Aesthetic Plastic Surgery

, Volume 34, Issue 4, pp 466–474

Comprehensive Considerations in Blepharoplasty in an Asian Population: A 10-year Experience

  • Lingli Guo
  • Hongda Bi
  • Chunyu Xue
  • Junhui Li
  • Chao Yan
  • Jianxing Song
  • Mingli Zhang
  • Xin Xing
Original Article

Abstract

Background

This article discusses the effectiveness, patient selection criteria, complications, and the appropriate procedures for lower blepharoplasty in an Asian population.

Methods

During the past 10 years (1998–2008), a total of 2400 patients underwent lower blepharoplasty in our department. Four different types of lower-blepharoplasty procedures were performed, including the traditional transcutaneous skin flap procedure (n = 862), the transcutaneous skin-muscle flap procedure (n = 738), the transconjunctival procedure (n = 433), and Hamra’s procedure (septal reset and fat-replacing technique) (n = 367). Among these 2400 patients, 925 were available for follow-up. The length of follow-up ranged between 1 month and 10 years.

Results

Most of the patients were satisfied with the result, but 32 patients had some postoperative complications, including five patients with ectropion, five with hollow eyes, two with dry eyes, and 20 with retraction.

Conclusions

Transconjunctival blepharoplasty is the first choice for primary eyelid bags. Transcutaneous lower blepharoplasty (skin flap or skin-muscle flap procedures) is indicated for the senile eyelid with excess skin and muscles. If supporting structures (skin, muscle, and septum) show laxity and other aging stigma are present, including tear trough deformity and obvious skeleton rim, Hamra’s procedure (septal reset and fat-replacing technique) is performed.

Keywords

Transconjunctival lower blepharoplasty Transcutaneous lower blepharoplasty Hamra’s lower blepharoplasty Asian population 

References

  1. 1.
    Jordan DR, Anderson RL (1990) The tarsal tuck procedure: avoiding eyelid retraction after lower blepharoplasty. Plast Reconstr Surg 85:22–28CrossRefPubMedGoogle Scholar
  2. 2.
    McCord CD, Boswell CB, Hester TR (2003) Lateral canthal anchoring. Plast Reconstr Surg 112:222–237CrossRefPubMedGoogle Scholar
  3. 3.
    Patel BCK, Patipa M, Anderson RL, McLeish W (1997) Management of postblepharoplasty lower eyelid retraction with hard palate grafts and lateral tarsal strip. Plast Reconstr Surg 99:1251–1260CrossRefPubMedGoogle Scholar
  4. 4.
    Sachs ME, Bosniak SL (1986) Correction of true periorbital fat herniation in cosmetic lower lid blepharoplasty. Aesthetic Plast Surg 10:111–114CrossRefPubMedGoogle Scholar
  5. 5.
    Goldberg RA, McCann JD, Fiaschetti D, Ben Simon GJ (2005) What causes eyelid bags? Analysis of 114 consecutive patients. Plast Reconstr Surg 115:1395–1402CrossRefPubMedGoogle Scholar
  6. 6.
    Camirand A, Doucet J, Harris J (1997) Anatomy, pathophysiology, and prevention of senile enophthalmia and associated herniated lower eye lid fat pads. Plast Reconstr Surg 100:1535–1546CrossRefPubMedGoogle Scholar
  7. 7.
    Hamra ST (1995) Arcus marginalis release and orbital fat preservation in midface rejuvenation. Plast Reconstr Surg 96:354–362CrossRefPubMedGoogle Scholar
  8. 8.
    Tessier P (1973) The conjunctival approach to the orbital floor and maxilla in congenital malformation and trauma. J Maxillofac Surg 1:3–8CrossRefPubMedGoogle Scholar
  9. 9.
    Rizk SS, Matarasso A (2003) Lower eyelid blepharoplasty: analysis of indications and the treatment of 100 patients. Plast Resconstr Surg 111:1299–1306CrossRefGoogle Scholar
  10. 10.
    Seckel BR, Kovanda CJ, Cetrulo CL Jr, Passmore AK, Meneses PG, White T (2000) Laser blepharoplasty with transconjunctival orbicularis muscle/eptum tightening and periocular skin resurfacing: a safe and advantageous technique. Plast Resconstr Surg 106:1127–1141 (discussion 1142-1145)CrossRefGoogle Scholar
  11. 11.
    Garcia RE, McCollough EG (2006) Transcutaneous lower eyelid blepharoplasty with fat excision: a shift-resisting paradigm. Arch Facial Plast Surg 8:374–384CrossRefPubMedGoogle Scholar
  12. 12.
    Lowe JB, Cohen M, Hunter DA, Mackinnon SE (2005) Analysis of the nerve branches to the orbicularis oculi muscle of the lower eyelid in fresh cadavers. Plast Reconstr Surg 116:1743–1749 (discussion 1750-1751)CrossRefPubMedGoogle Scholar
  13. 13.
    Carraway JH, Mellow CG (1990) The prevention and treatment of lower lid ectropion following blepharoplasty. Plast Reconstr Surg 85:971–981CrossRefPubMedGoogle Scholar
  14. 14.
    Hirmand H, Codner MA, McCord CD, Hester TR Jr, Nahai F (2002) Prominent eye: operative management in lower lid and midfacial rejuvenation and the morphologic classification system. Plast Reconstr Surg 110:620–628 (discussion 629-634)CrossRefPubMedGoogle Scholar
  15. 15.
    Hamra ST (2004) The role of the septal reset in creating a youthful eyelid-cheek complex in facial rejuvenation. Plast Reconstr Surg 113:2124–2141 (discussion 2142-2144)PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC and International Society of Aesthetic Plastic Surgery 2010

Authors and Affiliations

  • Lingli Guo
    • 1
  • Hongda Bi
    • 1
  • Chunyu Xue
    • 1
  • Junhui Li
    • 1
  • Chao Yan
    • 1
  • Jianxing Song
    • 1
  • Mingli Zhang
    • 1
  • Xin Xing
    • 1
  1. 1.Department of Plastic SurgeryChanghai Hospital, Second Military Medical UniversityShanghaiChina

Personalised recommendations