Aesthetic blepharoptosis correction with release of fibrous web bands between the levator aponeurosis and orbital fat

The Journal of Craniofacial Surgery
Joo Hyoung KimSeung Hun Lee

Abstract

Blepharoplasty remains one of the most frequent operations in Asia. The most common complaint of Asian patients is a limitation of eye opening, and a substantial proportion of patients have puffy eyelids, supratarsal folds in the upper eyelid, and a narrow palpebral fissure, thus exhibiting a tired and sleepy appearance. To correct these features, an accurate understanding of upper eyelid anatomy is essential, especially concerning the levator aponeurosis, orbital fat, and orbital septum. After a strip of orbicularis oculi muscle was removed through usual transcutaneous blepharoplasty incision, we excised the submuscular soft tissue to expose the fusion line of the septum and the levator aponeurosis. Blunt dissection was carried out between the levator aponeurosis and the orbital fat. During dissection, a three-dimensional fibrous web connecting the orbital fat and levator aponeurosis, and continuing to just behind the Whitnall ligament, was observed in all patients. All of the connections with these fibrous bands were resected during the procedure using a Steven scissors while controlling bleeding. After this dissection, we reevaluated the degree of blepharoptosis in the upright position and checked the function of the levator...Continue Reading

References

Apr 1, 1979·Archives of Ophthalmology·R L Anderson, R S Dixon
Aug 1, 1977·Archives of Ophthalmology·R L Anderson, C Beard
Oct 1, 1984·Annals of Plastic Surgery·R Siegel
Jul 16, 2009·Annals of Plastic Surgery·Hirohiko KakizakiDinesh Selva
Oct 2, 2009·Korean Journal of Ophthalmology : KJO·Han Woong LimYoon Jung Lee

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Citations

Nov 23, 2013·Aesthetic Plastic Surgery·Yeon Soo Kim
Oct 17, 2019·Aesthetic Surgery Journal·Jingyi ZhaoXiaolei Jin
Sep 24, 2020·Aesthetic Plastic Surgery·Mario Pelle-Ceravolo
Dec 29, 2020·Journal of Plastic, Reconstructive & Aesthetic Surgery : JPRAS·Yong Kyu KimEung Hyun Kim

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