眼睑年轻化的重要考虑

Plastic surgery procedures aimed to improve the appearance of the eyes are some of the most sought after aesthetic rejuvenation treatments. 仅去年一年，就有20多万女性和男性接受了手术 眼睑提升手术或者眼睑成形术 执照整形外科医生.

Pre-operative assessment of blepharoplasty patients requires a meticulous evaluation of their anatomy and ophthalmologic examination, 也会引发眼部问题，比如干眼症.

想要进行眼睑年轻化手术的患者通常会有以下一种或多种症状:

• 看起来很累或疲惫
• 重,下垂的盖子
• 眼袋或浮肿
• 过度，起皱，起皱的皮肤

这些问题大多可以通过上睑和/或下睑提睑手术成功矫正. 这些手术的重点是改善眼睑的三个主要组织成分:皮肤, 肌肉和脂肪. 当确定改善眶周的最佳方法时, there are additional physical characteristics to be assessed in order to formulate the most appropriate treatment plan. Here are some important factors that come into play and that plastic surgeons and patients need to consider prior to any aesthetic surgery around the eyes.

上眼睑下垂:是上睑下垂的表现?

大多数抱怨上眼睑外观的病人会注意到他们的眼睑很重, 悬挂上盖子, 或者LIDS的头巾. 上眼睑提升, 叫做上睑成形术, 包括去除多余的皮肤和肌肉，以及从肌肉深处凸出的脂肪. 手术立即产生改善眼睑轮廓的效果, 一个更开放的眼神和整体上更休息或精神焕发的外观. Determining the exact amount of soft tissues to be resected requires precise and detailed pre-operative evaluation, and differences between the ideal result men and women seek should also be taken into account so as not to remove too much tissue.

在某些情况下，上眼睑过度覆盖眼睛, 视力可能会受到影响，部分视野被下垂的眼睑遮挡. 医学术语上睑下垂描述的是由于眼睑肌肉功能不佳而导致的上睑下垂, 它可能是先天性的，也可能是由多种不同的条件造成的, 包括肌肉因年龄或暂时性衰弱而发生的变化 注射肉毒杆菌.

The function of the specialized muscles that lift the upper eyelid should be assessed prior to eyelid surgery in order to determine if it is functioning properly. 这是至关重要的，以确定是否需要任何程序来纠正上睑下垂，以确保最佳的结果. 上睑下垂修复术可与眼睑美容手术同时进行. 在一些病人, a brow lift may be indicated in addition to the eyelid lift if the soft tissues of the forehead have become lax and contribute to upper eyelid droopiness.

下眼睑皮肤:手术或非侵入性治疗?

The most common aspects of the lower eyelids that patients would like to improve upon involve excess skin and undereye bags. 下眼睑皮肤极其薄而敏感, 随着年龄的增长,, 它变得更薄, 与皱纹, 像绉纸一样的外观和隆起的脂肪. The most significant and only permanent improvement in the appearance of the lower lid is usually achieved with a lower eyelid lift or lower blepharoplasty. 这个手术包括直接切除多余的皮肤, 有或没有部分肌肉层, 去除或重新定位深层脂肪.

另一种选择是只进行皮肤捏, 哪一种方法适用于冗余较少的患者，使下眼睑轮廓更平滑. 除了外科手术, 越来越多的非侵入性治疗旨在改善下眼睑皮肤的外观. 可以提供一定程度皮肤紧致的非手术选择包括微针, 化学换肤和使用射频或超声波紧致松弛肌肤的技术:

• 微针疗法包括一个叫做胶原诱导疗法的过程.I.T.), 哪种能刺激新的胶原蛋白和弹性蛋白的产生，让皮肤更光滑, 更严格的, 年轻的皮肤.
• 化学换肤 with different formulations of botanical or natural acids can also stimulate skin rejuvenation with fewer wrinkles and smoother texture.
• 激光治疗 使用热刺激皮肤循环和收缩，使皮肤更光滑.
• 类似的, newer technologies such as radiofrequency and ultrasound can produce temporary skin contraction and smoother skin.

下眼睑松弛:是否需要做眦固定术/眦成形术?

任何下眼睑的年轻化过程都必须针对每个病人, and both potential benefits and inherent limitations of treatment options should be reconciled to ensure optimal results. Addressing skin laxity and redundancy requires either skin tightening by noninvasive treatment such as microneedling, 化学去皮、激光去皮或外科手术去除多余的皮肤.

One of the most important factors to be considered prior to proceeding with either surgery or nonsurgical treatment is to properly address lower eyelid tone and to determine if the lower lid is strong enough to keep its natural shape following any intervention.

眼睑松弛的病人, 任何对眼睑的手术都可能导致眼睑收缩或脱离正常位置, 导致眼睑变形. 为了防止这种情况的发生, 患者可能需要进行额外的眼睑加固或稳定手术, 比如眦固定术或眦成形术, 同时进行眼睑成形术，以保持眼睛的自然外观.

Careful and precise pre-operative assessment is key in deciding which patients are candidates for these procedures, 以及避免潜在的并发症.

泪槽矫正:增加容量，皮肤表面修复或两者兼备?

眼睑美学的一个基本的必然结果是泪槽区域, 下眼睑和脸颊交界处的凹陷是什么. The tear trough may become more prominent with age as the soft tissues of the face lose volume and gravity causes them to pull downwards. 这导致了眼睑下方明显的拱形，会让眼睛下面出现黑眼圈, 看起来又累又老.

Any plan to rejuvenate the eyes should take into account the area of the tear trough and determine the best way to improve it. 泪液槽的两个组成部分，可以改善的是体积的损失和薄，起皱的皮肤. 泪槽可以被以下两种方法所掩盖:

• 将下眼睑内的脂肪重新定位在骨性边缘上
• 添加卷到该区域 脂肪注射 (脂肪移植或脂肪转移)或 填料 (e.g. 透明质酸填充物，如Juvederm)

此外，可以通过以下方法使皮肤看起来更年轻、更厚、更紧致:

• 皮肤表面重修 上述措施，如微针或无创射频和超声方法
• Platelet Rich Plasma (PRP) injections that are rich in growth factors which can also stimulate skin rejuvenation overlying the tear trough, 可与微针联合使用或单独使用

The best solution for correcting a prominent tear trough may require a combination of procedures or several treatments to provide optimal results.

球体位置:眼睛有多突出?

Another important part of the pre-operative evaluation for an eyelid lift is noting the patient's eye position relative to the bony orbit. 一些病人可能会出现突出的、突起的眼球，也称为突发性眼球. 这可能是由于潜在的医疗条件, 最明显的是甲状腺机能亢进, 或者只是病人正常的外表和熟悉的特征. Medical problems should be worked up and corrected and patients optimized for surgery prior to undergoing eyelid lift or any other cosmetic procedure.

此外, 在自然眼位置较突出的患者, surgical technique may require adjustment and patients should be advised pre-operatively about what results can be expected due to modifications in technique. 和所有的美容手术一样, the plastic surgeon and patient should have a comprehensive discussion prior to surgery to address expectations and what results may be reasonably be achieved.

上下眼睑的整形手术可以立即见效, 持久且显著的效果. 尽管这些看起来很简单, 直接的审美过程, the area around the eyes is extremely delicate and should be fully evaluated prior to any treatment in order to include all appropriate techniques and interventions in the rejuvenation plan.

当经验丰富的人正确地执行时， 执照整形外科医生, 在确保所有相关细节都得到恰当处理的同时, 眼睑年轻化程序产生了杰出的结果和极高的病人满意度.