The Rejuvenation Comparison Of Arcus Marginalis Release And Orbital Fat Preservation With Traditional Blepharoplasty In Lower Eyelid Blepharoplasty

Objective:Previous traditional blepharoplasty with removing orbital fat was simple, which handled the fat and clumsy baggy eyelid,but tear trough deformity in the midfacial transition zone was not improved.This article ,by comparing arcus margialis release and fat preservation with traditional method, investigate and explore the advantages arcus marginalis release and orbital fat preservation in lower eyelid blepharoplasty in clinical application, and its clinical effect in midface rejuvenation.Methods: Select 36 cases,the patients need the blepharoplasty. Devided in two groups at random,for one group, we have the operation of the traditional blepharoplasty ,that is,to remove the orbital fat. For the other group,we have the operation of lower blepharoplasty using arcus marginalis release and orbital fat preservation,that is,on the basis of traditional blepharoplasty, instead of resection of obital septum fat ,orbital fat was exposed by dissection of orbital septum,the exposed orbital fat was moved by sitching it to periosteum or soft tissue of the orbital rim to fill the introcession in the inferior orbital rim, so a more natural looking plumpish eyelid was obtained.They use the methods through the transconjunctival approach or transcutaneous approach according skin relaxation,age and acceptance,etc. The point was fixed in any introcession of the lower eyelid.The distance of the point to the vertical plane which is passed by nasal tip and parallelled with face was measured before or after surgery. Changes of distances were observed and compared, which were conducted by statistial analysis. The patients were followed up for three months to one year.Results:36 patients were followed up for three months to one year in June 2009 to June 2010.One patient showed slow swelling. The patients of using traditional methods are satisfied with the surgery. baggy deformity is improved,but an improvement of introcession is not obvious.Some patiens will appear skeleton-like aging gradually.Using arcus margialis release methods make patients satisfied, and baggy deformity, herniation of the orbital fat, eyelid orbital margin groove, nasojugal groove and palpebromalar groove have been alleviated and resolved, obviously been corrected.Restore the natural, mellow and full lower eyelid contour. External canthus of the eye, lower eyelid and the inner canthus are not significant changes, no ectropion, epiphora, internal and external canthal distortion, recurrence, complications such as lower eyelid introcession. We found the changes unobviously for traditional method which only changed the loosen skin and baggy deformity under resection of the orbital septum fat through measuring the data before or after surgery,and The latter,changes of distances become greater,the introcessions are filled by orbital fat,midfacial rejuvenation can be achieved in transition zone.Conclusion:The lower blepharoplasty combined with orbital fat preservation is using the arcus marginalis release and fat preservation over the orbital rim.The technique is an effective method that can be performed concomitantly with facial rejuvenative procedures. Orbital septum fat which was released and moved down was filled in the introcession of lower eyelid.It restore the natural appearance. Anatomically, this article explain the causes,and correct baggy eyelid deformity according to signs of facial aging mechanism of to make it more reasonable and natural, can be achieved in the effect of orbital midfacial rejuvenation.