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Blepharoplasty - Eyelid Surgery Methods
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Upper Eyelid Blepharoplasty
Different types of Upper Blepharoplasty:
This method is the most commonly used - with the incision in the natural crease of the upper eyelid area. Varying amount of skin and muscle are removed, however as a general rule a conservative amount is removed. If the patient has excess fat in the upper lid, then the fat is removed to prevent any excess puffiness.
This technique is designed to create a crease in the upper lid between the eye-shadow space and the eyebrow. This is performed on Asian patients with almond shaped eyes who might have minimal upper lid folds, and they are desiring a double fold. This procedure is also performed on patients who have had prior blepharoplasty surgery which resulted in an uneven crease.
This technique combines the upper blepharoplasty with elevation of the temporal area through the upper blepharoplasty incision. This method is used for patients with an unstable brow that could be pulled down with the upper blepharoplasty procedure - to give a slight brow-lift. PROS:
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Sagging brows can contribute to a tired or sad appearance. Sometimes if upper eyelid surger is done alone it can actually make the problem worse, not better. In these cases, this technique in which combines the upper blepharoplasty procedure with an endoscopic brow lift to improve the appearance of the eyelids, forehead and eyebrows will be beneficial. The endoscopic brow lift is performed through tiny incisions hidden above in the hairline of the patient. PROS:
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Ptosis is a condition where the eyelid does not fully open. This technique combines an upper blepharoplasty with tightening of the loose levator muscle in which the muscle's tendon is repaired or shortened in order to restore the balance of the eyelids. Sometimes in extreme cases a sling might be needed to help prop up the eyelids. PROS:
There are two main types of blepharoplasty:
This technique hides the scar inside the lower eyelid. This procedure is designed to remove the fat from the three fat pads under the lower eyelid.
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Copyright © 2010 ASAPS - Used with permission
Transconjunctival Blepharoplasty
This technique combines the transconjunctival removal of fat with laser resurfacing with CO2, Erbium, or other types of skin tightening lasers under the eye area.
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This technique combines transconjunctival blepharoplasty with the use of a chemical peel around the eyes (TCA - Trichloroacetic Acid) PROS:
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Traditional Lower Lid Blepharoplasty This technique hides the scar just under the eyelashes. The lower blepharoplasty is designed to remove fat from underneath the eyelids and tighten loose skin and muscles. PROS:
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Copyright © 2010 - Abridged version from 'Eyelid Surgery' pamphlet © Mi-Tec Medical Publication & ASPS Plastic Surgery Incision location for traditional blepharoplasty
This technique is similar to a standard blepharoplasty with use of a flap of excess skin which is tightened while preserving the muscle. Skin Flap Lower Blepharoplasty was at one time considered the "gold standard" form of cosmetic lower eyelid surgery. It is the easiest form of lower blepharoplasty. The complication of eyelid retraction is known with this type of surgery. The incision is made along the lower lash line and skin is lifted away from the lower eyelid muscle. The fat pads are accessed through the muscular and fibrous layers of the lower eyelids and trimmed. The lower lid (skin flap) is then re-shaped and the excess is trimmed down and then the incisions are sutured. PROS:
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Skin muscle flap lower blepharoplasty is also the another form of the "gold standard" for lower eyelid surgery.The approach consists of:
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Standard blepharoplasty with repositioning of the fat pads to fill in areas of hollowness under the eyes. PROS:
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Canthopexy: is a technique that uses a permanent internal suture to secure tendons of the outside corner of the “lateral canthus”, to the bony rim of the eye socket at their existing level. Canthopexy is primarily used a preventative step to prevent sagging of this area with the healing process. PROS:
Canthoplasty: is different than canthopexy - as it the main goal is to free up and reposition a lateral canthus that is too low. The tendons of the outside corner of the eye are separated from their attachments to the outside rim of the eye socket, and secure the tendons in a higher position. A conservative canthoplasty can restore a youthful look in carefully selected patients, while an overdone canthoplasty can create a cat-like eye shape. PROS:
This technique is performed through the lower blepharoplasty incision to improve the appearance of the eyelids and the cheeks by lifting the fat pad above the cheekbone. PROS:
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