Jsmc-10340

THE EFFECT OF ORBICULARIS OCULI SLING ON LATERAL CANTHUS AND LOWER LID IN UPPER BLEPHAROPLASTY

Paiwand Mahmood Ali a , Ari Raheem Qader b, Hawree Abdulsattar Hasan c, Faraydoon Karim Rasul c, and Vyan Hiwa c

a Board Candidate at Kurdistan Board for Medical Specialties, Kurdistan Region, Iraq.

b Department of Surgery, College of Medicine, University of Sulaimani, Kurdistan Region, Iraq.

c Director of Health, Ministry of Health, Burn and Plastic Surgery Hospital in Sulaimani, Kurdistan Region, Iraq.

Submitted: 27/6/2021; Accepted: 20/1 /2022; Published: 21/3/2022

DOI Link: https://doi.org/10.17656/jsmc.10340

ABSTRACT

Background

Upper lid blepharoplasty is one of the most commonly performed procedures in aesthetic plastic surgery, which directly affects facial rejuvenation. The periocular region is the main point of focus in routine face-to-face interaction. Understanding the periorbital surgical anatomy, facial analysis, and specific change in the skin, muscle and fat with preoperative workup and a thoughtfully conceived surgical plan targeted according to the difference gives a successful outcome.

Objectives

This dynamic region has both functional and aesthetic influence on the face; unfortunately, this area develops ageing sooner than other regions of the face.

Patient and Methods

A total of 30 patients underwent upper lid blepharoplasty. In the most lateral part, the orbicularis oculi muscle was divided horizontally. The lower part was suspended to the periosteum of the orbital rim with a single stitch of the long-standing absorbable suture. The upper part overlapped over the lower part of the muscle and fixed them by a single stitch in a single stitch pant over vest fashion.

Results

This technique provides more youthfulness to the eye, especially at the region of lateral canthus, as it lifts the tissue superolateral. It has minimal effect on lateral canthus laxity but shows marked improvement in lateral lower lid and crowfeet; it also shows valuable improvement of lateral hooding.

Conclusion

The orbicularis oculi muscle suspension procedure is a good technique that reliably corrects and reshapes the outer portion of both upper and lower eyelids. It is an easy technique, and it would be helpful as an adjunctive procedure with blepharoplasty in selected cases.

KEYWORDS

Blepharoplasty, Orbicularis muscle, Crow’s feet, Lateral hooding, Lateral canthus.

References

1. Innocenti A, Mori F, Melita D, Dreassi E, Innocenti M. Effects of orbicularis oculi flap anchorage to the periosteum of the upper orbital rim on the lower eyelid position after transcutaneous blepharoplasty: Statistical analysis of clinical outcomes. J Plast Reconstr Aesthet Surg. 2017 Mar;70(3):385-391.

2. Chen B, Woo DM, Liu J, Zhu X, Lin Y, Chen X. Orbicularis Oculi Muscle Flap Rotation for Correction of Sunken Eyelid in Cosmetic Blepharoplasty. J Plast Reconstr Aesthet Surg. 2020 Sep;73(9):1732-1737.

3. Greco M, Vitagliano T, Fiorillo MA, Greto Ciriaco A. A new technique of upper eyelid blepharoplasty using the orbicularis muscle flap. Aesthetic Plast Surg. 2012 Feb;36(1):18-22.

4. Benjamin A. Bassichis, Cosmetic upper-lid blepharoplasty, Operative Techniques in Otolaryngology-Head and Neck Surgery. 2007;18(3):203–8.

5. Liu HP, Shao Y, Li B, Sun MR, Yu XJ, Zhang D. Upper blepharoplasty revision technique: Correction of the high eyelid fold using the pretarsal orbicularis oculi flap. J Plast Reconstr Aesthet Surg. 2019 Jan;72(1):125-130.

6. Tsai CC, Lin TM, Chou CS, Lai CS, Lin SD. Use of orbicularis oculi muscle flap for undercorrected blepharoptosis with previous levator muscle resection. Ann Plast Surg. 2003 Mar;50(3):292-5.

7. Hoorntje LE, Lei Bv, Stollenwerck GA, Kon M. Resecting orbicularis oculi muscle in upper eyelid blepharoplasty--a review of the literature. J Plast Reconstr Aesthet Surg. 2010 May;63(5):787-92.

8. Nemoto H, Togo T, Maruyama N, Miyabe K, Nakae S, Sumiya N. Orbicularis oculi muscle tightening for involutional entropion. J Plast Reconstr Aesthet Surg. 2017 Jul;70(7):946-951.

9. Huijing MA, van der Palen J, van der Lei B. The effect of upper eyelid blepharoplasty on eyebrow position. J Plast Reconstr Aesthet Surg. 2014 Sep;67(9):1242-7.

10. Ilankovan V. Aesthetic blepharoplasty. Br J Oral Maxillofac Surg. 2010 Oct;48(7):493-7.

11. Bellinvia G, Klinger F, Maione L, Bellinvia P. Upper lid blepharoplasty, eyebrow ptosis, and lateral hooding. Aesthet Surg J. 2013 Jan;33(1):24-30.

Full Text

This work is licensed under a Creative Commons Attribution 4.0 International License.