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Surgical treatment of complications of cosmetic blepharoplasty.

The principles of repair of complications of cosmetic blepharoplasty are aimed at correction of the deformity present. Shortage of skin is usually corrected by skin grafting, lax lower lids by lid shortening procedures, and poor upper lid closure by releasing restricting tissues. Some unusual complications and their treatment are also described.

Blepharoptosis↗

Burn injuries of the eyelids.

Burns of the eyelid and surrounding structures are relatively uncommon in spite of a high incidence of thermal injuries involving the face. The etiologic factors, circumstances that precipitated the injury, and the anatomical features unique to the eyelid and adnexal area may conceivably account for the low incidence. The basic aims in reconstructing deformities must include primarily measures of protecting corneal exposure and relieving epiphora. Early reconstruction of other deformities such as epicanthal folds, palpebral stenosis, and missing eyebrows and eyelashes should be discouraged because of frequent recurrence of deformities due to contracting scars and scar hypertrophy.

Adult↗

[Palliative treatment of facial paralysis].

Facial nerve palsy disrupts both the static and dynamic equilibrium of the half-face involved. The imbalance worsens with age and senility further aggravates the situation. Palliative surgery can be used in complete intractable facial palsy or rarement for partial palsies or as a temporary treatment. The operation is proposed mostly for elderly patients and does not create other malformations or dysfunctions. Simple and effective reduction, cervicofacial lifting and plicature of the skin muscles is used with ocular protection (passive eyelid circle, lateral de-epidermalized skin flap, blepharorraphia) with or without use of locoregional tissues (orbito-naso-genial and labiogenial flaps) are usually sufficient.

Aged↗

Lower eyelid tightening: a comparative study.

Tightening of the lower eyelid is often performed as an adjunct to various lower lid procedures, and many techniques are available. Herein the author describes a simple and effective surgical technique and compares its failure rate with that of full-thickness pentagonal lid resection and lateral tarsal strip technique. Over a 7-year period, the author has used this procedure on 121 patients (153 eyelids) requiring horizontal tightening of the lower eyelid. The average follow-up period is 19 months and the results have been excellent. Complications included three overcorrections, one undercorrection, three suture abscesses, two exposed sutures, and two suture breakages. The most common complication was a transient point tenderness over the orbital rim lasting 2 to 4 weeks. Comparison of these results with those obtained in 44 other patients (54 eyelids) whose lower eyelids were tightened with either the pentagonal lid resection or the lateral tarsal strip technique showed this procedure to be just as effective and versatile yet much easier to perform.

Aged↗