第11回国際整鼻術ワークショップ、韓国、ソウル 2007/11/24-25

招待講演 : secondary upper blepharoplasty
講演 : lower blepharoplasty for negative orbit

■ secondary upper blepharoplasty

Secondary upper blepharoplasty means mostly the revision of double fold to correct narrow fold to wide one or wide fold to narrow one. This presentation focuses on the correction of unexpected, unwanted, unplanned fold line which developed after upper blepharoplasty.
An unexpected fold occurs within 1 week after, probably immediately after or at the night of the partial or full length incisional double fold procedure or correction of blepharoptosis. It may disappear in a few weeks but could remain permanently.

Prevension is the key point in management of an unexpected fold. The suspension of thee incision line to the eye brow using buried suture, which maintains the upper eyelid in the open position is found very useful.

If the treatment is performed within 1 week after the upper eyelid surgery, the suspension suture for 1 week is sufficient.

If the fold persisted more than 1 week, we must perform release of adhesion between the unexpected fold and levator aponeurosis, creation of double fold and suspension for 1 week

■ lower blepharoplasty for negative orbit

The purpose of lower blepharoplasty is to reduce deep wrinkles in the lower eyelid skin and to correct the contour deformity that is eyelid bad and nasojugal groove

Negative vector orbit means the inferior orbital rim is recessed in the relationship with eyeball. It likely presents with proptotic eye, eye bag, deep nasojugal groove and flat cheek.

This is my current approach to lower eyelid rejuvenation. I like to remove the orbital fat and reposition the fat and septum to cover the inferior orbital rim. I do perform the orbicularis oculi muscle suspension. In case of flat or depressed mid face, I would like to add midface lift and mid face augmentation.