눈확지방의 재배치를 이용한 하안검성형술 = Lower Blepharoplasty by Repositioning of Orbital Fat

다국어 초록 (Multilingual Abstract)

Palpebral bag of the lower eyelid & tear trough groove is regarded as a sign of aging. This is mainly caused by weakening of the orbital septum, atrophy of the orbicularis oculi muscle and slackness of the skin. This palpebral bag is usually combined with a depression along the inferior orbital rim which is called a tear trough groove.In the past, the surgical excision of the fat pad has been the mainstay of the management of lower palpebral bag in cosmetic blepharoplasty. But, excision of the protruded orbital fat as a treatment for palpebral bag may contribute in long term to the senile enophthalmos due to a volume reduction of the intraorbital adipose tissue. Recently, fat pad sliding method with septal incision has been performed for preservation of orbital fat. This technique, however, causes problems such as lid ecchymosis, chemosis, lid contour irregularity, ectropion, and retrobulbar hematoma formation.The authors propose to restore the functional integrity of orbital septum. Attenuated orbital septum with orbital fat was stretched and transposed to cover the bony framework. The orbital septum with orbital fat meticulously sutured to the periosteum of inferior orbital rim with 5-0 nylon. This technique of septal draping over the inferior orbital rim was performed in 54 consecutive individuals(108 lower eyelids) for 27 months period. The overall results obtained, with the exception of mild degree of puffiness encountered soon after the surgery, were satisfactory and morbidity was minimal.

참고문헌 (Reference)

1 "The treatment of palpebral bags by repositioning of orbital fat into a subperiosteal pocket" 8 : 99-, 2002

2 "The correction of lower palpebral bulge & tear trough groove by repositioning of orbicularis oculi muscle, orbital septum & orbital fat" 32 : 304-, 2005

3 "Septo-orbitoperiosteoplasty for the treatment of palpebral bags: a 10 year experience" 101 : 1657-, 1998

4 "Repositioning the orbiculares oculi muscle in the composite rhytidectomy. Plast Reconstr Surg 90" 1992

5 "Reduction of lower palpebral bulge by placating attenuated orbital septa A technical modification in cosmetic blepharoplasty" 105 : 2552-, 2000

6 "Herniated fat and the orbital septum of the lower lid. Clin Plast Surg 20" 1993

7 "Fat preservation lower blepharoplasty: septal draping over inferior orbital rim" 28 : 100-, 2000

8 "Fat pad sliding and fat grafting for leveling lid depression. Clin Plast Surg 8" 1981

9 "Avoiding complications of fat repositioning" 16 : 199-, 2002

10 "Arcus marginalis release and orbital fat preservation in midface rejuvenation" 96 : 354-, 1995

11 "Anatomy, pathophysiology, and prevention of senile enophthalmia and associated herniated lower eyelid fat pads" 100 : 1535-, 1997

12 "A new technique for the treatment of palpebral bags. Plast Reconstr Surg 81" 1988