title: Dynamic analysis of modified transcutaneous lower blepharoplasty based on biochemical and biophysical principles.
abstract: In this study, we analyzed the key parameters of modified transcutaneous lower blepharoplasty based on multidisciplinary principles (biochemical findings and biophysical wrinkling theory). A total of 408 female patients received our subciliary lower blepharoplasty between March 2002 and January 2010. The severity of the eyebags (dynamic wrinkle numbers and prolapse) was evaluated through preoperative and postoperative photography, whereas the excised lower eyelid skin specimens from 56 patients were investigated with hematoxylin and eosin staining. The modified techniques produced significant improvements in the severity of eyebags in all age groups (P < 0.001). Poor surgical outcome was found to correlate significantly with preoperative dynamic wrinkle numbers (P < 0.001). Age, dynamic wrinkle numbers, and prolapse correlated significantly with dermal fiber density (P = 0.004, 0.000, and 0.000, respectively) but not epidermal, rete ridge, and dermal thickness or the number of rete ridges. In conclusion, modified transcutaneous lower blepharoplasty provides significant improvement to dynamic wrinkles and prolapse in the eyebags. Periorbital aging progressively disturbs the dermal compactness (fiber density) until the structure can no longer hold its integrity at the critical age (around the age of 40).
authors: From the *Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University. Department of Family Medicine, Taipei Municipal Wan Fang Hospital; †Division of Plastic Surgery, Department of Surgery, Center for Mathematical Biology, Taipei Medical University Hospital, Taipei Medical University; ‡Department of Anatomy, Taipei Medical University; and §Graduate Institute of Medical Sciences, College of Medicine, Department of Microbiology and Immunology, Taipei Medical University, Taipei, Taiwan.
authors: Chuh-Kai
authors: CK
authors: Liao
authors: Feng-Chou
authors: FC
authors: Tsai
authors: Tsorng-Harn
authors: TH
authors: Fong
authors: Chin-Ju
authors: CJ
authors: Huang
authors: Yi-Chin
authors: YC
authors: Shen
authors: Yuan-Hao
authors: YH
authors: Ku
authors: Ching-Hua
authors: CH
authors: Su
mesh_terms: D000328:Adult; D000368:Aged; D019882:Blepharoplasty / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D015595:Skin Aging / Q000473:pathology / Q000502:physiology*