Clinical Research Of The Operation Pattern And The Outcome Of Different Types Of Lower Eyelid Blepharoplasty

Background:Lower lid bulge is defined as the disequilibrium of orbital fat and supporting structure of lower eyelid. In detail, this primarily attributable to attenuation of the skin, subcutaneous tissue, orbicularis oculi and orbital septum of lower eyelid, and exerted orbital fat. Lower eyelid blepharoplasty is the only effective way to remove the Lower lid bulge and get facial rejuvenation. More and more patients want to do this kind of cosmetic surgery to have a youthful outlook again.The Lower lid bulge can be seperated into 5 types according to the anatomy: hypertrophy of orbicularis oculi, attenuation of skin, pseudoherniation of the orbital fat, pseudoherniation of the orbital fat with skin attenuate, skin attenuate with tear trough deformity. There are 3 different ways to do the blepharoplasty:trans conjunctival blepharoplasty, transcutaneous blepharoplasty and arcus release blepharoplasty. While the transcutaneous blepharoplasty can be seperated into skin-muscle flap and skin flap.By collecting the information of almost every patients'in our division from Feb. 2005 to Feb.2010, I know patients'physical examination, the operation way and the outcome post-op. I try to find out the suitable blepharoplasty to different types of lower lid bulge. Methods:Collecting the information of almost every patients'in our division from Feb. 2005 to Feb.2010. Our division had 84 patients aged 20—60 years-old here to do lower lid blepharoplasty, and all of them had bilateral lower lid bulge.29 of them were the type of pseudoherniation of the orbital fat, and 39 of these patients were the type of pseudoherniation of the orbital fat with skin attenuate, while 26 of them were the type of skin attenuate with tear trough deformity.Result:1. There is no differences between posterior orbital septum and anterior orbital septum approach in trans conjunctival blepharoplasty.2. In trans conjunctival blepharoplasty we shoud suture the tissue under conjunctiva if the incision is longer than 1cm. In order to make the incision recover better.3. Skin flap is better than skin-muscle flap for the patients whose lower lid is slack seriously.4. It is very necessarily to do the transcantho-canthopexy for the patients whose lower lid is slack seriously.5. Arcus release can avoid depression in infraorbital margin.Conclusions:We have to evaluate the types of every patient carefully, so that we can choose the suitable operation, and decrease the complication.