Skip to main content
View expanded cover

Plastic and Reconstructive Surgery pp 297–311Cite as

Eyelid and Periorbital Aesthetic Surgery

  • Chapter

Part of the Springer Specialist Surgery Series book series (SPECIALIST)

Summary

The eyelids and periorbital area are important aesthetic facial subunits as well as sensitive projectors of facial aging. Brow ptosis, eyelid ptosis, dermatochalasis, fat herniation or protrusion, tumors and trauma can critically alter the anatomical relationships in this region. Aging may also convey an inaccurate message of tiredness, anger, or sadness, diminishing the overall aesthetic appearance of the face.

This chapter describes the relevant eyelid and periorbital anatomy, techniques, and potential complications resulting from cosmetic surgical procedures performed in this area.

Keywords

  • Orbicularis Muscle
  • Inferior Oblique Muscle
  • Orbital Septum
  • Tarsal Plate
  • Transconjunctival Approach

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

This is a preview of subscription content, access via your institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • DOI: 10.1007/978-1-84882-513-0_22
  • Chapter length: 15 pages
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
eBook
USD   229.00
Price excludes VAT (USA)
  • ISBN: 978-1-84882-513-0
  • Instant PDF download
  • Readable on all devices
  • Own it forever
  • Exclusive offer for individuals only
  • Tax calculation will be finalised during checkout
Softcover Book
USD   289.00
Price excludes VAT (USA)
Hardcover Book
USD   289.00
Price excludes VAT (USA)
Learn about institutional subscriptions
Figure 22.1.
Figure 22.2.
Figure 22.3.
Figure 22.4.
Figure 22.5.
Figure 22.6.
Figure 22.7.
Figure 22.8.
Figure 22.9.
Figure 22.10.
Figure 22.11.
Figure 22.12.
Figure 22.13.
Figure 22.14.
Figure 22.15.

Abbreviations

MRD:

Margin reflex distance

ROOF:

Retro-orbicularis oculi fat

SOOF:

Suborbicularis oculi fat

SMAS:

Superficial muscular aponeurosis system

References

  1. Bartlett SP, Wornom I III, Whitaker LA. Evaluation of facial skeletal aesthetics and surgical planning. Clin Plast Surg. 1991 Jan;18(1):1–9.

    PubMed  CAS  Google Scholar 

  2. Baylis HI, Goldberg RA, Kerivan KM, Jacobs JL. Blepharoplasty and periorbital surgery. Dermatol Clin. 1997 Oct;15(4):635–647.

    PubMed  CrossRef  CAS  Google Scholar 

  3. Baylis HI, Long JA, Groth MJ. Transconjunctival lower eyelid blepharoplasty. Technique and complications. Ophthalmology. 1989 July;96(7):1027–1032.

    PubMed  CAS  Google Scholar 

  4. Behmand RA, Guyuron B. Endoscopic forehead rejuvenation: II. Long-term results. Plast Reconstr Surg. 2006 Apr;117(4):1137–1143; discussion 1144.

    PubMed  CrossRef  CAS  Google Scholar 

  5. Biesman B. Laser assisted upper lid blepharoplasty. Oper Tech Oculoplasty, Orbital Reconstr Surg. 1998;1:11–18.

    Google Scholar 

  6. Camirand A. The surgical correction of aging eyelids. Plast Reconstr Surg. 1999 Apr;103(4):1325–1326.

    PubMed  CAS  Google Scholar 

  7. Doxanas MT, Anderson RL. Oriental eyelids. An anatomic study. Arch Ophthalmol. 1984 Aug;102(8):1232–1235.

    PubMed  CrossRef  CAS  Google Scholar 

  8. Gatti JE. Eyelid phenol peel – an important adjunct to blepharoplasty. Ann Plast Surg. 2007. In press.

    Google Scholar 

  9. Gosain AK, Klein MH, Sudhakar PV, Prost RW. A volumetric analysis of soft-tissue changes in the aging mid-face using high-resolution MRI: implications for facial rejuvenation. Plast Reconstr Surg. 2005 Apr;115(4):1143– 1152; discussion 1153–1155.

    PubMed  CrossRef  CAS  Google Scholar 

  10. Guyuron B. Subcutaneous approach to forehead, brow, and modified temple incision. Clin Plast Surg. 1992 Apr;19(2):461–476.

    PubMed  CAS  Google Scholar 

  11. Hamra ST. Arcus marginalis release and orbital fat preservation in midface rejuvenation. Plast Reconstr Surg. 1995 Aug;96(2):354–362.

    PubMed  CrossRef  CAS  Google Scholar 

  12. Huang T. Reduction of lower palpebral bulge by plicat-ing attenuated orbital septa: a technical modification in cosmetic blepharoplasty. Plast Reconstr Surg. 2000 June; 105(7):2552–2558; discussion 2559–25560.

    PubMed  CrossRef  CAS  Google Scholar 

  13. Januszkiewicz JS, Nahai F. Transconjunctival upper blepharoplasty. Plast Reconstr Surg. 1999 Mar;103(3):1015–1018; discussion 1019.

    PubMed  CrossRef  CAS  Google Scholar 

  14. Jelks GW, Glat PM, Jelks EB, Longaker MT. The inferior retinacular lateral canthoplasty: a new technique. Plast Reconstr Surg. 1997 Oct;100(5):1262–1270; discussion 1271–1275.

    PubMed  CrossRef  CAS  Google Scholar 

  15. Jelks G W, Jelks EB. Repair of lower lid deformities. Clin Plast Surg. 1993 Apr;20(2):417–425.

    PubMed  CAS  Google Scholar 

  16. Jordan DR, Anderson RL. The lateral tarsal strip revisited. The enhanced tarsal strip. Arch Ophthalmol. 1989 Apr;107(4):604–606.

    PubMed  CrossRef  CAS  Google Scholar 

  17. Knize DM. An anatomically based study of the mechanism of eyebrow ptosis. PlastReconstr Surg. 1996 June;97(7):1321–1333.

    CrossRef  CAS  Google Scholar 

  18. Lambros V. Observations on periorbital and midface aging. Plast Reconstr Surg. 2007 Oct;120(5):1367–1376; discussion 1377.

    PubMed  CrossRef  CAS  Google Scholar 

  19. Loeb R. Fat pad sliding and fat grafting for leveling lid depressions. Clin Plast Surg. 1981 Oct;8(4):757–776.

    PubMed  CAS  Google Scholar 

  20. Marsh JL, Edgerton MT. Periosteal pennant lateral canthoplasty. Plast Reconstr Surg. 1979 July;64(1):24–29.

    PubMed  CrossRef  CAS  Google Scholar 

  21. Mendelson B. Fat preservation technique of lower lid blepharoplasty. Aesthet Surg J. 2001;21:450–459.

    PubMed  CrossRef  CAS  Google Scholar 

  22. Morrison C, Zins J. An alternative approach to brow lift fixation: temporoparietal fascia, galeal, and periosteal imbrication. Plast Reconstr Surg. 2007 Oct;120(5):1433– 1434; author reply 1434–1435.

    PubMed  CAS  Google Scholar 

  23. Moss CJ, Mendelson BC, Taylor GI. Surgical anatomy of the ligamentous attachments in the temple and periorbital regions. Plast Reconstr Surg. 2000 Apr;105(4):1475– 1490; discussion 1491–1498.

    PubMed  CAS  Google Scholar 

  24. Nahai F. Endoscopic Brow Lift. In: Nahai F, ed. The Art of Aesthetic Surgery Principles and Techniques. St. Louis, MO: Quality Medical Publishing; 2005:551–93.

    Google Scholar 

  25. Pessa JE, Zadoo VP, Mutimer KL, et al. Relative maxillary retrusion as a natural consequence of aging: combining skeletal and soft-tissue changes into an integrated model of midfacial aging. Plast Reconstr Surg. 1998 July;102(1):205–212.

    PubMed  CrossRef  CAS  Google Scholar 

  26. Roberts E, Holck D. Prospective clinical evaluation of wound healing after carbon dioxide laser upper lid blepharoplasty closed with polypropylene suture or octylcyanoacrylate tissue adhesive tissue. ARVO; 1999; Fort Lauderdale, FL.

    Google Scholar 

  27. Seckel BR, Younai S, Wang KK. Skin tightening effects of the ultrapulse CO2 laser. Plast Reconstr Surg. 1998 Sep;102(3):872–877.

    PubMed  CAS  Google Scholar 

  28. Silkiss R, Carroll R. Transconjunctival surgery. Ophthal Surg. 1992;23(4):288–291.

    CAS  Google Scholar 

  29. Teng CC, Reddy S, Wong JJ, Lisman RD. Retrobulbar hemorrhage nine days after cosmetic blepharoplasty resulting in permanent visual loss. Ophthal Plast Reconstr Surg. 2006 Sep–Oct;22(5):388–389.

    PubMed  CrossRef  Google Scholar 

  30. Tessier P. The conjunctival approach to the orbital floor and maxilla in congenital malformation and trauma. J Maxillofac Surg. 1973 Mar;1(1):3–8.

    PubMed  CrossRef  CAS  Google Scholar 

  31. Tomlinson FB, Hovey LM. Transconjunctival lower lid blepharoplasty for removal of fat. Plast Reconstr Surg. 1975 Sep;56(3):314–318.

    PubMed  CrossRef  CAS  Google Scholar 

  32. Volpe CR, Ramirez OM. The beautiful eye. Fac Plast Surg Clin N Am. 2005 Nov;13(4):493–504.

    CrossRef  Google Scholar 

  33. Walden JL, Brown CC, Klapper AJ, Chia CT, Aston SJ. An anatomical comparison of transpalpebral, endoscopic, and coronal approaches to demonstrate exposure and extent of brow depressor muscle resection. Plast Reconstr Surg. 2005 Oct;116(5):1479–1487; discussion 1488–1489.

    PubMed  CrossRef  CAS  Google Scholar 

  34. Walden JL, Orseck MJ, Aston SJ. Current methods for brow fixation: are they safe? Aesthet Plast Surg. 2006 Sep–Oct;30(5):541–548.

    CrossRef  Google Scholar 

  35. Westmore M. Facial Cosmetics in Conjunction with Surgery. Aesthetic Plastic Surgical Society Meeting; May 1975; Vancouver, British Columbia.

    Google Scholar 

  36. Zarem HA, Resnick JI, Carr RM, Wootton DG. Browpexy: lateral orbicularis muscle fixation as an adjunct to upper blepharoplasty. Plast Reconstr Surg. 1997 Oct;100(5):1258–1261.

    PubMed  CrossRef  CAS  Google Scholar 

  37. Zarem HA, Resnick JI. Expanded applications for transconjunctival lower lid blepharoplasty. Plast Reconstr Surg. 1991 Aug;88(2):215–220; discussion 221.

    PubMed  CrossRef  CAS  Google Scholar 

  38. Zarem HA, Resnick JI. Minimizing deformity in lower blepharoplasty. The transconjunctival approach. Clin Plast Surg. 1993 Apr;20(2):317–321.

    PubMed  CAS  Google Scholar 

  39. Zins J. Invited discussion: eyelid phenol peel – an important adjunct to blepharoplasty. Ann Plast Surg. 2007. In press.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Plastic Surgery, Addenbrooke's Hospital, Cambridge, UK

    Colin M. Morrison

  2. Department of Plastic and Reconstructive Surgery Cleveland Clinic Cleveland, OH, USA

    Claude-Jean Langevin

  3. Department of Plastic Surgery Cleveland Clinic Cleveland, OH, USA

    James E. Zins

Authors
  1. Colin M. Morrison
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Claude-Jean Langevin
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. James E. Zins
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Professor of Surgery, Director of Plastic Surgery Research, Head of Microsurgery Training, Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA

    Maria Z. Siemionow

  2. Director, Department of Plastic and Aesthetic, Hand, and Reconstructive Surgery, Caritas-Krankenhaus St. Josef, affiliated with Regensburg University, Regensburg, Germany

    Marita Eisenmann-Klein

Rights and permissions

Reprints and Permissions

Copyright information

© 2010 Springer-Verlag London Limited

About this chapter

Cite this chapter

Morrison, C.M., Langevin, CJ., Zins, J.E. (2010). Eyelid and Periorbital Aesthetic Surgery. In: Siemionow, M.Z., Eisenmann-Klein, M. (eds) Plastic and Reconstructive Surgery. Springer Specialist Surgery Series. Springer, London. https://doi.org/10.1007/978-1-84882-513-0_22

Download citation

  • DOI: https://doi.org/10.1007/978-1-84882-513-0_22

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84882-512-3

  • Online ISBN: 978-1-84882-513-0

  • eBook Packages: MedicineMedicine (R0)