Wen-Her Wang(王文禾)

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  • The important concept of gliding Factor for Upper Blepharoplasty: technique and painful experience

    In the society of oriental people, upper blepharoplasty is the most common aesthetic procedure. Due to the dynamic character of eyelid movement, upper blepharoplasty is not a easy procedure. Complicated factors such as the muscle traction power, soft tissue condition and the quality of upper eyelid skin were involved. Comprehensively understanding the whole process of eye-opeining movement is very important. If the eye-opening movement was not smooth, triple fold or extra-adhesive fold would be noted. And patient would not be satisfied. As we presented in previous speech, we introduced three factors trying to explained the mechanism of supratarsal fold formation and the relationship between the factors and position of supratarsal fold. They are adhesion factor, traction factor and gliding factor. They would work together to contribute the supratarsal crease and determine the height of supratarsal fold. Among these factors, gliding factor is the most important one. A smooth eye-opening process occurs only when the gliding zone is intact. If the gliding zone is damaged, multiple supratarsal creases, mechanical ptosis or unexpected position of supratarsal fold will happen. Besides, Delboeuf illusion effect also plays a important role in the appearance of orbital area. A suitable position of supratarsal fold would make our eyes seem larger, but in a case of high supratarsal fold, the eyes would look like smaller. This effect also explained the difference in the orbital appearance between oriental and Caucasian people, especially in the cases with sunken upper eyelid. Therefore, In the upper eyelid surgery, we should make every effort in the restoration of the gliding zone and avoid any scarring or adhesion in upper eyelid. In this presentation, we will show some painful experiences in the case who is devoid of gliding factor after surgery and how we do to rebuild the gliding zone in the revision surgery.
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