Kosmetische Medizin 5-2010: 228 – 244

State of the art blepharoplasty
Advanced blepharoplasty – a reliable concept for permanent removal of tear trough-deformity

MARIAN STEFAN MACKOWSKI

KEY WORDS: Communications unit eyes, periorbital alterations, tear trough-deformity, combined surgical intervention, arcus marginalis release, ventral septoplasty, lateral MOO-suspension

SUMMARY:
The eyes represent the fundamental non-verbal aesthetic-emotional unit of communication of the face. The condition of the periorbital region provides information about mood and age. The desire to change this region, especially removing the signs of aging, has occuppied mankind for millenia. Who, when and where the first blepharoplasty was conducted, can not be exactly answered. No more than in the 60’s and 70’s authors like Converse, Lewis, Castanares and Furnas, later Jelks, Mendelson, Hamra, Flowers, Codner and McCord [4, 7, 8, 9, 11, 16] described techniques, that have until today kept their significance, even as considerable modifications have evolved. Many of the modifications have been discarded again, since they where considered as too complex. But one thing has become clear: the ruling ideology “less is more” of the past years does not reach the objective and makes clear, that blepharoplasty is much more than just skin-, muscle- and fat resection. The correction of the eye lids, especially the blepharoplasty of the lower palpebra is the most challenging and most difficult intervention in aesthetic surgery – last but not least – because of the functional anatomy of the sphincter mechanism. Decisive for getting good results is the preoperative analysis combined with the knowledge of the fundamental techniques for the given situation. In principle the upper lid blepharoplasty is the technically less difficult operation even though certain steps have to be adhered to as well, or else the results will be unsatisfactory. The here presented and by the author over 5 years applied advanced blepharoplasty of the upper and lower eyelid is explained and exemplified.

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