbital rim for the correction of tear trough deformity and palabromalar groove in lower blepharoplasty.

METHODS56 cases of lower eye baggy deformity with tear trough deformity and palabromalar groove were treated with the procedure of stripping eye orbicularis oculi muscle from orbital rim by a transcutaneous approach in lower blepharoplasty. The orbital septum was opened along the arcus marginalis for releasing the orbital fat. Some orbital fat was removed if necessary. Then the inferior edge of the orbital septum fat was reset over the orbital rim so as to smooth the infraorbital groove.

RESULTS56 patients were available for 6 to 18 month's follow-up. 54 patients were quite satisfied with the cosmetic result. One developed lower eyelid retraction and another one showed asymmetrical subcutaneous local uneven after 1 month's. They were all corrected by the second operation after 3 months.

CONCLUSIONSStripping orbicularis oculi muscle from orbital rim plays an important role for the correction of tear trough deformity and palabromalar groove in lower blepharoplasty.

Adult ; Aged ; Blepharoplasty ; methods ; Eyelids ; surgery ; Female ; Humans ; Male ; Middle Aged

OBJECTIVETo find a new method to perform medial canthoplasty and upper eyelid fold formation at one stage.

METHODSBased on the principle to release the skin tension and minimize incision scarring around the medial canthus, an operation was designed for medial canthoplasty together with upper eyelid fold formation. 136 patients with mild or moderate epicanthus underwent this procedure. Postoperative follow-up was as long as 34 months.

RESULTSBased on the follow-up of 67 cases, the appearances of the upper eyelid fold and medial canthus were evaluated. The upper eyelid fold was the parallel type. The epicanthus was corrected completely or mostly.

CONCLUSIONThis new method for medial canthoplasty together with upper eyelid fold formation is suitable to all the simple epicanthus except the reverse epicanthus. The operative results were effective and satisfactory.

Blepharoplasty ; methods ; Cicatrix ; prevention & control ; Eyelids ; surgery ; Humans ; Postoperative Period ; Skin

OBJECTIVEIn order to explore a new method to perform the medial canthoplasty applied with upper eyelid fold formation in a single procedure.

METHODSAccording to the principles to correct the deformity of the medial canthus, a new method was designed to fetch up the skin defect of the medial side of upper eyelid, minimize the skin scarring around the medial canthus, and form upper eyelid fold.

RESULTSThe 86 cases, which mild or moderate epicanthus without upper eyelid fold, were treated with this technique and long-term follow-ups above 6 months were made. The 67 cases were given the follow-ups. The appearances of upper eyelid fold and medial canthus were evaluated. The appearances of eyelid fold were paralleled type. The epicanthus was corrected completely or in major.

CONCLUSIONSThis new canthoplastic method with upper eyelid fold formation may be suitable to all the medial epicanthus except inverse epicanthus. All of the patients were satisfied with the final results.

Adolescent ; Adult ; Blepharoplasty ; methods ; Eyelids ; surgery ; Humans ; Middle Aged ; Young Adult

OBJECTIVETo compare the clinical effects of different surgical methods for the epicanthus corrective surgery.

METHODSCanthoplasty with asymmetric Z-flap is applied in 46 cases, Y-V advancement procedure for epicanthoplasty is applied in 42 cases. The epicanthus aesthetic measurement were measured and calculated by software before and after surgery, the diameter of the iris was measured as a reference value,and the postoperative scar was assessed by VSS scale. At the same time, by measuring the lateral canthal distance, the accuracy of the measurement method can be verified.

RESULTSAll patients were satisfied with the long-term results and there were no recurrences of the epicanthal fold. The shortening ratio of the ICD is 8.36% in the group with the Z-plasty, and 5.88% in Y-V plasty. the lateral canthal distance have no diffrence before and after surgery.

CONCLUSIONSTwo surgical methods can get good results. The magnitude of correction in Z-plasty may larger than Y-V plasty, but postoperative retraction may existed in Z plasty.

Blepharoplasty ; methods ; Cicatrix ; Esthetics ; Eyelids ; surgery ; Humans ; Recurrence ; Software ; Surgical Flaps

OBJECTIVETo investigate the application and therapeutic effect of advanced orbicularis oculi muscle (OOM ) flap for eyelid defect.

METHODSUni-pedicle or bi-pedicle advanced OOM flaps were designed according to the location, depth and size of the eyelid defects. The resulted wounds in the donor sites were closed directly. The flap size ranged from 1.5 cm x 0.5 cm - 6.0 cm x 3.5 cm.

RESULTS120 cases were treated. All the flaps survived except for 3 flaps with epidermis necrosis at the end of flaps, which healed after dressing. The patients were followed up for 3 -36 months with inconspicious scar in donor sites. The flap color, texture had a good match with surrounding skin.

CONCLUSIONSThe OOM flap is ideal for eyelid defect with reliable blood supply, satisfied color and texture. The wound at donor site can be closed directly with less morbidity.

Blepharoplasty ; methods ; Cicatrix ; Eyelids ; surgery ; Facial Muscles ; transplantation ; Humans ; Surgical Flaps ; transplantation ; Transplant Donor Site ; surgery