eMedicine Specialties > Plastic Surgery > Eyelids

Blepharoplasty, Lower Lid Festoons: Follow-up

Author: Andrew Jacono, MD, Chief, Section of Facial Plastic and Reconstructive Surgery, The North Shore University Hospital at Manhasset; Assistant Professor, Division of Facial Plastic Surgery, The New York Eye and Ear Infirmary, New York Medical College; Assistant Professor, Department of Head and Neck Surgery, Albert Einstein College of Medicine; Director, The New York Center for Facial Plastic and Laser Surgery
Coauthor(s): David W Furnas, MD, Clinical Professor Emeritus, Department of Surgery, Division of Plastic and Reconstructive Surgery, University of California at Irvine
Contributor Information and Disclosures

Updated: Apr 2, 2008

Outcome and Prognosis

Palpebral festoons, malar mounds, and palpebral bags occur in a number of configurations and combinations. The patient's appearance can virtually always be helped by a carefully planned and executed surgical procedure. The countenance of some patients can be dramatically improved.

Future and Controversies

Medicolegal pitfalls

Medicolegal pitfalls are few if the proper procedure is chosen and is performed well at an excellent facility and if the patient is properly prepared and screened. The surgeon's burden is to ensure that the above conditions are met.

Special concerns

The surgeon should never forget that eyelid surgery is orbital surgery and an error in judgment or technique is potentially catastrophic. The photographs of the patient and the diagrams of the proposed operation should be studied again by the surgeon in the operating room, and the photographs should be placed where the surgeon can refer to them during surgery. If the photographs are in view of the anesthesiologist and the surgical staff, extra interest in the conduct of the procedure is generated and additional observers can help judge if the basic orientation is correct.

 


More on Blepharoplasty, Lower Lid Festoons

Overview: Blepharoplasty, Lower Lid Festoons
Treatment: Blepharoplasty, Lower Lid Festoons
Follow-up: Blepharoplasty, Lower Lid Festoons
Multimedia: Blepharoplasty, Lower Lid Festoons
References
[ CLOSE WINDOW ]

References

  1. Muhlbauer W, Holm C. Orbital septorhaphy for the correction of baggy upper and lower eyelids. Aesthetic Plast Surg. Nov-Dec 2000;24(6):418-23. [Medline].

  2. Castanares S. Classification of baggy eyelids deformity. Plast Reconstr Surg. May 1977;59(5):629-33. [Medline].

  3. Pessa JE, Garza JR. The malar septum: The anatomic basis of malar mounds and malar edema. Aesthetic Surg J. 1997;17:11-7.

  4. Furnas DW. Festoons of orbicularis muscle as a cause of baggy eyelids. Plast Reconstr Surg. Apr 1978;61(4):540-6. [Medline].

  5. Aiache A. The suborbicularis oculi fat pad: an anatomic and clinical study. Plast Reconstr Surg. May 2001;107(6):1602-4; discussion 1605-6. [Medline].

  6. Bernardi C, Dura S, Amata PL. Treatment of orbicularis oculi muscle hypertrophy in lower lid blepharoplasty. Aesthetic Plast Surg. Sep-Oct 1998;22(5):349-51. [Medline].

  7. Carraway JH, Mellow CG. Innovations in blepharoptosis surgery. Adv Plast Surg. 1992;8:85.

  8. Carriquiry CE, Seoane OJ, Londinsky M. Orbicularis transposition flap for muscle suspension in lower blepharoplasty. Ann Plast Surg. Aug 2006;57(2):138-41. [Medline].

  9. de la Plaza R, Arroyo JM. A new technique for the treatment of palpebral bags. Plast Reconstr Surg. May 1988;81(5):677-87. [Medline].

  10. Dutton JJ, Waldrop TG. Atlas of Clinical and Surgical Orbital Anatomy. ed. Philadelphia, Pa: WB Saunders; 1994.

  11. Flowers RS. Cosmetic blepharoplasty: State of the art. Adv Plast Reconstr Surg. 1992;8:31-43.

  12. Furnas DW. The orbicularis oculi muscle. Management in blepharoplasty. Clin Plast Surg. Oct 1981;8(4):687-715. [Medline].

  13. Garcia RE, McCollough EG. Transcutaneous lower eyelid blepharoplasty with fat excision: a shift-resisting paradigm. Arch Facial Plast Surg. Nov-Dec 2006;8(6):374-80. [Medline].

  14. Hamra ST, Owsley JQ. Rhytidectomy. Teleplast Video Tape #9122. Arlington Height, Ill: Plastic Surgery Educational Foundation; 1991.

  15. Jelks GW. Correlative anatomy of the eyelid and orbit. Instructional course #501. 25th Annual Meeting of the American Society for Aesthetic Plastic Surgery. Los Angeles, Calif; May 7, 1992.

  16. Jelks GW, Jelks EB. The influence of orbital and eyelid anatomy on the palpebral aperture. Clin Plast Surg. Jan 1991;18(1):183-95. [Medline].

  17. Le Louarn C. The concentric malar lift: malar and lower eyelid rejuvenation. Aesthetic Plast Surg. 2004 Nov-Dec;28(6):359-72. 2004;28:359-372. [Medline].

  18. May JW Jr, Fearon J, Zingarelli P. Retro-orbicularis oculus fat (ROOF) resection in aesthetic blepharoplasty: a 6-year study in 63 patients. Plast Reconstr Surg. Oct 1990;86(4):682-9. [Medline].

  19. Owsley JQ. Lifting the malar fat pad for correction of prominent nasolabial folds. Plast Reconstr Surg. Mar 1993;91(3):463-74; discussion 475-6. [Medline].

  20. Owsley JQ Jr. Resection of the prominent lateral fat pad during upper lid blepharoplasty. Plast Reconstr Surg. Jan 1980;65(1):4-9. [Medline].

  21. Ramirez OM, Fuente del Campo A. Subperiosteal face lift. Instructional course #604. 25th Annual Meeting of the American Society for Aesthetic Plastic Surgery. Los Angeles, Calif. May 7, 1992.

  22. Rees TD. Aesthetic Plastic Surgery. ed. Philadelphia, Pa: WB Saunders; 1981..

  23. Shin YH, Hwang K. Cosmetic lateral canthoplasty. Aesthetic Plast Surg. 2004;28:317-320. [Medline].

  24. Stuzin JM, Baker TJ, Gordon HL. The relationship of the superficial and deep facial fascias: relevance to rhytidectomy and aging. Plast Reconstr Surg. Mar 1992;89(3):441-9; discussion 450-1. [Medline].

  25. Zide BM, Jelks GW. Surgical Anatomy of the Orbit. New York, NY: Raven; 1985..

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

Blepharoplasty, lower lid festoons, eyelid festoons, eyelid surgery, orbicularis muscle, redundant folds, lax skin, malar mounds, palpebral bags, baggy eyelids, eyelid festoons, herniated intraorbital fat, aesthetic deficiency of the eyelids, aesthetic eyelid deficiency, malar mounds, malar festoons, malar bags, eye tuck, eyelid tuck

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Andrew Jacono, MD, Chief, Section of Facial Plastic and Reconstructive Surgery, The North Shore University Hospital at Manhasset; Assistant Professor, Division of Facial Plastic Surgery, The New York Eye and Ear Infirmary, New York Medical College; Assistant Professor, Department of Head and Neck Surgery, Albert Einstein College of Medicine; Director, The New York Center for Facial Plastic and Laser Surgery
Andrew Jacono, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, and American Medical Association
Disclosure: Nothing to disclose.

Coauthor(s)

David W Furnas, MD, Clinical Professor Emeritus, Department of Surgery, Division of Plastic and Reconstructive Surgery, University of California at Irvine
David W Furnas, MD is a member of the following medical societies: Alpha Omega Alpha, American Association of Plastic Surgeons, American Cleft Palate/Craniofacial Association, American College of Surgeons, American Head and Neck Society, American Medical Association, American Society for Aesthetic Plastic Surgery, American Society for Surgery of the Hand, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, American Society of Transplantation, California Medical Association, Phi Beta Kappa, Plastic Surgery Research Council, Royal College of Physicians and Surgeons of Canada, Royal Society of Medicine, and Society of University Surgeons
Disclosure: Nothing to disclose.

Medical Editor

Neal R Reisman, MD, JD, Associate Chief, Department of Plastic Surgery, Clinical Associate Professor, St Luke's Episcopal Hospital, Baylor College of Medicine
Neal R Reisman, MD, JD is a member of the following medical societies: American Association of Plastic Surgeons, American College of Medical Quality, American College of Surgeons, American Society for Aesthetic Plastic Surgery, American Society for Surgery of the Hand, Lipoplasty Society of North America, Texas Medical Association, and Texas Society of Plastic Surgeons
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Jorge I de la Torre, MD, FACS, Professor of Surgery and Physical Medicine and Rehabilitation, Residency Program Director, Division of Plastic Surgery, University of Alabama at Birmingham; Director, Center for Advanced Surgical Aesthetics
Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Association of Plastic Surgeons, American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society for Reconstructive Microsurgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Association for Academic Surgery, and Medical Association of the State of Alabama
Disclosure: Nothing to disclose.

CME Editor

Nicolas (Nick) G Slenkovich, MD, Practice Director, Colorado Plastic Surgery Center at Swedish Medical Center
Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, American Society of Plastic Surgeons, and Colorado Medical Society
Disclosure: Nothing to disclose.

Chief Editor

Lars M Vistnes, MD, FRCSC, FACS, Professor of Surgery, Emeritus, Stanford University Medical Center
Lars M Vistnes, MD, FRCSC, FACS is a member of the following medical societies: Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.