A Novel Way for Upper Eyelid Rejuvenation by Combination of Local Fat-Fascia-Muscle Flap Repositioning for Middle-Aged Asian Women

8 Aug 2020

Xiyuan Mao, Yunkun Pei, Lu Zhang, Ying Zhang, Rong Jin, Liying Cheng, Xiaoming Sun, Yuguang Zhang

Journal : JPRAS

Ref : Facial Aesthetics Sunken upper lid Upper blepharoplasty

Examining the Role of Retrobulbar Hyaluronidase in Reversing Filler-Induced Blindness: A Systematic Review

27 Jun 2020

Paap, Michael K.; Milman, Tatyana; Ugradar, Shoaib; Goldberg, Robert; Silkiss, Rona Z.

Journal : OPRS

Ref : Facial Aesthetics Hyalouronidase Hyaluronic acid fillers

The Anatomy and Clinical Application of Preorbital Septum Fiber

3 Jun 2020

Jingyi Zhao, MD, Xiaoshuang Guo, MD, Chenzhi Lai, MD, Dong Zhang, MD, Hong Du, MD, Changsheng Yang, MD, Yingying Yue, MD, Xiaolei Jin, MD

Background

In patients with mild superior sulcus deformity, pseudoptosis, or multiple eyelid folds, several bulky fibers can be found anterior to the orbital septum. These fibers, called preorbital septum fibers, may constrict protrusion of the fat pad and movement of the levator palpebrae muscle.

Objectives

In this study, the authors illustrated the anatomy of these fibers and described the double-eyelid procedure to correct pseudoptosis, mild superior sulcus deformity, and multiple eyelid folds, which may be caused by these fibers.

Methods

The bulky preorbital septum fibers were dissected and severed during upper blepharoplasty to release the orbital septum fat pad and levator palpebrae muscle. This procedure was performed between January 2016 and January 2018 in 56 patients with distinct preorbital septum fibers.

Results

Of the 56 patients, 38 displayed mild to moderate upper eyelid depression and multiple eyelids, and 18 displayed pseudoptosis. Bulky fibers that existed in the superficial layer of the orbital septum were all dissected and removed. After 6 months’ recovery, the superior sulcus deformity improved in all patients. No recurrence of multiple eyelids was observed. Patients with pseudoptosis showed a notable release of their upper eyelids.

Conclusions

This is the first time to our knowledge that the preorbital septum fibers are described as a distinct anatomical structure. They are clinically important in upper eyelid anatomy and the improvement of sunken upper eyelids or pseudoptosis. The combination of blepharoplasty with release of these fibers is easy to perform and promote.

https://academic.oup.com/asj/article-abstract/40/6/597/5588586?redirectedFrom=fulltext

COMMENTARY:

William P D Chen, MD

This paper “The Anatomy and Clinical Application of Preorbital Septum Fiber” 1 set out to attribute the finding of superior sulcal deformity, pseudoptosis, and multiple eyelid crease lines to the presence of bulky fibers within the superficial (front) layer of the orbital septum in the upper eyelid. It stated that in these cases, opening the orbital septum by severing this novel layer to allow repositioning of the orbital fat (preaponeurotic fat) appears to improve sunken sulcus deformity.

The authors cited papers dating as far back as 2010 that espoused the benefits of fat repositioning as well as fat grafting as methods to relieve sulcal deformity.2-6 This approach involves repositioning fat to the retro-orbicularis oculi space or the preaponeurotic space….

https://academic.oup.com/asj/article-abstract/40/6/603/5588585?redirectedFrom=fulltext

Journal : Aesthetic Surgery Journal

Ref : Facial Aesthetics Orbital septum