Soft tissue composition and tailor-made blepharoplasty for upper eyelid puffiness
	    		
		   		
		   			
		   		
	    	
    	 
    	10.3760/cma.j.issn.1671-0290.2021.03.010
   		
        
        	
        		- VernacularTitle:上睑臃肿的软组织构成及个性化处理
 
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Le DU
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Xiaolei JIN
			        		
			        		;
		        		
		        		
		        		
			        		Xianlei ZONG
			        		
			        		;
		        		
		        		
		        		
			        		Guodong SONG
			        		
			        		;
		        		
		        		
		        		
			        		Changsheng YANG
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. 中国医学科学院北京协和医学院整形外科医院整形十六科,北京 100144
			        		
		        		
	        		
        		 
        	
        	
        	
        	
        		- Keywords:
        			
	        			
	        				
	        				
			        		
				        		Blepharoplasty;
			        		
			        		
			        		
				        		Upper eyelid puffiness;
			        		
			        		
			        		
				        		Retro-orbicularisoculus fat (ROOF);
			        		
			        		
			        		
				        		Lacrimal gland prolapse
			        		
			        		
	        			
        			
        		
 
        	
            
            
            	- From:
	            		
	            			Chinese Journal of Medical Aesthetics and Cosmetology
	            		
	            		 2021;27(3):195-198
	            	
            	
 
            
            
            	- CountryChina
 
            
            
            	- Language:Chinese
 
            
            
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		        	Abstract:
			       	
			       		
				        
				        	Objective:To explore the soft tissue composition underlying upper eyelid puffiness and the experience in treating it with tailor-made procedure during upper blepharoplasty.Methods:In a retrospective study from January 2017 to December 2018, 165 patients with upper eyelid puffiness underwent full-incision upper blepharoplasty. During the procedure, the anterior wall of orbital septum was exposed, and the volume of the retro-orbicularis oculus fat (ROOF) and preaponeurotic fat was observed. The orbital septum would be opened if lacrimal gland prolapse was suspected. The puffy upper eyelid would be targeted with tailor-made procedure such as partial ROOF resection, removal or transposition of the preaponeurotic fat, as well as lacrimal gland refixation.Results:All 165 cases were healed by first intention. No relapse was found after a 6 to 24 months follow-up. Persistent mild pain and local skin tightness epiphora chemosis were presented in isolated cases with self-resolution within a short time. There were no severe adverse reaction or complications occurred during the operation and follow-up.Conclusions:The tailor-made procedure during upper blepharoplasty targets the soft tissue anatomy underlying upper eyelid puffiness. It is safe and effective in maintaining a natural look of upper eyelids while retaining the appropriate amount of adipose tissue in the upper eyelid.