Techniques and methods

Application of a new type of eyelid blepharoplasty through the lower eyelid margin incision in mid-face rejuvenation

  • GE Wenjia ,
  • XU Jin
Expand
  • Department of Plastic Surgery, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200050, China
XU Jin, E-mail: xujin202@sina.com.

Received date: 2024-10-17

  Accepted date: 2024-11-19

  Online published: 2025-03-24

Abstract

Objective ·To explore the application effect of a new type of blepharoplasty with a lower eyelid margin incision in the mid-face rejuvenation. Methods ·From September 2019 to September 2022, 35 patients with lower eyelid pouches, eyelid-cheek junction depression, and mid-face sagging were treated in Department of Plastic Surgery, Tongren Hospital, Shanghai Jiao Tong University School of Medicine. The surgical procedure involved incising the lower eyelid margin of the patient, bluntly separating the orbital zygomatic space and maxillary space, and opening the orbital septum to release the orbital fat flap. Subsequently, the fat flap was spread downward to cover the infraorbital margin and fixed onto the zygomatic bone membrane. Then, the maxillary space was separated below the orbital zygomatic ligament, and the composite tissue in the infraorbital area was suspended and fixed outward and upward. The lateral orbicularis oculi muscle of the lower eyelid was suspended and fixed on the periosteum above the lateral orbital canthus, lifting the relaxed soft tissue in the mid-face. The upper and lower orbicularis oculi muscles were sutured to form a reclining silkworm, restoring the original tissue structure and morphology under the orbit. Outpatient follow-up visits were conducted at 1, 3, and 6 months postoperatively, with digital cameras capturing frontal, left lateral and right lateral views. Postoperative complications were recorded, including subcutaneous bruising, swelling, conjunctival edema, hematoma, eyelid separation, lower eyelid eversion, diplopia, strabismus, dry eyeball, and tear overflow. The patients were followed up irregularly 6‒12 months after surgery to observe the long-term effects. Results ·All 35 patients were followed up for 6 to 12 months after surgery, with all incisions healing primarily. The blepharoplasty, palpebral sulcus depression, and nasolabial sulcus folds were significantly improved. The sagging tissue of the mid-face was reduced, and the effect was satisfactory. No complications, such as lower eyelid retraction, ectropion, or infection, occurred. Conclusion ·The new type of eyelid blepharoplasty through the lower eyelid margin incision can significantly rejuvenate the lower eyelid and mid-face. This method has less trauma, less bleeding, reliable effect, and is easy to promote.

Cite this article

GE Wenjia , XU Jin . Application of a new type of eyelid blepharoplasty through the lower eyelid margin incision in mid-face rejuvenation[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2025 , 45(3) : 381 -386 . DOI: 10.3969/j.issn.1674-8115.2025.03.016

References

1 洪城, 田诗政. 面部脂肪室衰老的解剖学变化及其应用的研究进展[J]. 中华整形外科杂志, 2023, 39(1): 107-111.
  HONG C, TIAN S Z. Research progress of anatomical changes and application of facial fat compartments aging[J]. Chinese Journal of Plastic Surgery, 2023, 39(1): 107-111.
2 杨渊, 马强良, 董雪, 等. 经结膜入路眶隔脂肪释放法矫正泪槽畸形的效果分析[J]. 中华整形外科杂志, 2022, 38(5): 540-545.
  YANG Y, MA Q L, DONG X, et al. Effect of transconjunctival lower eyelid blepharoplasty with release of tear trough ligament and orbital septum fat reposition for correction of tear trough deformity[J]. Chinese Journal of Plastic Surgery, 2022, 38(5): 540-545.
3 COTOFANA S, SCHENCK T L, TREVIDIC P, et al. Midface: clinical anatomy and regional approaches with injectable fillers[J]. Plast Reconstr Surg, 2015, 136(5 Suppl): 219S-234S.
4 杨晓珂, 黄晓, 荆文涛. 中面部提升联合肌皮瓣法睑袋成形术治疗中老年皮肤轮匝肌松弛型睑袋膨出的效果[J]. 河南医学研究, 2020, 29(9): 1593-1595.
  YANG X K, HUANG X, JING W T. Effect of midface lift combined with myocutaneous flap blepharoplasty in the treatment of middle-aged and elderly patients with skin orbicularis muscle relaxation type baggy eyelids[J]. Henan Medical Research, 2020, 29(9): 1593-1595.
5 BARTON F E Jr, HA R, AWADA M. Fat extrusion and septal reset in patients with the tear trough triad: a critical appraisal[J]. Plast Reconstr Surg, 2004, 113(7): 2115-2123.
6 WONG C H, HSIEH M K H, MENDELSON B. Midcheek lift by dissecting through the facial soft tissue spaces[J]. Plast Reconstr Surg, 2023, 151(6): 941e-946e.
7 STUTMAN R L, CODNER M A. Tear trough deformity: review of anatomy and treatment options[J]. Aesthet Surg J, 2012, 32(4): 426-440.
8 金云波, 林晓曦. 改善睑颊结合部的术式进展及其在现代下睑成形术中的作用[J]. 中华整形外科杂志, 2019, 35(6): 614-616.
  JIN Y B, LIN X X. The development of surgical technique for blending the lid-cheek junction in lower blepharoplasty[J]. Chinese Journal of Plastic Surgery, 2019, 35(6): 614-616.
9 尚卫国, 孙晨, 周震明, 等. 眶隔脂肪瓣转位联合下垂组织复位在中面部年轻化中的应用[J]. 中国美容整形外科杂志, 2022, 33(1): 44-47.
  SHANG W G, SUN C, ZHOU Z M, et al. Application of orbital fat flap transposition combined with sagging tissue reposition in mid-face rejuvenation[J]. Chinese Journal of Aesthetic and Plastic Surgery, 2022, 33(1): 44-47.
Outlines

/