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2001, Number 1

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Cir Plast 2001; 11 (1)

Suborbicular oculi complex fixation transconjunctival approach.

Vallarta RA, Montoya GC, Andrade Dl

Language: Spanish
References: 48
Page: 16-21
PDF size: 799.30 Kb.


ABSTRACT

Time and its results have established the benefits of subperiosteal techniques in facial plastic surgery. One of the most benefited zones is the midfacial region, where the results render more expressive eyes to attenuate the nasogenian rut and to redistribute the volume of the malar region. The technique redistributes the tension vectors of the suborbicular complex, improving the position of the deep and superficial tissues, to avoid the usual complications by hypotonicity and ectropion. The technique consists of transconjuctival access, using two-thirds of the exposed conjunctival zone. Blepharoplasty is carried out by resecting the excess of the fat bags as an alternative. Once it is completed, an incision in the periosteum makes access possible to the orbital zone and the eyebrow remains at approximately 1.8 to 2.1 cm. at the level of the edge of the orbital floor. This will allow the subperiosteous dissection in the conventional way. At the same time abrasion is possible using a 10 to 14 watt powered CO2 laser, with 0.10 millisecond exposition. With this technique we treated 52 patients, with isolated procedure or together with ritidectomy, and a 6 to 19 months follow-up. The infraorbital collapse, the ptosis of the malar bag and the nasogenian depression were all reduced, with improvement of the centrofacial appearance and without relapse. There were temporary complications in six patients. This technique involves no external scars, as well as preservation of the orbicular muscle, optional resection of fat, and physiological redistribution of the suborbicular tissues thus reducing the percentage of existing complications in the management of this deformity. The technique is simple, reproducible and is another step in the midfacial rejuvenation evolution.


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