Wydanie 3/2008
str. 16

Kosmetyczna plastyka powieki dolnej

Cosmetic Lower Eyelid Blepharoplasty

Mariusz Kęcik, Dariusz Kęcik

Klinika Okulistyki I Wydziału Lekarskiego Warszawskiego Uniwersytetu Medycznego Kierownik: prof. nadzw. dr hab. n. med. Dariusz Kęcik

Summary: The most common motive for blepharoplasty, however, is to have wrinkles or extra tissue removed in order to look younger and more attractive. Cosmetic eyelid surgery today has the benefit of 2000 years of development and refinement of surgical techniques. A variety of options are now available for the aesthetic rejuvenation of the lower eyelid. In this article we review lower eyelid blepharoplasty, highlighting the key points of the procedure including preoperative evaluation and complications after surgery. We present advantages and disadvantages of skin/muscle flap and transconjunctival approach. Now the transconjunctival blepharoplasty has become a simpler and more effective alternative in many instances, because fat removal can be accomplished without violation of the various anterior eyelid lamella structures to avoid lower eyelid malposition. The transconjunctival approach very often have been joined with dermabrasion, chemical peel or laser resurfacing. The surgeon frequently used CO2 or Er:YAG lasers. During resurfacing, the epidermis and a superficial portion of the dermis are removed. Tissue shrinkage occurs and, together with wound remodeling, contributes to a smoother, more youthful skin appearance after healing is complete. Complications of lower blepharoplasty are extremely distressing for both the patients and the surgeon. The most common anatomic complications are eyelid retraction and cicatrical ectropion followed by scar formation and contraction of the septum and to excessive skin removal. Other complications are following: problems with wound healing, fat underexcision or overexcision, asymmetry. Orbital complications (visual loss, vertical diplopia) are serious but not very often.

Keywords: lower blepharoplasty skin approach, transconjunctival approach.