Even the most experienced surgeons often experience blepharoplasty complications such as over- or under-excision of the skin, abnormal folds on the eyelids, and visible scarring.
At the same time, modern patients want to receive natural results after aesthetic procedures, including upper eyelid blepharoplasty, without a long recovery period.
This is not an easy task for the surgeon, but Drs. Chedly Bouzouaya and Ronald Feiner have introduced a new technique described in the estet-portal.com article that will provide good results and avoid formation of noticeable scars in the area of the upper eyelid.
Non-aggressive blepharoplasty techniques – cosmetic surgery trend
Traditionally, before performing upper eyelid blepharoplasty, the doctor first eliminates the problem of eyebrow ptosis, which is one of the causes of excess skin in this area. However, with the advent of effective minimally invasive procedures (botulinum toxin injections and dermal fillers), the need for invasive surgical brow lift is often eliminated.
The authors are of the opinion that for the normal functioning of the upper eyelid, the length of its anterior plate should be 20 mm.
Moreover, surgical brow lifts are associated with risks of bleeding, nerve damage, scarring, alopecia, asymmetry, and changes in brow height.
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What is special about Chedly C
upper eyelid blepharoplasty techniqueThe presented technique was developed in accordance with modern principles, combines earlier author's solutions and greatly simplifies the process of upper blepharoplasty.
The incision is made on the natural crease of the patient's eyelid, and its lateral part is visually smoothed out due to the C-curve. The Chedly C technique avoids the lateral extension of the scar beyond the orbital ridge.
The purpose of the presented approach – provide an aesthetically pleasing upper blepharoplasty result without visible scarring.
Correction of the middle third of the face: what to choose – fillers, lifting or blepharoplasty
Chedly C Upper Blepharoplasty Technique Description
Traditionally, the incision is made along a line in the crease of the eyelid that originates above the superior lacrimal punctum, extends to the outer corner of the eye, and rises 5 to 6 cm above the canthal angle of one of the lateral canthal folds. The line extends about 1.5 cm beyond the outer corner of the eye (or a little further, depending on the degree of sagging skin). Outside the canthal angle, the manipulation is no longer performed with the skin of the eyelid, but with the skin in the orbit area.
However, in the orbital region, the skin is much thicker than the skin of the upper eyelid, and after healing, a more noticeable scar forms on it. The Chedly C technique involves excision of the skin of the eyelid only, and the incision is "hidden" in the crease of the upper eyelid along its entire length.
During the preoperative examination, any deformities of the eyelid should be documented. The amount of excess eyelid skin is determined when the patient is in an upright position, because in the supine position, its amount visually decreases. After that, they move on to marking the skin that sags in the lateral part of the eyelid. The patient lies prone and the lower incision line is made on the existing lid fold or, if the fold is to be repositioned, 10-12 mm above the center point of the lid margin.
During preoperative manipulations, the authors carefully stretch the eyebrow and mark the crease of the upper eyelid with a marker. Its beginning is located above the lacrimal opening. The patient is asked to look up; the drawn line should fall into the crease of the upper eyelid, which is formed while looking up. Then, using a clamp, they capture the excess skin located above the applied line and first mark the points located in the center, and then – along the edges, from the side of the nose and temple.
The resulting points are connected, and the line is continued medially and lowered down so that it runs approximately 5 mm above the edge of the eyelid. The lateral endpoint of the line is at the canthal angle, approximately 6 mm above the margin of the eyelid. From this point, a C-shaped incision line is made and lifted up towards the lateral part of the eyebrow. The width of the resulting C-bend depends on the degree of sagging of the skin. Unlike the traditional technique, the incision line is not drawn to the crow's feet (Fig. 1–4).
Thanks to the C-shaped incision, the scar does not extend laterally beyond the eyelid and the recovery is faster.
On the side of the nose, an incision is made in the medial part in a vertical position and resection of the orbicular muscle of the eye is performed, which ensures ease of closing of the eyelids without the formation of a canthal mesh and without the need for an additional skin incision and an increase in the length of the scar, as a result of which it does not extend beyond the crease century.
Volume blepharoplasty: Dirk Riecher's description of the technique
The authors prefer to use radio frequency technology for surgical tissue manipulation, including incisions, dissections, resections, and bleeding control. Radiofrequency technologies also contribute to a slight tightening of the skin, thereby fixing the result of blepharoplasty.
The amount of skin excised during upper eyelid blepharoplasty should be sufficient to provide a good lifting effect while avoiding iatrogenic lagophthalmos.
According to Prime magazine
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