Eyelids blepharoplasties

If surgical blepharoplasty is not combined with a facelift, Lip Eyelid formula can be applied on the eyelids at the same time as the face-lift. 

On the eyelids, however, the fat hernia around the orbit was removed through the transconjunctival approach and combined - in expert hands - successfully and safely with a local phenol peel. McCollough and Maloney combined surgical blepharoplasty with a phenol peel, but left the skin to rest for 3 months before doing the eyelid peel. 

Typical abnormalities of the upper eyelid after several surgical blepharoplasties. 

Occlusion of the upper eyelid, which is only indicated to increase the depth of action of the peel, will always be essentially extratarsal (Figure 36.6). In the large majority of cases, a chemical blepharoplasty is done without occlusion. 

Application of bismuth to all four eyelids chemical blepharoplasty and evening-out peel (Unideep ). The Unideep post-peel cream is applied to the face immediately after the peel, the evening of the peel and the following morning. This photograph was taken on day 1. 

Normal edema over the first 2 days that has spread to the cheek area, (a) Chemical blepharoplasty of the four eyelids, (b) Chemical blepharoplasty of the upper eyelid only, (c) Chemical blepharoplasty of the lower eyelids only. 

Examples of the results of chemical blepharoplasty. (a,b) Chemical blepharoplasty of the upper eyelids and Easy TCA as an evening-out peel. (c,d) Chemical blepharoplasty of the lower lids and Easy TCA as an evening-out peel. 

When a chemical blepharoplasty is performed without occlusion, the increased depth of action of the phenol sometimes translates into a persistent moist scab in the inside corner of the upper eyelid (Figure 36.16), where the phenol has macerated more intensely. Applying an antibiotic cream or ointment remedies the problem, and it should resolve before the 15th day. There are no sequelae from this slow healing. If the scab persists for more than 2 weeks, the doctor should remain alert and monitor the patient more closely. 

Chemical blepharoplasty of the upper and/or lower eyelids with Lip Eyelid formula is a relatively simple technique... 

A chemical cheiloplasty or labioplasty treats wrinkles around the lips. The principle of the treatment is identical to that of a chemical blepharoplasty, but it is easier to treat wrinkles on the upper lip than on the eyelids. It is also less stressful for an inexperienced doctor. 

Cryoanesthesia with a cold pack during combined chemical blepharoplasty (Lip Eyelid ) and TCA to the papillary dermis... 

Chemical blepharoplasty and cheiloplasty are ideally carried out with Lip Eyelid formula its action is more gradual than that of Baker-Gordon or Litton phenol, and it can be applied locally without any anesthetic since the pain only lasts 12-15 seconds. 

Chemical blepharoplasty is treatment of the eyelids with a localized deep peel. Chemical cheUoplasty is treatment of the lips with a localized deep peel (see Chapter 36). 

The high risk of focal or widespread facial necrosis contraindicates a phenol peel immediately after a face-lift. If a face-lift and a deep peel have to be combined, the surgical face-lift must be done first and the chemical peel afterwards to avoid the demarcation line being surgically lifted to the cheek. Caution usually dictates a gap of 6 months between a surgical face-lift and a deep peel. It is of course possible to perform a face-lift without blepharoplasty and a phenol peel around the mouth and eyelids at the same time... 

Deep peeling can be performed on the eyelids to improve periorbital pigmentation or wrinkling or as an adjunct procedure to surgical blepharoplasty [18]. 

Gatti JE (2008) Eyelid phenol peel an important adjunct to blepharoplasty. Ann Plast Surg 60 14-18... 

Periocular skin is particularly delicate and prone to ectropion. After discussing what ectropion is, 1 discuss the risk factors for its occurrence. These include blepharoplasties and previous resurfacing procedures. 1 perform a simple snap test to determine the elasticity of the lower eyelids in patients who wish to reduce the wrinkling in that area. Lower eyelids which quickly return to the normal position after being pulled down may tolerate straight phenol without forming an ectropion. Patients whose eyelids very slowly return to full apposition should not receive phenolic peels of any kind on the lower lids. Loss of elasticity in the lower lid is common following blepharoplasty and in elderly patients. 

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