D. Chelariu, A. Chelariu, V. Chiriac Dr. Chelariu Clinic, Bacău

Retensioning of the lower eyelid

Reducing the risk of ectropion

•Wrinkles and excess skin at the lower/upper eyelids;•Large palpebral bags: upper eyelid – internal compartment, lower eyelid – middle compartment;•Orbicular distension and hypotonia;•Hypotonia and relaxation of the lower lid complex;•High palpebro-malar tegumentary ptosis – with pigmentary anomalies;

XanthelasmaSenile kerathosis

Photos Routine analysis Complete clinical

examination (Botti sketch)

Local + neurolept-analgesia;

General – the safest.

Upperlid blepharoplasty – classic

-Drawing

-Incision

-Tegumentary excision

-Muscle excision – 2,5 mm from the upper plapebral crease

-No suturing

Lowerlid blepharoplasty

- Drawing

-Incision – extended in an upward and lateral direction from the outer canthus

- Submuscular dissection

- Dissection and excision of the excessive fatty tissue.

Lowerlid blepharoplasty

-Lowerlid tegumentary excision, according to the sketch:

o deepidermization (external triangle) +

o tegument and muscle excision (internal triangle)

Lowerlid blepharoplasty

-An external triangular muscle flap is passed underneath the lateral orbicularis muscle, at the lateral canthus and fixed at the upper-lateral orbital periosteum

- Tegumentary correction, if needed – "crow's feet"

Upper eyelid suture (continuous thread - Prolene 5-0)

Lower eyelid suture (separate threads - Prolene 5-0)

38 blepharoplasties;

Age limits between 35 and 70 years old;

95% (36) were performed on women, out of which

16 were associated with facelifts and

5 with subpalpebral Faivre lift.

Before

Drawings

After

Before

Before

After

Complications

Bruising (40-45%);

Hematoma (0%);

“Scleral show” (0%);

Ectropion (0%), Chemosis (0%), Epiphora (0%),

Corneal lesions(0%).

The intervention lasts about 30% longer than the classic lowerlid blepharoplasty;

It requires a trained team.

It allows the tensioning of the lower eyelid;

Reduces the risk of ectropion;

It can be associated with a facelift or a subpalpebral Faivre lift;

Immediate patient satisfaction;

Prolonged, aesthetically pleasing results.