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Objective:To analyze the failure causes and repair methods of conjoint fascial sheath (CFS) suspension in ptosis correction.Methods:From 2021 September to September 2022, 13 cases (5 males and 8 females, aged from 19 to 49 years with an average of 25 years) were collected, and there were 18 eyes of CFS suspension in the Department of Burn and Plastic Surgery Center, the 940th Hospital of the Joint Logistic Support Force of PLA with a failed ptosis surgeries, including levator palpebrae superioris muscle shortening, CFS suspension, and frontalis muscle suspension.Results:Among the 13 patients (18 eyes), the failure causes included a result of the unfamiliar anatomy of CFS, unstable suture fixation, dysplasia of CFS, and improper suture site, CFS suspension failed to correct ptosis. After following-up for 6 to 30 months after reconstructive surgery, 14 eyes were corrected satisfactorily, 2 eyes were relieved of ptosis, and 2 eyes had ptosis recured six months after restorative surgery and a frontalis muscle suspension was used in the recured cases with a satisfactory outcome.Conclusions:According to the patient′s eye condition, mastering the indications, be familiar with the local anatomy and accurate surgical procedures are the key to success.
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Objective:To explore the importance of managing retro-orbicularis oculi fat (ROOF) in double-fold eyelid operation for patients with swollen upper-eyelid.Methods:From January 2018 to December 2020, 76 cases of swollen upper-eyelid were treated with double-fold eyelid operation by PARK method. In operation, an oval shape ROOF was removed from the outside-to the inside, and then appropriate lateral intraorbital fat was also removed. If fleshy orbicularis oculi muscle and anterior tarsus fat affected appearance of double-fold eyelid, both of them might be removed properly.Results:All patients were followed up from seven days to two years, two cases presented with shallowed double-fold eyelid, 5 cases of lacrimal gland prolapse had good lacrimal gland reduction and no recurrence; 4 cases of ptosis had normal corneal exposure and natural appearance after correction; the swollen upper-eyelid was obviously improved in 74 cases, and restoration stage was short, the apperaence and radian of doule-fold eyelid were beautiful, local scar was slight, satisfactory operative effect was achieved.Conclusions:In double-fold eyelid operation by PARK method for patients with swollen upper-eyelid, an ideal effect would be achieved, if transconjunctival route and fleshy orbicularis oculi muscle are appropriately removed in turn according to the reasons to give rise to swollen upper-eyelid.
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Objective@#To summarize the clinical effects of meticulous fat transplantation with fat grafts in the treatment of sunken upper eyelid.@*Methods@#From September 2016 to January 2019, 58 patients with sunken upper eyelid were treated in the 940th Hospital of the Joint Logistic Support Force of PLA. There were 2 males and 56 females, aged from 20 to 63 years. Among them, 14 cases were congenital, 30 cases were senile, 8 cases were postoperative, and 6 cases were traumatic. The prepared autologous granule fat was extracted with a 1 ml syringe, which matched with a 1.0 mm diameter needle. The 1 ml syringe was packed into the card slot of a fat graft booster, and the needle was inserted into the orbital fat zone of a depressed upper eyelid to homogenously inject the granule fat. For patients with iatrogenic and traumatic upper eyelid depression, the adhesion was released by small needle knife before injection. For those with aging skin, subcutaneous injection of nano-fat was applied.@*Results@#The amount of granule fat transplantation was 0.5 ml to 3.6 ml, with an average of 1.5 ml. The amount of nano-fat injection was 0.5 ml to 1.0 ml, with an average of 0.7 ml. All patients were followed up for 1 month to 2 years. Except 2 patients with severe traumatic upper eyelid depression, the other patients were satisfied with their full and natural upper eyelids after treatments.@*Conclusions@#When the upper eyelid depression was treated with granule fat transplantation by the booster, the small needle knife peeling technique and nano fat transplantation can be combined to correct different types of congenital, aging and surgical derived sunken upper eyelid and traumatic sunken upper eyelid from mild to severe cases. At the same time, the skin of the upper eyelid can be rejuvenated as well.