Intricacies of Upper Blepharoplasty in Asian Burden Lids
<두꺼운 눈꺼풀의 동양인 안검성형술의 복잡성>
책임저자 : 최웅철 교수
동양인의 눈꺼풀과 서양인의 눈꺼풀의 차이점은 과거 여러 보고서에서 자세히 보고되어왔습니다.
동양인의 눈은 서양인에 비해 상대적으로 눈 크기가 작고, 눈꺼풀과 눈주변의 피부가 두꺼운데요, 이 논문에서는 이러한 특징을 갖고 있는 동양인의 상안검 눈꺼풀 성형술의 기능적 측면을 논의하고 수술 전 적절한 평가, 수술 기술 및 수술 후 관리를 제시하며, 환자의 기능적 측면과 미용적인 결과, 수술 후 만족도를 모두 향상시키는데 도움이되는 기술을 제시합니다.
Differences between Oriental and Caucasian eyelids have been explained in great detail in several reports in the past. The purpose of this article is to discuss the functional aspects of Asian double fold upper blepharoplasty and to present techniques that help to improve both the functional and cosmetic outcomes and satisfaction after surgery. The eyes of Asians are relatively small with thick skin in the eyelids and periorbital area. They typically lack the upper eyelid crease (creating the so-called double eyelid) due to burden factors like thick skin, hypertrophied orbicularis oculi muscle (OOM), submuscular fibroadipose tissue, thick orbital septum, abundant preaponeurotic fat, and lower positioned transverse ligament. Asian eyes may also have a superior visual field defect due to skin overriding the upper lid margin (skin-OOM-fat complex slide down). These burden factors result in the eyelashes appearing short and becoming misdirected and pressed toward the globe, causing functional discomfort. As a compensatory mechanism, Asian people tend to engage the frontalis muscle to lift the eyebrow to help them open their eyes. Along with aesthetic enhancement, double-eyelid surgery in Asian burden lids can improve the functional deficiencies helping the patients to open the eyes more easily. In addition, treatment of the Mongolian fold (medial epicanthal fold), caused by medial hypertrophy of preseptal OOM, augments the surgical results. In this report, we present the appropriate preoperative assessment, surgical technique, and postoperative care that should be employed to achieve consistently good functional and aesthetic outcomes in these patients.