A new crease fixation technique for double eyelidplasty using mini-flaps derived from pretarsal levator tissues.
Summary of "A new crease fixation technique for double eyelidplasty using mini-flaps derived from pretarsal levator tissues."
BACKGROUND:
: Most double eyelid operations focus on using a levator insertion into the upper eyelid skin that induces adhesion. Although incision method provides a significant supratarsal fold, it has the disadvantage of causing a visible depression or scarring when eyes are closed in downward gaze.
METHODS:
: The authors elevated multiple comblike mini-flaps from upper eyelid pretarsal levator tissues under loupe magnification. Flap bases were anchored on the tarsus using 7-0 nylon sutures, and distal flap portions were pulled out to the skin through a separate incision line and then interposed between edges of orbicularis muscle using absorbable microsutures to achieve a complete myocutaneous layer-by-layer repair.
RESULTS:
: Five hundred twenty-two double eyelidplasties were performed by the senior surgeon (Y.C.) using the described miniflap method. Patients were followed for 6 to 38 months (mean, 26 months). Seven palpebral fold failures were encountered, especially on the medial side, and 12 cases of fold asymmetry occurred because of inappropriate anchoring of miniflaps; all 12 were revised secondarily. No granuloma formation or scar hypertrophy occurred on upper lids. Although mild erythematous skin changes inevitably occurred during the early postoperative period, patients were satisfied with the palpebral folds, which showed no scars during downward gaze at 2 years postoperatively.
CONCLUSIONS:
: The authors introduce a modified double eyelidplasty involving the interposition of multiple comblike mini-flaps derived from the pretarsal levator tissue of the upper eyelid. The procedure not only allows clean repair of the upper eyelid without disrupting tissue layer continuity but also enables double eyelidplasty with minimal scar formation.
Affiliation
Seoul and Ilsan, South Korea From Choi Yeop Plastic Surgery Clinic and the Department of Plastic and Reconstructive Surgery, DongGuk University International Hospital.
Journal Details
This article was published in the following journal.
Name: Plastic and reconstructive surgery
ISSN: 1529-4242
Pages: 1048-57
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20811237
- DOI: http://dx.doi.org/10.1097/PRS.0b013e3181e3b72a
Medical and Biotech [MESH] Definitions
Surgical Flaps
Tongues of skin and subcutaneous tissue, sometimes including muscle, cut away from the underlying parts but often still attached at one end. They retain their own microvasculature also transferred to the new site. They are used in plastic surgery for filling a defect in a neighboring region. The concept includes pedicled flaps, rotation flaps, tube flaps, etc.
Ilizarov Technique
A bone fixation technique using an external fixator (FIXATORS, EXTERNAL) for lengthening limbs, correcting pseudarthroses and other deformities, and assisting the healing of otherwise hopeless traumatic or pathological fractures and infections, such as chronic osteomyelitis. The method was devised by the Russian orthopedic surgeon Gavriil Abramovich Ilizarov (1921-1992). (From Bull Hosp Jt Dis 1992 Summer;52(1):1)
Tissue Fixation
The technique of using FIXATIVES in the preparation of cytologic, histologic, or pathologic specimens for the purpose of maintaining the existing form and structure of all the constituent elements.
Histocytological Preparation Techniques
Methods of preparing cells or tissues for examination and study of their origin, structure, function, or pathology. The methods include preservation, fixation, sectioning, staining, replica, or other technique to allow for viewing using a microscope.
Nucleic Acid Hybridization
Widely used technique which exploits the ability of complementary sequences in single-stranded DNAs or RNAs to pair with each other to form a double helix. Hybridization can take place between two complimentary DNA sequences, between a single-stranded DNA and a complementary RNA, or between two RNA sequences. The technique is used to detect and isolate specific sequences, measure homology, or define other characteristics of one or both strands. (Kendrew, Encyclopedia of Molecular Biology, 1994, p503)
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