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Objective: To investigate the prefabricated to dilator fibrous capsule implanted in the body to form as lining advancement flap repair complete upper eyelid defect feasibility. Background: Complete upper eyelid defect is relatively rare in clinical problem mainly seen in the tumor resection, trauma, and congenital malformations. Reconstruction complete upper eyelid defects include two basic levels: outer flexible skin and conjunctiva of the inner layer of smooth. I observed to the skin and soft tissue expander implanted in the body to form the fibrous capsule, synovial-like appearance smooth, moist, and normal conjunctiva similar. So design advancement flap reconstruction experimental animal rabbit prefabricated fibrous capsule lined a fully upper eyelid defect. Methods: 31 New Zealand white rabbits were implanted in the frontal subcutaneous 10ml round dilator, the continued expansion of 6-8 weeks. The application of the forehead to promote the formation of the flap (with expander implant fibrous capsule) rectangular defect repair of full-thickness upper eyelid. Observe the fibrous capsule as the eyelid lining the outcome: three days, one week, two weeks, one month, two months, four specimens were taken for histological detection. Advancement flap repair rabbit complete upper eyelid defect 2 months later, we have chosen to change from the inner canthus point to the outer canthus point palpebral length, as a one-dimensional parameter reflecting flap contracture. Results: Gross observation after 2 months: the horizontal distance of the eye fissure shorten the bulbar conjunctiva and corneal damage, as the lining of the fibrous capsule surface moist, smooth, slightly white color than normal conjunctiva. Histological detection visible, advancing flap after 1 week of coating layer inflammatory cell infiltration; 1 month after the formation of single-layer flat like epithelial; 2 months after the fibrous capsule into columnar epithelium and goblet cells can be found close to normal conjunctiva layer. The average length of the retraction of the upper eyelid margin rate is not obvious to 10.9 ± 6.7%. Conclusion: The dilator envelope lining advancement flap reconstruction experiment animal rabbit large area of ??the upper eyelid defect is feasible, and the reconstruction of the eyelid exhibits satisfactory flap color and thickness. Fibrous capsule as conjunctiva substitute for a large area of ??full-thickness eyelid defects repair cell reconstitution platform, anti-infective barrier. Objective: To investigate a orbicularis muscle suspension for lower eyelid bags resection, supported by completely loosen orbicularis muscle ligaments, so attached to the periosteum of the orbital rim, loose skin, subcutaneous tissue are fully released and reached under improved surgical techniques the eyelid tissue orbitozygomatic, the organization as a whole to mention tight effect. Methods: 409 cases with more obvious groove deformity patients, lower eyelid bags resection process line orbicularis muscle suspension method increases the orbicularis muscle to support ligament transection orbicularis muscle support ligament stump The mention with orbital fascia fixed means of enhancing the orbicularis muscle suspension for lower eyelid bags resection. Results: 2006 began to apply this treatment lower eyelid bags total of 409 cases, female 391 cases, 18 males, aged 31-75 years old, were followed up for 1-3 years. Mild in 16 patients with lower eyelid skin and orbicularis muscle relaxation completely calm, good appearance. Moderate 354 cases, 352 cases of lower eyelid skin and orbicularis muscle relaxation completely improve, good appearance, two cases of skin still mild relaxation, but has improved remarkably compared with preoperative. Severe 39 cases, 36 cases of lower eyelid skin and orbicularis muscle relaxation completely improved, 3 patients still had mild skin relaxation and orbital fat prolapse, but improved significantly compared with the preoperative. 390 cases of trench deformity after surgery significantly improved, and no case of increase, the more serious of the three cases of bags under the eyes, to feel lower eyelid has not been completely removed within six months, 5 patients underwent a second surgery. About 1/6 patients with early the outer canthus palpable and elimination of a small the induration (line junction), 1-2 months or so. The postoperative generally common the outer canthus involved there with eyes closed sense, to ease within a few days. Postoperative lower eyelid flat area of ??skin, nose and cheek sulcus and orbital buccal groove disappear. All surgical results were satisfactory, and no case of post-operative complications such as ectropion and deformity. Conclusion: this improved lower eyelid bags resection, loosen the skin of the orbital zygomatic, there is conducive to the resumption of the eyelid-cheek the formation of the complex natural especially effective to solve the trench malformations. This method is simple, safe, and can be a good choice as the lower eyelid bags rejuvenation surgery.
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