A

Ablative lasers, for periorbital resurfacing, 148

fractional, 149

Adipose tissue. See Fat.

Adjunctive procedures/therapies, for cosmesis and function, injectable, 139–144 . See also Hyaluronic acid (HA) fillers.

skin care and, 145–146

for full-thickness lower eyelid defect repair, 184–185

for retrobulbar hematoma prevention, 202

Advancement flaps, for anterior lamellae defects repair, in upper eyelid, 174–175, 179

for full-thickness defects repair, in lower eyelid, 184–185

bilamellar, 184

lateral, 185–187

in upper eyelid, 175, 178, 181

semicircular, 178–179

myocutaneous. See Myocutaneous advancement flaps.

Aesthetic complications, of eyelid surgery, 193–194

Aesthetic evaluation, of eyelids, 97–106

beautiful components in, 97–98

aging as, 98

symmetry as, 97–98

clinical history in, 102–104

functional evaluation vs., 98–104

eyebrow in, 101–102

forehead in, 101–102

lower eyelid in, 100–101

skin in, 98–99

upper eyelid in, 98–100

ideal features in, 101–102, 153

introduction to, 97

key points of, 97

review of symptoms in, 102–104

specific concerns in, 102–104

surgical complications and, 193–194

upper eyelid blepharoplasty and, 121–123

of periorbital region, 107–108

Aesthetic goals, of eyelid reconstruction, 184–185

A-frame deformity, 122

Aging, of eyelids, aesthetic evaluation and, 98

laxity related to. See Eyelid laxity.

lower eyelid blepharoplasty and, 129–133

upper eyelid blepharoplasty and, 121–122

of periorbital region, 107–108

Alloplastic implants, for midface rejuvenation, 114

Anatomy of eyelids, functional, 102–104, 183–184

surgical, 89–95 . See also Surgical anatomy.

Anchoring point, for l full-thickness defect repair, of upper eyelid, 174, 178–179

Anterior lamellae, of lower eyelid, ectropion repair and, 167–169

in functional anatomy, 183–184

in surgical anatomy, 90, 163–164

reconstructive surgery and, 184, 187

of upper eyelid, blepharoplasty and, 120

crease derived from, 153, 160–161

defects of, decision schematic for, 179, 181

reconstructive surgery for, 174–175, 179

in surgical anatomy, 89–91

Antioxidants, for periorbital rejuvenation, 146

Appearance, of eyelids, 97, 122. See also Aesthetic evaluation.

Arterial anatomy, of eyelids, 94

Asymmetry of upper eyelid, 153–162

contralateral ptosis prevention with, 156–157

crease formation for, 154, 160–161

indications for correction of, 154–155

introduction to, 153–154

key points of, 153

levator advancement for, 157–159

Müller muscle conjunctival resection for, 155–156, 158–160

postoperative care for, 160–161

preoperative planning for, 154–155

preoperative preparation for, 155–156

ptosis repair and, 156–160

blepharoplasty vs., 156

external, 157–159

internal, 158–160

technique choice for, 157

B

Beautiful eye, components of, 97–98

evaluation of. See Aesthetic evaluation.

ideal features of, 101–102, 153

Bell phenomenon, in functional vs. aesthetic evaluation, of eyelids, 104, 155

upper eyelid blepharoplasty and, 122

Bicanalicular intubation, in lower eyelid reconstruction, 188–189

Bimatoprost, for periorbital rejuvenation, 146

Bleeding risk. See also Hematoma.

in functional vs. aesthetic evaluation, of eyelids, 102

intraoperative measures for decreasing, 202

preoperative assessment of, 201

Blepharoplasty, complications of. See Surgical complications; specific technique.

for lower lids, 129–138 . See also Lower eyelid blepharoplasty.

for upper lids, 119–127 . See also Upper eyelid blepharoplasty.

main purpose of, 193

traditional techniques for, 119

Blepharoptosis, of upper eyelid, 154

Blink reflex, 184

Bone loss, with cheek and lower lid aging, 130, 132, 140

Botulinum toxin (BoNT), for lower eyelid malposition, 169–170

for periorbital rejuvenation, 115–116, 149–150

formulations and doses of, 150

key tips for, 150–151

Bowman probe, 188

Bridging procedure, 2-stage, for full-thickness defects repair, in upper eyelid, 178, 181

Brimonidine (Alphagan, Allergan), in functional vs. aesthetic evaluation, of eyelids, 103

Brow fat span (BFS), in upper eyelid, 100, 121

Brow ptosis, injectable adjunctive procedures for, 140

Browlift, in periorbital surgery, 110–112

coronal, 112

direct, 111–112

endoscopic, 110–111

mid-forehead, 112

pretrichial/trichophytic, 112

special considerations of, 116

temporal, 111

Buccal branch, of facial nerve, in periorbital surgery, 113

B

Beautiful eye, components of, 97–98

evaluation of. See Aesthetic evaluation.

ideal features of, 101–102, 153

Bell phenomenon, in functional vs. aesthetic evaluation, of eyelids, 104, 155

upper eyelid blepharoplasty and, 122

Bicanalicular intubation, in lower eyelid reconstruction, 188–189

Bimatoprost, for periorbital rejuvenation, 146

Bleeding risk. See also Hematoma.

in functional vs. aesthetic evaluation, of eyelids, 102

intraoperative measures for decreasing, 202

preoperative assessment of, 201

Blepharoplasty, complications of. See Surgical complications; specific technique.

for lower lids, 129–138 . See also Lower eyelid blepharoplasty.

for upper lids, 119–127 . See also Upper eyelid blepharoplasty.

main purpose of, 193

traditional techniques for, 119

Blepharoptosis, of upper eyelid, 154

Blink reflex, 184

Bone loss, with cheek and lower lid aging, 130, 132, 140

Botulinum toxin (BoNT), for lower eyelid malposition, 169–170

for periorbital rejuvenation, 115–116, 149–150

formulations and doses of, 150

key tips for, 150–151

Bowman probe, 188

Bridging procedure, 2-stage, for full-thickness defects repair, in upper eyelid, 178, 181

Brimonidine (Alphagan, Allergan), in functional vs. aesthetic evaluation, of eyelids, 103

Brow fat span (BFS), in upper eyelid, 100, 121

Brow ptosis, injectable adjunctive procedures for, 140

Browlift, in periorbital surgery, 110–112

coronal, 112

direct, 111–112

endoscopic, 110–111

mid-forehead, 112

pretrichial/trichophytic, 112

special considerations of, 116

temporal, 111

Buccal branch, of facial nerve, in periorbital surgery, 113

C

Canalicular probing, in lower eyelid reconstruction, 188–189

Canaliculi, of lower eyelid, 184

Canthal defects, of lower eyelid, reconstruction and, 188–189

of upper eyelid, full-thickness, reconstructive surgery for, 174

Canthal tendons, of lower eyelid, 183–184

reconstructive surgery and, 183–184, 188

Cantholysis, in full-thickness defect repair, of lower eyelid, 185

of upper eyelid, 175–177, 179

Canthoplasty, for involutional ectropion, 198

in lower eyelid malposition, 167–168

for surgical complications, 198

Canthotomy, for cicatricial ectropion, in lower eyelid malposition, 167–169

for surgical complications, 202

in full-thickness defect repair, of lower eyelid, 185–186

of upper eyelid, 175–176, 179

Canthus, lateral. See Lateral canthus.

medial. See Medial canthus.

Capsulopalpebral fascia, in eyelid anatomy, 92–93

in lower eyelid, blepharoplasty and, 132

malposition and, 164–167

Carbon dioxide (CO ₂ ) laser, for periorbital resurfacing, 148

fractional, 149

Cataracts, in functional vs. aesthetic evaluation of eyelids, 102–103

Cheek, eyelid transition to, 101, 108

in periorbital surgery, 112–113

Cheek flap, Mustarde, in lower eyelid reconstruction, 185, 189

Chemical peels, for periorbital resurfacing, 146–147

Chemosis, as surgical complication, 200

Cicatricial ectropion, as surgical complication, 190, 198

lower eyelid malposition related to, 167–169

Cicatricial entropion, lower eyelid malposition related to, 169–170

Clinical history. See History taking.

Collagen formation, laser resurfacing impact on, 148–149

Complications, in eyelid surgery, 193–203 . See also Surgical complications.

Conjoint tendon, in periorbital surgery, 110–111

Conjunctiva, in eyelid anatomy, 183

in full-thickness defect repair, of upper eyelid, 178–179

Conjunctival flap, in full-thickness defect repair, of lower eyelid, 186

of upper eyelid, 178, 181

Conjunctivodacryocystorhinostomy (CDCR), in lower eyelid reconstruction, 184, 188

Contact lens, in functional vs. aesthetic evaluation of eyelids, 103

Contour correction, lateral suspension and, in lower eyelid blepharoplasty, 134–135

with upper eyelid ptosis repair, 157–159

Contour deformity, brow fillers for, 140

with upper eyelid blepharoptosis, 154, 157–158

Coronal browlift, in periorbital surgery, 112

Corrugator supercilii muscle, in eyebrow region, 109, 111

upper eyelid blepharoplasty and, 119–120

Crease, eyelid. See Eyelid crease.

nasojugal. See Nasojugal crease/fold/groove.

Cross-sectional anatomy, of eyelids, 89–90, 120, 154

Cutler-Beard procedure, for full-thickness defects repair, in upper eyelid, 178, 181

D

Deep galea plane (DG), in periorbital surgery, 111

Dehiscence, involution with, of levator aponeurosis in upper eyelid, 153–155

wound, post-upper eyelid blepharoplasty, 126

Depressor supercilii muscle, in eyebrow region, 109

Dermabrasion, mechanical, for periorbital resurfacing, 147–148

Dermatochalasis, lower eyelid blepharoplasty and, 134, 136

upper eyelid blepharoplasty and, 122

Diplopia, as surgical complication, 200

Direct browlift, in periorbital surgery, 111–112

Direct closure, of full-thickness defects, in lower eyelid, 185

in upper eyelid, 175, 179

Distraction test, preoperative, for eyelid surgery, 195

Donor sites, of skin flaps/grafts, for anterior lamellae defects repair, in upper eyelid, 174–175, 179

for full-thickness defects repair, in lower eyelid, 184, 186, 189

in upper eyelid, 179, 181

Dry eye syndrome (DES), as surgical complication, 199

in functional vs. aesthetic evaluation of eyelids, 103

upper eyelid asymmetry and ptosis and, 155

upper eyelid blepharoplasty and, 122, 126

injectable adjunctive procedures for, 141–142

lower eyelid malposition and, 164

preoperative evaluation of, 194–195

E

Ectropion, as surgical complication, 190, 198

definition of, 167, 198

injectable adjunctive procedures for, 141–143

lower eyelid malposition related to, 167–168

cicatricial, 167–169

involutional, 167–168

mechanical, 168

paralytic, 168

Endoscopic browlift, in periorbital surgery, 110–111

Entropion, definition of, 168

lower eyelid malposition related to, 168–170

cicatricial, 169–170

involutional, 169

spastic, 170

Epiphora, as surgical complication, 199–200

Erbium:Yttrium-Aluminum-Garnet (Er:YAG) laser, for periorbital resurfacing, 148

Ethnicity, in upper eyelid crease formation, 160

in upper eyelid evaluation, 98–99, 121

Eversion, of eyelid margin, in lower eyelid malposition, 167

of upper eyelid, for ptosis repair, 159–160

Excursion. See Levator excursion.

Extraocular muscles, Herring law of, 156–157

Eye protection, during skin resurfacing, 146

Eye removal, injectable adjunctive procedures following, 141

Eyebrows, functional vs. aesthetic evaluation of, 101–102

upper vs. lower eyelid and, 100–101

in eyelid topography, 90

in periorbital surgery, anatomy of, 108–110

hair of, 109, 119

special considerations of, 109

techniques involving, 110–112. See also Browlift.

in upper eyelid crease asymmetry and ptosis, 154–155

surgical anatomy of, in periorbital surgery, 108–110

in upper eyelid blepharoplasty, 119–120

Eyelashes, in lower eyelid reconstructive surgery, 185

Eyelid crease, asymmetry of, as surgical complication, 197

in upper eyelid, 153–162 . See also Asymmetry of upper eyelid.

upper. See Upper eyelid crease.

Eyelid height, upper, functional vs. aesthetic evaluation of, 99–100

with crease asymmetry and ptosis, 153–155, 157, 161

Eyelid laxity, in functional vs. aesthetic evaluation of eyelids, 101

in lower eyelid, as surgical complication, 198

blepharoplasty and, 135–137

horizontal, assessment of, 164, 167

ectropion related to, 167–168

entropion related to, 168–169

in upper eyelid, horizontal, reconstructive surgery and, 174–175, 179

Eyelid length, lower, aging impact on, 130

upper, in reconstructive surgery, 174–175

Eyelid margin, in full-thickness lower eyelid defects, reconstructive surgery for, 184–185

in full-thickness upper eyelid defects, 174

reconstructive surgery for, 174–178, 181

in lower eyelid malposition, eversion of, 167

inward rotation of, 168

Eyelid position/malposition, in functional vs. aesthetic evaluation of eyelids, 101

injectable adjunctive procedures for, 141–142

of lower lid, 163–171 . See also Lower eyelid malposition.

post-blepharoplasty, lower eyelid, 135–136

upper eyelid, 126

Eyelid ptosis, as surgical complication, 198–199

in periorbital surgery, 108

of lower eyelid, blepharoplasty and, 130

of upper eyelid, blepharoplasty and, 122–126

correction of, 153–162 . See also Ptosis of upper eyelid.

Eyelid retraction, lower. See Lower eyelid retraction.

upper, 153–154

Eyelids, aesthetic evaluation of, 97–106 . See also Aesthetic evaluation.

cross-sectional anatomy of, 89–90, 120, 154

functional anatomy of, 183–184

functional evaluation of, 97–106 . See also Functional evaluation.

in periorbital surgery, 107–117 . See also Periorbital surgery.

lower. See Lower eyelid.

surgical anatomy of, 89–95 . See also Surgical anatomy.

surgical complications in, 193–203 . See also Surgical complications.

surgical reconstruction of, general principles of, 184

lower, 183–191 . See also Lower eyelid reconstruction.

upper, 173–182 . See also Upper eyelid reconstruction.

surgical rejuvenation of, lower, 129–138 . See also Lower eyelid blepharoplasty.

upper, 119–127 . See also Upper eyelid blepharoplasty.

topography of, 89–90, 101

transition to cheek, 101, 108

in periorbital surgery, 112–113

upper. See Upper eyelid.

F

Facial nerve, branches of, in lower eyelid, 184

in periorbital surgery, 110–111, 113

Facial paralysis, ectropion related, in lower eyelid malposition, 168

Facial thirds, in periorbital surgery, multimodality aspects of, 116

preoperative assessment of, 108–109

Fat, in cheek and lower lid, 130–131, 133

in eyelids, 90–91, 93, 154

in forehead and eyebrows, 110

in midface, 113

Fat compartments, in eyelid anatomy, 93, 120–121. See also Orbital fat.

upper eyelid blepharoplasty and, 120–125

Fat grafts/transplant, autologous, in lower eyelid blepharoplasty, 136

in midface rejuvenation, 113–114

for periorbital rejuvenation, 151

Fat pads. See also specific anatomical location.

in lower eyelid, 91

aging impact on, 130–131, 133

caution with blepharoplasty, 131, 133

lift with blepharoplasty, 134–136

in midface, 113

in upper eyelid, 120–121, 124

Fat span, brow, in upper eyelid, 100, 121

Festoons, lower eyelid blepharoplasty and, 137

Fillers, nonautologous injectable, for cosmesis and function, 139–144 . See also Hyaluronic acid (HA) fillers.

for periorbital rejuvenation, 115–116, 150–152

Flaps. See Skin flaps; specific anatomy or type.

Forehead, functional vs. aesthetic evaluation of, 101–102

in periorbital surgery, anatomy of, 108–110

fascia of, 110–111

special considerations of, 116

techniques involving, 110–112. See also Browlift.

Fractional laser resurfacing, for periorbital rejuvenation, 149

Frontal branch, of facial nerve, in periorbital surgery, 110–111

Frontalis muscle, in eyebrow region, 109–111

upper eyelid, 153–154

blepharoplasty and, 119–120

Full-thickness defects, of lower eyelid, category characteristics of, 184–185

reconstructive surgery for, 185–190

of upper eyelid, reconstructive surgery for, 174–179, 181

canthal, 174

decision schematic for, 180–181

large, 181

moderate, 178–179, 181

small, 174–177, 179

Full-thickness skin graft (FTSG), for anterior lamellae defects repair, in upper eyelid, 174, 179

for cicatricial ectropion, in lower eyelid malposition, 167–169

for full-thickness lower eyelid defects, 184–189

Functional anatomy, of eyelids, 102–104, 183–184

Functional complications, of eyelid surgery, 193–194

Functional evaluation, of eyelids, 97–106

aesthetic evaluation vs., 97–98

anatomy and, 102–104

eyebrow in, 101–102

forehead in, 101–102

lower eyelid in, 100–101

skin in, 98–99

upper eyelid in, 98–100, 153

clinical history in, 102–104

introduction to, 97

key points of, 97

review of symptoms in, 102–104

specific concerns in, 102–104

surgical complications and, 193–194

upper eyelid blepharoplasty and, 121–123