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The Use of P45 Plastination Technique to Study the Distribution of Preseptal and Preaponeurotic Fat Tissues in Asian Eyelids

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Abstract

This study evaluated the anatomical features of preseptal and preaponeurotic fat tissues in the upper eyelids of individuals of Asian heritage. Specifically, we attempted to elucidate the role of these tissues in the formation of sunken upper eyelids and devise an easy and feasible approach to rectify this. Sixteen heads (32 facial halves) from fresh adult cadavers were processed using the P45 plastination techniques. The polymer resulted in transparent plastination, and the sagittal median section of the eyeballs was dissected. Gross anatomy results of 12 adult cadaveric heads (24 facial halves) were included as supplementary data. The orbital septum was observed on sagittal section slides prepared with P45 sheet plastination. Based on the amount of fat distribution, the upper eyelid was classified into three groups: preseptal fat predominant type, preaponeurotic fat predominant type, and orbital septum equilibrium type (relative distribution of 31.3, 12.5, and 56.3 % in plastinated slices, and 29.2, 16.7, and 54.2 % in gross anatomical studies). Major tissues on P45 sheet plastination slices in the supraorbital region were preseptal fat, preaponeurotic fat, frontalis muscle and frontalis muscle aponeurosis, and partial orbicularis oculi muscle. The muscle fibers of the frontalis muscle and orbicularis oculi were interconnected and extended backward to connect with the orbital septum through preseptal fat. In conclusion, the morphology and external appearance of the upper eyelids depend on the relative relationship between preseptal and preaponeurotic fat tissues. Mildly or moderately sunken upper eyelids can be corrected by modifying the soft tissue in the supraorbital margin.

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References

  1. Uchida, J. (1962). A surgical procedure for blepharoptosis vera and for pseudo-blepharoptosis orientalis. British Journal of Plastic Surgery, 15, 271–276.

    Article  CAS  PubMed  Google Scholar 

  2. Niechajev, I. A., & Ljungqvist, A. (1991). Central (third) fat pad of the upper eyelid. Aesthetic Plastic Surgery, 1991(15), 223–228.

    Article  Google Scholar 

  3. Ullmann, Y., Levi, Y., Ben-Izhak, O., Har-Shai, Y., & Peled, I. J. (1997). The surgical anatomy of the fat in the upper eyelid medial compartment. Plastic and Reconstructive Surgery, 99, 658–661.

    Article  CAS  PubMed  Google Scholar 

  4. Shen, S., Kanagasuntheram, R., Fong, K. S., & Choo, C. T. (2008). Medial pretarsal adipose tissue in the Asian upper eyelid. Ophthalmic Plastic and Reconstructive Surgery, 24, 40–42.

    Article  PubMed  Google Scholar 

  5. May, J. W., Jr, Fearon, J., & Zingarelli, P. (1990). Retro-orbicularis oculus fat (ROOF) resection in aesthetic blepharoplasty: A 6-year study in 63 patients. Plastic and Reconstructive Surgery, 86, 682–689.

    Article  PubMed  Google Scholar 

  6. Sui, H. J., & Henry, R. W. (2007). Polyester plastination of biological tissue: Hoffen P45 technique. Journal of International Society for Plastination, 2007(22), 78–81.

    Google Scholar 

  7. von Hagens, G., Tiedemann, K., & Kriz, W. (1987). The current potential of plastination. Anatomy and Embryology, 175, 411–421.

    Article  Google Scholar 

  8. Weber, W., & Henry, R. W. (1992). Sheet plastination of body slices—P35 technique, filling method. Journal of International Society for Plastination, 6, 29–33.

    Google Scholar 

  9. Weber, W., & Henry, R. W. (1993). Sheet plastination of body slices—E12 technique, filling method. Journal of International Society for Plastination, 7, 16–22.

    Google Scholar 

  10. Gao, H., Liu, J., Yu, S., & Su, H. (2006). A new polyester technique for sheet plastination. Journal of International Society for Plastination, 21, 7–10.

    Google Scholar 

  11. Owsley, J. Q., Jr. (1980). Resection of the prominent lateral fat pad during upper lid blepharoplasty. Plastic and Reconstructive Surgery, 65, 4–9.

    Article  PubMed  Google Scholar 

  12. Hoffmann, K. T., Hosten, N., Lemke, A. J., Sander, B., Zwicker, C., & Felix, R. (1998). Septum orbitale: High-resolution MR in orbital anatomy. American Journal of Neuroradiology, 19, 91–94.

    CAS  PubMed  Google Scholar 

  13. Zide, B. M., & Jelks, G. W. (2005). Surgical anatomy around the orbit: The system of zones: A continuation of surgical anatomy of the orbit. Alphen aan den Rijn, The Netherlands: Wolters Kluwer.

    Google Scholar 

  14. Seiff, S. R., & Seiff, B. D. (2007). Anatomy of the Asian eyelid. Facial Plastic Surgery Clinics of North America, 15, 309–314. v.

    Article  PubMed  Google Scholar 

  15. Ichinose, A., & Tahara, S. (2008). Extended preseptal fat resection in Asian blepharoplasty. Annals of Plastic Surgery, 60, 121–126.

    Article  CAS  PubMed  Google Scholar 

  16. Siegel, R. (1984). Surgical anatomy of the upper eyelid fascia. Annals of Plastic Surgery, 13, 263–273.

    Article  CAS  PubMed  Google Scholar 

  17. Chen, W. P. (1996). Concept of triangular, trapezoidal, and rectangular debulking of eyelid tissues: Application in Asian blepharoplasty. Plastic and Reconstructive Surgery, 1996(97), 212–218.

    Article  Google Scholar 

  18. Park, J., Cho, H. K., & Moon, J. I. (2011). Changes to upper eyelid orbital fat from use of topical bimatoprost, travoprost, and latanoprost. Japanese Journal of Ophthalmology, 55, 22–27.

    Article  CAS  PubMed  Google Scholar 

  19. Camirand, A., Doucet, J., & Harris, J. (2005). Eyelid aging: The historical evolution of its management. Aesthetic Plastic Surgery, 29, 65–73.

    Article  PubMed  Google Scholar 

  20. Regensburg, N. I., Wiersinga, W. M., van Velthoven, M. E., Berendschot, T. T., Zonneveld, F. W., Baldeschi, L., et al. (2011). Age and gender-specific reference values of orbital fat and muscle volumes in Caucasians. British Journal of Ophthalmology, 95, 1660–1663.

    Article  PubMed  Google Scholar 

  21. Park, S., Kim, B., & Shin, Y. (2011). Correction of superior sulcus deformity with orbital fat anatomic repositioning and fat graft applied to retro-orbicularis oculi fat for Asian eyelids. Aesthetic Plastic Surgery, 35, 162–170.

    Article  PubMed  Google Scholar 

  22. Putterman, A. M., & Urist, M. J. (1974). Surgical anatomy of the orbital septum. Annals of Ophthalmology, 1974(6), 290–294.

    Google Scholar 

  23. Meyer, D. R., Linberg, J. V., Wobig, J. L., & McCormick, S. A. (1991). Anatomy of the orbital septum and associated eyelid connective tissues. Implications for ptosis surgery. Ophthalmic Plastic and Reconstructive Surgery, 7, 104–113.

    Article  CAS  PubMed  Google Scholar 

  24. Iwanami, M., & Tsurukiri, K. (2007). Histological comparison between young and aged specimens of the oriental lower eyelid using sagittal serial sections. Plastic and Reconstructive Surgery, 119, 2061–2071.

    Article  CAS  PubMed  Google Scholar 

  25. Doxanas, M. T., & Anderson, R. L. (1984). Oriental eyelids. An anatomic study. Archives of Ophthalmology, 1984(102), 1232–1235.

    Article  Google Scholar 

  26. Kakizaki, H., Zako, M., Nakano, T., Asamoto, K., Mito, H., & Iwaki, M. (2005). Intermuscular transverse ligament goes under the orbital part of the lacrimal gland and attaches to the lateral orbital wall. Japanese Journal of Ophthalmology, 49, 542–543.

    Article  PubMed  Google Scholar 

  27. Lee, Y., Kwon, S., & Hwang, K. (2001). Correction of sunken and/or multiply folded upper eyelid by fascia-fat graft. Plastic and Reconstructive Surgery, 107, 15–19.

    Article  CAS  PubMed  Google Scholar 

  28. Maniglia, J. J., Maniglia, R. F., Jorge dos Santos, M. C., Robert, F., Maniglia, F. F., & Maniglia, S. F. (2006). Surgical treatment of the sunken upper eyelid. Archives of Facial Plastic Surgery, 8, 269–272.

    Article  PubMed  Google Scholar 

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Correspondence to Hongzhi Qin or Hongjin Sui.

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Chun, P., Yu, S., Qin, H. et al. The Use of P45 Plastination Technique to Study the Distribution of Preseptal and Preaponeurotic Fat Tissues in Asian Eyelids. Cell Biochem Biophys 73, 313–321 (2015). https://doi.org/10.1007/s12013-015-0581-0

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