By Raul Loeb M.D. (auth.)
At final, an entire reference detailing some of the most ordinarily played beauty facial tactics - aesthetic blepharoplasty. In Aesthetic surgical procedure of the Eyelids, Dr. Loeb stocks his 30 years of expertise within the box. This special quantity distills the confirmed recommendations of an across the world revered plastic general practitioner. The "Scleral express" bankruptcy is the main entire remedy in this subject and the part on surgical correction of melancholy deformities masterfully demonstrates the author's unique ideas. Aesthetic surgical procedure of the Eyelids is an fundamental device for all beauty and reconstructive plastic surgeons.
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Extra resources for Aesthetic Surgery of the Eyelids
It should be emphasized that it is better to leave a postoperative excess of skin, causing an earlier reappearance of the wrinkles, than to remove too much and thus generate a scleral show or ectropion. Patients know that their wrinkles are going to return sooner or later and easily accept them. The same cannot be said of a scleral show or an ectropion; the patient's reation to these is total dissatisfaction. FIGURE 1. When using the subciliary incision, we recommend that no more than one third of the thickness of the orbicular muscle be resected in the tarsal portion.
Once the absence of ectropion or scleral show has been observed, the head of the patient is returned to the dorsal position. D. The excess skin is then resected from the mesial and central thirds of the lower lid. Care should be taken in these cases of second- degree wrinkles so as not to resect tissue in the lateral third of the lower eyelid. E. The sutures are placed (without resecting tissue) in the lateral third. F. Post-operative results 60 days after surgery. (From Loeb R: Esthetic blepharoplasties based on the degree of wrinkling.
We initiate local anesthesia with an insulin needle, followed by a larger gauge. We use 1 % or 2 % Xylocaine, diluted in accordance with the patient's preoperative cardiovascular evaluation. In patients with a history of high blood pressure, we use adrenaline very conservatively, or avoid it completely. We also use local anesthesia when the patient is under general anesthesia, and intubation if the anesthetist finds it advisable. We believe that local anesthesia is ideal for a blepharoplasty because it facilites the detection of possible future occurrences of scleral show or ectropion: The patient can be asked to raise his/ her head so that gravity will exert its pull on the lids, and then asked to open and close the lids.