medial canthal webbing after blepharoplasty

fontecchio March 14, 2022 after , medial , webbing Comment

Unrecognized or untreated lower lid laxity may contribute to well-recognized deformities after aesthetic eyelid surgery such as the round-eye syndrome canthal malposition and scleral show. The best way to handle it is to do a push-pull massage of the surgical area.

Medial Canthal Webbing Seen After Upper Lid Blepharoplasy Done By A Download Scientific Diagram

Persistent cases are treated by a V- to-Y plasty procedure.

. If it persists then revision by Y-Vtype incisions is warranted. Although it appears that you have subtle webbing this appearance may be quite different after complete healing. If a line is drawn between medial and lateral canthi it will show an upward inclination to the lateral side.

Post-blepahroplasty webbing can be seen when upper and lower blepharoplasty is performed together and the lateral skin incisions of the procedures are in close proximity less than 5 mm apart. The lateral upturning line if marked correctly will induce an upward lift of the lateral canthal area and the medial one will help in avoiding medial incision webbing of the epicanthal folds which is very annoying for the patient Fig. Canthal webbing occurs when incisions are car- ried too medially as seen in Figure 9.

The cosmetic result was highly satisfactory in all cases. Seven 88 of the patients had lateral canthal webs after surgery and 1 12 patient had a medial canthal web after a motor vehicle accident. Results The transposition flap corrected the lateral canthal web improving the patients symptoms and the appearance of the eyelids.

The skin and orbicularis oculi muscle form the anterior layers of the upper eyelid. They are surgically corrected by a variety of micro-skin flaps. Postoperative canthal webbing is aesthetically displeasing and may be noticed by the patient andor surgeon.

May be due to incision extended too far medially. Early recognition and aggressive massage will eliminate the majority of cases. Canthal webbing Fireskin burnsinged lashes.

Canthal webbing can be associated with scleral show laterally due to inferior lid retraction and is a known complication of blepharoplasty or reconstruction following trauma or tumour excision. Do it at least 3 times a day with 3 repeatitions and 20-30 seconds hold in each more Sorry about your problem. An effective preventive measure is to taper the nasal incision markings superiorly and to avoid extending the marking medially to the punctum.

Determine the position of the lower eyelid and lateral canthus after release of the lower lid retractors with the inside-out technique by measuring the MR2 and use of the lateral canthal rounding scale. The skin then bridges the superomedial hollow of the upper lid in a straight line. Previous article Next article.

And blepharoplasty represent the commonest iatrogenic causes of medial canthal webbing. Ad When it comes to blepharoplasty or surgery of the eyelids there are certain things that. If a medial canthal web does result time massage and steroid injections can help.

Prevent by planning an incision that extends to the medial commissure. The skin then bridges the superomedial hollow of the upper lid in a straight line. At this point after surgery it is normal to have thickening and redness of the incision line.

Gravitational forces acting upon excessive eyelid skin and prolapsed orbital fat may distort the lower eyelid. May be due to inadvertent trauma to the levator complex including postsurgical edema and dehiscence. A thorough understanding of the upper eyelid anatomy is essential when evaluating patients for possible upper blepharoplasty.

Medial canthal web after upper blepharoplasty. This is called positive canthal tilt. Download high-res image 98KB Download.

No matter how meticulous the surgical technique bleeding is inevitable with skin incisions and bruising should be expected following surgery. 78 of the 171 patients with the inside out blepharoplasty had follow up of 3 months. Everyone has seen their eyes be tired and puffy but some people have to live with that.

Canthal webs occur because there is a relative deficiency of skin in the vertical as compared to the horizontal plane. The rhomboid flap is an effective quick and simple technique for medial canthal reconstruction. A vertical lengthening procedure can correct the lateral canthal web.

Aggressive excision of medial eyelid skin including some nasal skin spectacle deformation of the medial canthus and a preexisting tarsal fold increase the risk of web formation. Medial canthal webbing Attention to a few important surgical guidelines regarding medial upper eyelid wound closure will help prevent webbing in the medial canthus. Medial canthal webbing can be revised with a Z-plasty.

Suture is passed through the lateral canthal tendon and suspended superiorly up through an upper eyelid blepharoplasty incision. Webbing 3 weeks after blepharoplasty. In most patients the lateral canthal angle is positioned at 2 mm superior to the medial canthal angle.

Conclusions A lateral canthal web may form as a consequence of vertical tissue insufficiency after blepharoplasty. May be corrected by Zplasty Wplasty transposition flaps or YV advancement procedures. Anatomy of the upper eyelid.

In some cases early recognition and aggressive massage can result in better aesthetic results by improving. The connection of the upturning lines of the incision laterally and medially is very important. Excessive skin resection from the eyelid can retract the lower lid.

Less Sorry about your problem. 46 73 Reported complications and reoperation in the literature are generally low 6 8 9 11-13 59 68 69 but probably do not reflect common practice as they are often published in series of experienced surgeons. Abstract Secondary lateral canthal webs may occur after trauma or blepharoplasty.

I recommend Z-plasty repair of the medial canthal webbing. It provides excellent cosmesis and is associated with minimal complications. A negative canthal tilt is present when the medial canthus is superior to the lateral canthus.

Every patient voiced aesthetic concerns with the web and 4 57 of the 7 patients with lateral canthal webs. Cicatricial forces can produce an ectropion after prior surgical dissection. December 11 2018 Answer.

Two cases had minor webbing of the medial upper lid. Most plastic surgeons avoid addressing canthal webs as they are difficult to. The scars usually occur when the incisions are carried too medially and the skin bridges the supero-medial hollow of the upper lid in a straight line.

Involutional or senile ectropion is due to laxity of the lateral and medial canthal tendons. Bleeding is especially inevitable in blepharoplasty because the eyelid has a rich vascular supply. There were no major complications or re-operations.

Medial canthal webbing occurs when incisions are carried too medially as seen in Figure 9. The most devastating complication after blepharoplasty is blindness that can occur as a result of globe injury retrobulbar hematoma andor fat grafting. Age-related attenuation of the canthal constituents particularly the tarsoligamentous imparts laxity to the lower eyelid.

Deep to these layers is the orbital septum which originates from the arcus marginalis at the superior. Massage and steroid injections can help. Periosteal flap Leone Am J Ophthalmol 1992 After exposure of the lateral orbital rim a tongue of periosteum is incised in.

Revisional Eyelid Surgery Fixing The Canthus Dr Guy Massry