RU2503434C1 - Upper-lid blepharoplasty technique - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to aesthetic surgery, and can find application in upper-lid blepharoplasty. The technique involves skin marking with section lines, skin section along the marking lines, detachment and resection of the excess skin. An orbitalis muscle is preserved and corrugated along the whole length by three vicryl "П"-sutures 6/0.

EFFECT: using the given invention provides the high aesthetic and functional effect in the patients following the upper-lid blepharoplasty.

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Description

The invention relates to medicine, namely to aesthetic surgery, and can be used in the technique of upper blepharoplasty.

A known method of cosmetic blepharoplasty of the upper eyelids (RF Patent No. 2139022, A61F 9/007, Bull. No. 28, 10/10/1999), including marking and contouring the outline of the code flap to be excised with a scalpel. The skin is excised with the capture of the underlying muscle layer. Separate the intended flap. A strip of circular muscle is excised along the outer edge of the wound. Fatty hernias are isolated and excised. The musculoskeletal layer is marked and excised in the form of a wedge in the medial and lateral zone of the wound and an external upholstery suture is applied to the skin wound.

However, this method leads to a negative aesthetic effect in age-related patients.

Closest to the attached is a method of aesthetic blepharoplasty (RF Patent No. 2190376, A61F 9/007, Bull. No. 28, 10.10.2002), including an intra-conjunctival linear incision, and provide access to fatty hernias. Fatty hernias are isolated and excised. Perform hemostasis, impose a continuous suture on the conjunctiva. Under a tissue defect in the region of the lacrimal groove, the patient's adipose tissue obtained after removal of fatty hernias is injected. The introduction of adipose tissue is carried out portionwise in the direction from top to bottom between the skin and fiber. At the end of the operation, the skin of the lower eyelids is subjected to chemical peeling using a 35% trichloroacetic acid solution.

However, this method has a significant drawback:

with age-related soft tissue malnutrition and emptying in the upper eyelid region, a negative aesthetic and functional effect is noted.

The objective of the proposed method: aesthetic and functional effect in patients after upper blepharoplasty.

The task is carried out due to the fact that they retain the orbital muscle and corrugate it along the entire length with three U-shaped sutures from 6/0 vicryl.

The method is as follows:

Mark the cut lines on the skin, cut the skin along the mark lines, detach and excise the excess skin, save the orbital muscle and corrugate it along the entire length with three U-shaped 6/0 vicryl stitches.

Percutaneous superior blepharoplasty is performed both under local anesthesia and under general anesthesia. The average operation time is 30-40 minutes.

Immediately before the operation, the incision lines on the upper eyelid are marked with a special marker (Fig. 1, a): a line is drawn from the inner corner horizontally by about 0.7-0.9 cm from the ciliary edge, which marks the place of the lower incision. Then mark the place of the natural folds of the upper eyelid with a parallel line. At the outer and outer corners of the eye, these lines are connected at an obtuse angle. The second eyelid is marked in the same way. Then, on both eyelids, the amount of excisable skin in the nasal, central and temporal parts is compared to ensure that they are symmetrical. The operation area is treated twice with a skin antiseptic, and the targeted skin area is removed under local anesthesia (Fig. 1, b). The underlying stripe of the circular muscle of the eye is not removed in order to avoid "entrapment" of the upper edge of the orbit. Also, fat is not removed in the upper eyelid in order to maintain the “fullness” of the upper eyelid. The circular muscle of the eye is corrugated with three P-shaped seams of 6/0 vicryl along the entire length of the muscle. (Fig. 1, c). The upper eyelid is sutured with an intradermal suture (Fig. 1, d). An aseptic dressing and a cold compress are applied to the eyelids, which are usually removed 20 minutes after surgery.

Patient S., 62 years old, upon receipt of a complaint about the “aging” eyelid and overhang of the upper eyelid. Operation: with a special marker in the supine position with open eyes, we marked the lower edge of the overhanging fold of the eyelid, which is located 0.7 cm above the ciliary edge, in a natural fold. Using tweezers, the upper edge of the overhanging skin fold was determined and marked along the entire length. The second eyelid is marked in the same way. They performed filtration anesthesia with 0.2% lidocaine solution with an adrenaline of 1: 100000 skin and underlying layers, including the orbital muscle. After the incision, a marked strip of skin was removed. The circular muscle of the eye is corrugated with three U-shaped seams of Vicryl 6/0 along the entire length of the muscle. The skin wound is sutured with an intradermal suture. An aseptic blindfold and a cold compress were applied to the eyes, which was removed 20 minutes after the operation.

On day 5: Condition is satisfactory. There are no complaints. Healing per prima. The seams are removed. A moderate paraorbital hematoma persists.

After 1 month: There are no complaints about the aesthetic and functional nature after surgery. Postoperative scars are normotrophic.

The proposed method allows to improve the aesthetic and functional effect after surgery on the upper eyelid.

Claims (1)

The method of upper blepharoplasty, including marking the cut lines on the skin, a skin cut along the marking lines, detachment and excision of excess skin, characterized in that the orbital muscle is saved and corrugated along the entire length with three U-shaped 6/0 vicryl stitches.

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