Infrabrow excision to correct upper eyelid dermatochalasis in middle-aged and elderly patients / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To evaluate the effects, advantages, disadvantages, and indications of infrabrow skin excision to correct upper eyelid dermatochalasis in middle-aged and elderly Chinese women.<p>METHODS: Sixty eyelids in 30 patients were subjected to this surgical procedure from January to June 2018. All patients had upper eyelid dermatochalasis, and the functions of their levator palpebrae were all normal. The primary indications of the procedure were upper lid dermatochalasis with lateral hooding. All 30 patients underwent infrabrow skin excision at Shanxi Eye Hospital. The degree of skin relaxation before and after surgery was evaluated in all patients, and surgical outcomes and postoperative complications were also assessed.<p>RESULTS: All patients were female, ranging from 40 to 64(mean: 53.20±7.10)years old. Skin relaxation of the upper eyelid was improved in all 30 patients. One month after the operation, 52 lids(86.7%)showed good results and 8 lids(13.33%)showed fair results. The objective Strasser system was applied to evaluate surgical results at 1 and 6mo. All patients had scores between 0 and 1 point, indicating good results. Preoperative unsatisfactory position and shape of the eyebrows were improved, and crow's feet and frontal lines were reduced. All patients were satisfied with the results. No complications related to wound dehiscence, lagophthalmos, or hypertrophic scars were observed.<p>CONCLUSION: Infrabrow skin excision is a simple, useful operation to reconstruct the upper eyelids in selected patients of Chinese ancestry. This procedure not only retains the advantages of classic blepharoplasty, but also alleviates many eyebrow problems at the same time, and maintains the original shape of the eyelid, minimizes scarring, and produces a smoother, more youthful appearance.

Influence of Extract from T. Ramosissima on the Skin-wounded Mice / 浙江中医药大学学报

[Objective]To research the effect of acetic ether extract from T. ramosissima on the skin-wounded mice. [Methods]The acetic ether extract of T. ramosissima was administrated to skin-wounded mice by gavage methods. [Results] The experimental groups in different dosages had significant difference ,compared to the control group, with the areas of wound healing 17.68 mm2, 17.90 mm2, 20.18 mm2 and 31.48 mm2,after the acetic ether extract of T. ramosissima administration to skin-wounded mice by gavage methods. [Conclusions] It was suggested that the acetic ether extract of T. ramosissima had some protective effects on improving the wound healing.

Septal Approach on Upper Blepharoplasty in Elderly Person

PURPOSE: Blepharoplasty plays a vital role in facial rejuvenation. Aging eyelids are the result of relaxation of lid structures as the skin, the orbicularis muscle, and mainly the septum, with subsequent protrusion or pseudoherniation of intraorbital fat contents. Traditional blepharoplasty has often involved the excision of excessive lax skin and muscle and removal of fat, leaving the eyelid unnatural and even causing the brow ptosis. The authors propose the septal approach through which the amount of skin excision can be decreased and solid fixation can be achieved in the upper blepharoplasty. METHODS: From November 2007 to February 2010, total of 15 patients underwent upper blepharoplasty with septal approach. In 9 patients, orbital septum anchored into the orbital periosteum only. But in 6 patients, the attenuated septum was strengthened through shortening and fixing into orbital periosteum with non-absorbable suture. RESULTS: Pleasing results were obtained from most of the patients. But one patient who had septum anchoring procedure complained of slight undercorrection, therefore secondary operation with septum shortening procedure was followed. CONCLUSION: We found that the method using orbital septum fixation into orbital periosteum has several advantages: less amount of skin excision, less recurrence rate, and more natural appearance. And the results were reliable and satisfactory.

Transconjunctival Capsulopalpebral Fascia Fixation for the Correction of Orbital Fat Bulging

PURPOSE: The orbital fat bulging may cause irregular contour of lower eyelid, which is not youthful appearance. The conventional method of fat excision may cause the eyeball to move backward and downward, making enopthalmia is inevitable. The transcutaneous approach to reach the orbital septum can increase the risks of scleral show resulting from scarification at the level of the septum orbicularis junction and damaging the vertical motor branches of the preseptal orbicularis oculi muscle of the lower eyelid. METHODS: From July 2007 to March 2008, total of 21 patients underwent transconjunctival capsulopapebral fascia fixation procedure. In 8 patients, the herniated fat pad of the lower eyelid was relocated back into the orbit without external skin excision using capsulopalpebral fascia fixation. But in 13 patients, excision of redundant skin of the lower eyelid was performed using pinching technique, not involving orbicularis oculi muscle. In 5 patients, lateral canthotomy was done bilaterally for good visual field. In 6 patients, lateral canthopexy was also combined to correct loosening of lower eyelid. RESULTS: Most of the patients were satisfied after at least 5 months of follow up. No patient showed scleral show. But 2 patients complained of undercorrection slightly, without secondary operation in 1 patient and re- capsulopalpebral fascia fixtation through transconjunctival approach in another patient. CONCLUSION: Orbital fat repositioning using transconjunctival capsulopalpebral fascia fixation is a good procedure to maintain youthful appearance without increasing the risk of scleral show and also showed fast recovery compared to the conventional transcutaneous approach.

The Effect of Transconjunctival Lower Blepharoplasty Combined with Pinch Skin Excision Technique

PURPOSE: The aim of this study was to analyze the effects of transconjunctival lower blepharoplasty combined with the pinch skin excision technique. METHODS: This study followed 15 patients over a six-month period who had undergone transconjunctival lower blepharoplasty combined with the pinch skin excision technique. The follow-up period exceeded 6 months. After subconjunctival injection of local anesthetic, incisions of the conjunctiva and lower lid retractors were made. The exposed fat pads were excised by clamping, excising, and cauterizing the base of the pad. The conjunctiva was closed with a continuous 6-0 Vicryl suture. If there was mild skin excess, a pinch skin excision technique was used. RESULTS: There were no complications (i.e., lower eyelid retraction, ectropion, etc.). All 15 patients were satisfied with the final result. CONCLUSIONS: The transconjunctival lower blepharoplasty combined with the pinch skin excision technique in middle-aged patients with prominent lower eyelid fat and skin excess had lower complication rates and higher patient satisfaction than the transcutaneous approach.

Easy Method to Determine Skin Excision Amount in Upper Blepharoplasty

The aging change that occur to the upper eyelid is the obscurity of the position of eyelid crease by the appearance of redundant upper eyelid skin and fold displacement. The solution is to raise the eyelid crease of the affected upper eyelid through the excision of excess soft tissue. Despite of many descriptions of blepharoplasty in the literature, marking the upper lid skin excision has not been well described. Many operators advocate use of a forceps to measure the amount of skin to be excised. But this method is not accurate and may result asymmetric double folds especially in less- experienced operators. Thus we present easy, accurate, and simple method to determine the amount of the skin to be excised as follows: The lower incision is drawn 6-8mm apart from the lid margin in sitting position while gently pulling upward the upper eyelid. While the marking pen is held at the level of the lower incision line, upper lid return to initial natural position, then a mark is made at the same level. After this procedure is repeated at several points, the dots are connected to a continuous line for the upper line of skin excision.