Asian Blepharoplasty and the Eyelid Crease

Asian Blepharoplasty and the Eyelid Crease......Page 2
Copyright Page......Page 5
With a contribution from......Page 6
Dedication......Page 7
Video Table of Contents......Page 8
Preface......Page 9
Acknowledgments......Page 11
1 What Is an Upper Lid Crease?......Page 12
References......Page 26
Cosmetic Oculoplastic Surgery: Evolution of Double-Eyelid Cosmetic Surgery in the Japanese Literature......Page 27
References......Page 28
The Upper Lid and Crease......Page 29
Individuals with a Lid Crease......Page 31
The Fat Pads of the Upper Lids......Page 32
The Medial Canthus......Page 39
Upper Tarsus......Page 42
Vascular Supply of the Upper Eyelid......Page 43
Concept of Facial Symmetry......Page 46
References......Page 48
4 The Eyelid Crease......Page 49
External Incision Methods......Page 52
Reference......Page 53
5 Consultation and Counseling......Page 54
The Consultation......Page 55
Shape......Page 56
Continuity and Permanence......Page 57
References......Page 58
Evolution of Double-Eyelid Cosmetic Surgery in the Japanese Literature......Page 59
Variations among Suture Ligation Methods......Page 62
Alternative 1: Full-Thickness Suture Technique (Figure 6-2)......Page 63
Alternative 2: Full-Thickness Suture Technique with Stab Incisions (Figure 6-3)......Page 64
Alternative 3: Transconjunctival Intramuscular Suture Technique (Figure 6-5)......Page 67
Alternative 4: Transcutaneous Intramuscular Suture Technique (without Piercing the Conjunctiva) (Figure 6-6)......Page 68
Alternative 5: Twisted Needle and Compression Method (Transcutaneous and Intratarsal Suturing with Twisted Needle Tracking Method) (Figure 6-7)......Page 69
Alternative 6: Transcutaneous Intradermal and Intratarsal Suturing Technique (Figure 6-8)......Page 71
References......Page 73
7 External Incision Methods......Page 75
Skin–Levator–Skin Approach......Page 76
Levator Aponeurosis to Inferior Subcutaneous Plane......Page 78
References......Page 82
9 Asian Blepharoplasty II: The Second Vector......Page 83
Rotation of Myocutaneous Strip Away From Underlying Levator Aponeurosis and Preaponeurotic Fat Pad, Hinging It Along Superior Tarsal Border......Page 84
Partial Excision of Preaponeurotic Fat (Figure 9-4)......Page 86
Advanced Discussion......Page 87
Treatment of Inferior Edge of Wound (Orbicularis Oculi) (Figure 9-6)......Page 88
Formation of Lid Crease and Closure of Wound......Page 89
Further Reading......Page 91
Depth of Crease......Page 92
Involutional Changes......Page 93
Local Care, Dietary Advice......Page 94
Opening of Orbital Septum......Page 96
Concept of Triangular, Trapezoidal and Rectangular Debulking of Eyelid Tissues......Page 97
References......Page 101
The Concept of a Dynamic Versus a Static Crease......Page 102
Dynamic Interaction of the Pretarsal Platform and the Preaponeurotic Zone......Page 103
Suture Type.......Page 105
Crease-Enhancing Eye Exercises for Patients without a Pre-Existing Crease......Page 106
13 Primary Asian Blepharoplasty Results (Before and After)......Page 116
14 Suboptimal Factors......Page 155
Height......Page 156
Shape......Page 159
Continuity and Permanence......Page 162
The Circle of Suboptimal Parameters, Etiology and Interrelatedness......Page 165
Crease Asymmetry......Page 166
Repair of a Low Crease......Page 167
Repair of Late Obliteration......Page 168
Repair of a Hollow Supratarsal Sulcus......Page 169
A. Patients with Some Redundancy of Skin.......Page 171
A. Patients with Some Redundancy of Skin.......Page 172
Summary of Solutions in Revisional Blepharoplasty......Page 173
Further Reading......Page 177
16 Revisions in Suboptimal Cases......Page 178
17 Advanced Concept of a Glide Zone as It Relates to Upper Lid Crease, Lid Fold and Application in Asian Blepharoplasty......Page 237
References......Page 247
Anesthetic Mixture and Injections......Page 248
Measure Tarsal Height......Page 250
Design of Nasally Tapered Crease Shape (Figure 8-4)......Page 251
Design of Parallel Crease Shape (Figure 8-5)......Page 252
Incision......Page 254
References......Page 256
18 Advanced: Beveled Approach and Mid-Lamellar Clearance in Revisional Asian Blepharoplasty......Page 257
Dynamics of the Upper Eyelid Crease......Page 261
References and Further Reading......Page 265
Anatomic Definition of an Upper Eyelid Crease......Page 266
Upgaze (Figure 19-4)......Page 267
Positive ao......Page 269
Negative ao......Page 270
Angle of Observation (ao)......Page 271
20 Advanced: The Concept of Trasal Tilt - Its Effects in Normal and Abnormal Clinical Conditions......Page 272
Discrepancy between Observed Apparent Crease Height and True Anatomic Crease Height......Page 275
Asian Anatomy......Page 276
Normal Eye Schema......Page 278
Caucasian with 10 mm Tarsus (Figure 20-5)......Page 279
Caucasian with 4 mm Ptosis (Figure 20-6)......Page 280
Caucasian with 2 mm of Upper Lid Retraction (Figure 20-7)......Page 281
Asian with Upper Lid Tarsus of 7 mm (Figure 20-8)......Page 282
Asian Eye with 7 mm Tarsus, with 4 mm Ptosis (Figure 20-9)......Page 283
Asian with 2 mm of Upper Lid Retraction (Figure 20-10)......Page 284
Clinical Applications......Page 285
High Crease......Page 287
Low Crease, Poor Crease Formation......Page 288
Further Mathematical Modeling......Page 289
21 Advanced: Effect of Higt Anchoring of the Crease, Faden-like Effect and Use of Buried Sutures......Page 291
References......Page 300
What Is an Upper Eyelid Crease?......Page 301
Height of Crease......Page 303
Predictors of Crease......Page 308
References......Page 316
23 Advanced Concept of the Eyelid Crease......Page 317
Variation in Function of the Unipoints......Page 322
In Conclusion......Page 323
24 Asian Eyelid Surgery: My Thoughts......Page 324
Medications and Instruments......Page 326
Further Reading......Page 331
25 Treatment of Medial Upper Lid Fold and the Fog Surrounding Epicanthoplasty......Page 332
Solutions for Reduction of Medial Upper Lid Fold in Relation to Crease Shape Design......Page 333
References......Page 337
Surgical Steps......Page 338
A Look to the Future......Page 342
Reference......Page 343
Appendix 1 Pre-1952 Japanese Literature on Cosmetic Eyelid Surgery (in Japanese)......Page 344
Appendix 2 Modern Literature on Asian Eyelid Surgery (in English)......Page 346
Appendix 3 Recent Literature (1998–2014) on Asian Eyelid Surgery (in English)......Page 358
Appendix 4 Recent Literature on Epicanthoplasty (in English)......Page 365
Appendix 5 Aesthetic Effects of Asian Blepharoplasty......Page 371
Appendix 6 Recent Literature on Anatomy......Page 372
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