23 Lateral Canthal Complications in Aesthetic Eyelid Surgery: Prevention and Reconstruction
نویسنده
چکیده
The lateral canthus is an important aesthetic facial landmark. It is formed by fusion of the upper and lower tarsal plates and is supported by muscular and fibrous lateral orbital attachments (▶ Fig. 23.1). The posterior limb of the canthal tendon (lateral palpebral ligament) anchors the tarsi to the internal zygoma at the lateral orbital tubercle (Whitnall’s tubercle) (▶ Fig. 23.2). The comparatively diminutive anterior limb interdigitates with the orbicularis oculi muscle. In addition to supporting the lower eyelid, it limits medial displacement of the tarsi during blinking. Age-related attenuation of the canthal constituents, particularly the tarsoligamentous, imparts laxity to the lower eyelid. Unrecognized or untreated lower lid laxity may contribute to well-recognized deformities after aesthetic eyelid surgery, such as the round-eye syndrome, canthal malposition, and scleral show. Functional consequences may also result if eyelid blink and tear drainage are compromised. An extensive literature describes these multifaceted problems and viewpoints regarding their diagnosis and treatment.1,2,3,4,5,6,7,8 This chapter describes the prevention or reconstruction of these complications.
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