Clinical Application Of The Pretarsal Orbicularis Oculi Muscle Flap In The Correction Of High Fold In The Secondary Blepharoplasty

Objective: To explore the clinical application effect for pretarsal orbicularis oculi muscle flap in the secondary blepharoplasty of the high fold.Methods: A retrospective study of nineteen medical records of consecutive high fold patients that underwent the revision surgeries using the pretarsal orbicularis oculi muscle flap from December 2014 to December 2016 in the Department of Plastic and Reconstructive Surgery,the First Bethune Hospital of Jilin University.All the patients were female,age from 19 to 47,mean age 26.Three groups were divided according to the relation between the crease location and the suitable range which is the common width of the eyelid fold.Double high group was in eight patients,single high group in 6 patients,and part high group in 5 patients.All were followed up for 6 months to 18 months postoperatively.The revision effects and degree of satisfaction were reviewed,evaluated and analyzed.Results: Of the nineteen patients who were corrected the blepharoplasty complications of high fold using the pretarsal orbicularis oculi muscle flap following 6 months to 18 months postoperatively.In the single high group most of them were great satisfied(87.5%).But 1 patients(12.5%)expressed satisfaction because of mild asymmetry;And in the double high group,great satisfied were 4(66.7%)patients,1 patient(16.65%)expressed satisfaction because of mild asymmetry and dissatisfaction was in only 1 patient(16.65%)because of mild hollowing.In the part high group great satisfied were 4(80%)patients and 1 patient(20%)expressed satisfaction because of mild asymmetry.Nineteen patients were no obvious scar or triple eyelid on during postoperative follow-up.Conclusion: The application of pretarsal orbicularis oculi muscle flap in the blepharoplasty revision is safe and effective.It repaired morphology and asymmetry of the eyelids.Lowering the high placement of lid folds and thinning of the lower flap are performed;harvested muscle tissue is used as a local flap to prevent re-adhesion.It was succeeded in the blepharoplasty revision with a satisfying aesthetic outcome.