Research Of Blepharoplasty With Intensifying Orbital Septum And Removing Partial Orbital Fat

Background:The baggy eyelids deformity is a common disease and frequently encountered disease in the elderly. Generally, the pouchs under eyes are classified into three types in Chinese according to Castanares’s classification in baggy eyelids. The type Ⅰ:The ocular orbicularis along the margins of lower eyelids are hypertrophy and protruding. When the patients smile, the ocular orbicularis become much thicker and clearer. The type Ⅱ:The orbital fats are protruding and herniating down forward. Mainly, the baggy eyelids deformity looks a lot obvious. The type Ⅲ:The ocular orbicularis along the margins of lower eyelids are thicker and more protruding. At same time, the orbital fats are protruding and prolapsing.The reasons which cause baggy eyelids deformity are often very complicated. The young patients with baggy eyelids deformity are usually caused by genetic reason. The aged patients with it are often caused by the regression of orbital septum membrane, hernia of orbital fats, weakening of the orbicularis oculi muscle tension and loose of the skin. In addition, the infraorbital superficial soft tissues are effected by the gravity to prolapse down to cheek and the infraorbital depression grooves are formed at aged patients. Therefore, the young patients with type II of Castanares’s classification in baggy eyelids can be treated by the blepharoplasty in which the transconjunctival incision is taken to remove only herniated orbital fats. The aged patients with pouch under eyes have to take skin incision to remove not only herniated orbital fats, but a part of loosing skin also. To improve the infraorbital depression grooves, Hamra suggest to preserve and release orbital fats then put them under the infraorbital depression grooves.No matter which method of above, all of them may cause ineffective result of blepharoplasty because it is not easy to remove orbital fat suitably.Objective:To explore a new blepharoplasty which is easier to master and more effective than traditional methods. Specially, that is a universal blepharoplasty for repairing baggy deformity caused by too much orbital fat.Methods:The method of skin flap was adopted through incision in margin of palpebra inferior, then the orbital fat, weakened septum orbital, partial orbicularis oculi and loose skin were properly excised. Ocular orbicularis and orbital septum are jointed with the periorbita by means of suture.Results:Since March 2010 to June 2013,169 cases suffering from baggy eyelids accepted blepharoplasty with intensifying orbital septum and removing partial orbital fat. The curative effect was satisfied.Conclusion:The balance between the orbital fat and supporting tissue of sockets of eyes was reconstructed. It can prevent not only from the poor operative effect for orbital fat not enough excised, but from the sunken sockets of eyes for orbital fat too much excised also. The operating is simple and easy to master. It can postpone recrudescence of baggy eyelids in the future. It could be considered as a regular operation.