ABSTRACT
ObjectiveTo improve an obvious postoperative man-made crease when eyes closed and to achieve the optimal cosmetic and functional results.MethodsExposing and scissoring the levator aponeurosis were performed to make it move freely.Fairly infra-incision and lower margin orbicularis oculi muscle were cut.The double eyelids were formed by fixing the palpebral dermis of the lower skin flap onto the levator aponeurosis.ResultsThe follow-up of 580 patients (1160 eyes) showed that double eyelid crease were natural and fluent,eyelashes raised slightly,there was no an obvious postoperative man-made crease when eyes closed,and there was no sausage-appearing. Conclusions The method is quick,with minor injury and fast restoration. There is no sausage appearance and an obvious man-made crease when eyes are closed,and so double eyelids are natural and nice,the postoperative results are all aesthetically and functionally pleased.
ABSTRACT
BACKGROUND: Although many authors recently have reported good results with subfascial breast augmentation, it still is controversial whether the integrity of the pectoral fascia can be preserved. Some authors think the pectoral fascia will be broken during the operation because it is thin and weak. Therefore, this study aimed to investigate whether the integrity of the pectoral fascia can be preserved during subfascial breast augmentation through an axillary incision without endoscopic assistance. METHODS: For this study, 10 patients underwent subfascial augmentation mammaplasty through the axillary approach. The technique was used for patients with small or moderate breasts. The pockets were made with the fingers. The area beyond the reach of the fingers was dissected using a breast dissector. Then the pocket and major pectoral fascias were examined with an endoscope. The endoscope was used only to inspect the fascia and major pectoral muscle after the subfascial dissection was completed. The fascia and surgical effects were evaluated. RESULTS: The integrity of 11 (55%) of 20 pectoral fascias in 10 patients was preserved during the surgery. Four fascias (20%) were broken at about the fourth intercostal space or at the fifth costa. In five breasts (25%), the superficial layer of the pectoral muscle was split, but the integrity of the fascia was maintained. All the patients except one with asymmetric breasts achieved satisfactory results. There was no active bleeding, hematoma, infection, or fibrous capsule contracture during the follow-up period. CONCLUSION: The integrity of most pectoral fascias (11 + 5 fascias) could be preserved through the axillary approach during subfascial breast augmentation without endoscopic assistance. Even if the lower portion of the pectoral fascia was broken, this did not interfere with the aesthetic outcome or the normal postoperative recovery.
