The Correction of Lower Palpebral Bulge & Tear trough Groove by Repositioning of Orbicularis Oculi Muscle, Orbital Septum & Orbital Fat

Bulging of the lower eyelid & tear trough groove is regarded as a sign of aging. In the past, the surgical excision of the fat pad has been the mainstray of the management of lower palpebral bag in cosmetic blepharoplasty, Recently, fat pad sliding method has been introduced to make more attractive lower eyelids. We used the fat pad for covering the hollowness of the lower eye lid. And we use redundant fat pad for filling & augmentation of the lower eye lid by reflexion. Redraping of the orbicularis arc, with its accompanying midfacial fat repositioning, anatomically restores the cheek and lower lid to make more youthful contour. By redraping and fixing the orbicularis arc on the medial surface of the orbital rim, it becomes a more attractive midface and may prevent of ectropion. From August, 2002 to July, 2004 in correction of lower palpebral bulge & tear trough groove, these two technique were performed in 42 consecutive individuals (84 lower eyelid) for two-year period. Follow up ranged from 3 to 15 months. (an average of 9 months) Palpebral bulge & tear trough groove were corrected and obtained a youthful midface. Complication was rare. The advantages of these techniques are that: prevent in of secondary palpebral bulge and irregularity of lower eyelid by using of reflexed fat fad; prevent in of ectropion. Thus an attractive midface is obtained by redraping of orbicularis arc.

Alternative Intermaxillary Fixation Method Using Drill-Free Screws

In the treatment of maxillofacial surgery, proper intermaxillary fixation is very important in improving bone union and restoration of normal occlusion. Bone screws are placed bicortically in predrilled holes in the maxilla and mandible are commonly used for temporary intermaxillary fixation in the treatment of maxillofacial surgery. Their main advantages are that they are quick and easy to place and remove, save operating time; they reduce the risk of needle-stick injury; they can be used with heavily restored teeth. However, several authors report damage to the roots of teeth in placing these screws with drills and shearing of the screw head. To overcome these disadvantages, a drill-free screw that is self-drilling and self-tapping has been applied. From August, 2003 to May, 2004 drill free scerws have been used in total 11 patients with variable maxillofacial surgery. No complications from the use of these screws were encounterd. Compared with intermaxillary fixation method using predrilled intermaxillary screws, this method is useful, because this method do not cause damage to the roots of teeth and shearing off the screw head.