Lower eyelid blepharoplasty through conjunctival incision

The lower ankle bag correction through the conjunctival incision has been reported in the literature as early as 1924, but this method is not as common as transcutaneous sacral relaxation correction, mainly because it is not familiar enough with the anatomy of the conjunctiva to sputum fat, followed by The superiority of transdermal resection of sputum fat was evaluated too high. At present, many scholars have realized that the complications of transsacral palpebral relaxation surgery are as follows: receding, valgus valgus, varus, and the like. The lower ankle bag correction through the conjunctival incision does not have the above complications, so the current correction of the lower ankle bag for the conjunctival incision has been re-emphasized. Curing disease: Indication The lower ankle bag correction through the conjunctival incision applies to: 1. Young people have phlegm and fat, but their skin elasticity is good. 2. Properly combined with the transdermal route and external augmentation, it is suitable for any age. Contraindications 1. Platelet count <90 x 109 / L. 2. The coagulation mechanism is not normal. 3. Hypertension, arteriosclerosis, diabetes, etc. Preoperative preparation 1. Before the operation, talk to the patient, especially for cosmetic purposes. The patient must know any eyelid cosmetic surgery. Although the operation is particularly careful, there will be a certain percentage of complications. Discuss possible complications with the patient before surgery and help the patient determine if there is a good reason to be worthy of surgery. 2. Generally, the lower jaw fat is prominent, and the bilateral sides are more asymmetrical. The amount of fat removed on each side should be estimated before surgery. 3. Check the sagging of the skin and the orbicularis muscle to determine whether it is necessary to remove excess skin and rim muscle at the same time. 4. Take a picture of the patient's face before surgery for reference when cutting fat. Surgical procedure 1. The assistant pulls the central part of the jaw with the eyelid hook, and the tarsal pad is placed under the dome to protect the cornea (or protect the cornea with a contact lens). 2. Lightly press the eyeball back to allow the fat to escape to the gingival margin. 3. Understand the lower edge of the iliac crest, and use the diathermy to coagulate the conjunctiva and the lower fascia sac 1~2mm. 4. In order to expose the sputum fat, the incision is enlarged, which is under the base of the lacrimal gland (at least 4 mm from the small point of the tear), and from the outside to the outside. 5. The median cellulite was isolated from the arched dilation of the inferior oblique muscle of the external malleolus, and the medial cellulite was found from the central cellulite. 6. After all the cellulite is fully exposed, use a hemostatic forceps to hold the fat, remove the fat with scissors and then diathermy (there are larger blood vessels in the fat to prevent postoperative bleeding, and must be adequately stopped during surgery). When the eyeball is lightly pressed, the residual cellulite can be flush with the edge of the eyelid. 7. The conjunctiva and the inferior fascia sac are sutured continuously with 7-0 silk thread, leaving a long thread to remove the thread. 8. Conjunctival sac is coated with antibiotics, steroid eye ointment, dressing, bandage and light pressure bandage. complication 1. Insufficient correction. 2. Lower valgus. 3. Hemorrhage in or after the ball This complication is very serious. If it cannot be detected in time, timely rescue will affect the visual function. In severe cases, the visual function may be lost.

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