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D. Chelariu, A. Chelariu, V. Chiriac Dr. Chelariu Clinic, Bacău
Retensioning of the lower eyelid
Reducing the risk of ectropion
•Wrinkles and excess skin at the lower/upper eyelids;•Large palpebral bags: upper eyelid – internal compartment, lower eyelid – middle compartment;•Orbicular distension and hypotonia;•Hypotonia and relaxation of the lower lid complex;•High palpebro-malar tegumentary ptosis – with pigmentary anomalies;
XanthelasmaSenile kerathosis
Photos Routine analysis Complete clinical
examination (Botti sketch)
Local + neurolept-analgesia;
General – the safest.
Upperlid blepharoplasty – classic
-Drawing
-Incision
-Tegumentary excision
-Muscle excision – 2,5 mm from the upper plapebral crease
-No suturing
Lowerlid blepharoplasty
- Drawing
-Incision – extended in an upward and lateral direction from the outer canthus
- Submuscular dissection
- Dissection and excision of the excessive fatty tissue.
Lowerlid blepharoplasty
-Lowerlid tegumentary excision, according to the sketch:
o deepidermization (external triangle) +
o tegument and muscle excision (internal triangle)
Lowerlid blepharoplasty
-An external triangular muscle flap is passed underneath the lateral orbicularis muscle, at the lateral canthus and fixed at the upper-lateral orbital periosteum
- Tegumentary correction, if needed – "crow's feet"
Upper eyelid suture (continuous thread - Prolene 5-0)
Lower eyelid suture (separate threads - Prolene 5-0)
38 blepharoplasties;
Age limits between 35 and 70 years old;
95% (36) were performed on women, out of which
16 were associated with facelifts and
5 with subpalpebral Faivre lift.
Before
Drawings
After
Before
Before
After
Complications
Bruising (40-45%);
Hematoma (0%);
“Scleral show” (0%);
Ectropion (0%), Chemosis (0%), Epiphora (0%),
Corneal lesions(0%).
The intervention lasts about 30% longer than the classic lowerlid blepharoplasty;
It requires a trained team.
It allows the tensioning of the lower eyelid;
Reduces the risk of ectropion;
It can be associated with a facelift or a subpalpebral Faivre lift;
Immediate patient satisfaction;
Prolonged, aesthetically pleasing results.