Lower Eyelid Blepharoplasty: Minimizing Complications and Correction of Lower Eyelid Malposition.


Journal

Facial plastic surgery : FPS
ISSN: 1098-8793
Titre abrégé: Facial Plast Surg
Pays: United States
ID NLM: 8405303

Informations de publication

Date de publication:
Feb 2023
Historique:
entrez: 27 1 2023
pubmed: 28 1 2023
medline: 1 2 2023
Statut: ppublish

Résumé

Lid retraction is a feared complication of lower blepharoplasty. Anatomical variations like negative orbital vector, horizontal lid laxity, and preexisting lid retraction are more prone to lid malpositions. Meticulous and precise execution of a series of surgical steps is key to preventing complications. This includes minimizing surgical trauma, meticulous hemostasis, preserving innervation to the medial lid and pretarsal orbicularis, safe method of fat excision, septal tightening while maintaining lid traction, and conservative and titrated skin excision. Canthal fixation addresses lid laxity and maintains the lid stretched vertically while postoperative healing and fibrosis are taking place. Post-blepharoplasty lid retraction may occur due to failure to address lid laxity and the occurrence of middle lamellar fibrosis. Excessive skin excision may also result in anterior lamellar deficiency. The "sag and drag" concept is useful to evaluate the post-blepharoplasty retracted lid. The treatment of the retracted lid includes lid massage, replacing the anterior lamella, or releasing the middle lamellar fibrosis or a combination of techniques. In conclusion, understanding the mechanisms of lid retraction, careful preoperative assessment, and surgical precision will help surgeons to prevent and manage this complication.

Identifiants

pubmed: 36706744
doi: 10.1055/s-0043-1761912
doi:

Types de publication

Journal Article

Langues

eng

Pagination

28-46

Informations de copyright

Thieme. All rights reserved.

Déclaration de conflit d'intérêts

None declared.

Auteurs

Manvi Sobti (M)

Ophthalmology department, Chelsea and Westminster Hospital, London, United Kingdom.

Naresh Joshi (N)

Cromwell Hospital, London, United Kingdom.

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Classifications MeSH