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      Tratamento da bolsa malar e festoons Translated title: Treatment of malar mounds and festoons

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          Abstract

          RESUMO Introdução: A alteração da região do malar, em muitos casos, é de difícil solução. O envelhecimento traz grande variação de deformidade na região. Neste sentido o objetivo do trabalho foi apresentar que procedimentos cirúrgicos com simplicidade e pouca agressividade têm demonstrado um bom resultado e rápida recuperação. Método: Desenha-se uma figura em forma de canoa ou elíptica margeando a bolsa malar ou da dobra de pele. Em seguida realiza-se a incisão até o plano do subcutâneo. Retira-se a pele e logo após realiza-se a sutura. Resultado: Os pacientes operados pelo método direto evoluíram de maneira convincente e com cicatrizes muito pouco visíveis. Conclusão: é uma maneira direta e que traz resultado bastante favorável e rápida recuperação. A indicação esta relacionada ao bom senso do cirurgião, a idade do paciente e a flacidez existente.

          Translated abstract

          ABSTRACT Introduction: Changes to the malar region are, in many cases, difficult to resolve. The ageing process causes great variation and deformity of this region. Therefore, the aim of this study was to describe a simple and less aggressive surgical procedure that has demonstrated good results and quick recovery. Method: A canoe-shaped or elliptical-shaped line is drawn bordering the malar mound or the skin fold. The skin is incised down to the subcutaneous plane. The excess skin is removed and a suture is then performed immediately. Result: The patients undergoing this direct surgical method showed a favorable postoperative course, and the scars were not very visible. Conclusion: This direct procedure provides a favorable result and quick recovery. Indications depend on surgical judgment, age of the patient, and degree of skin flaccidity.

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          Festoons of orbicularis muscle as a cause of baggy eyelids.

          D W Furnas (1978)
          Occasionally, baggy eyelids are caused by a laxity of the orbicularis oculi muscle. The extent of these orbicularis festoons is evaluated by a careful examination--including the "squinch" and the "pinch" tests. We excise such festoons of excess muscle and then support the orbicularis oculi of the lower lid by using periosteal and muscular sutures. (Orbicularis plication is an alternate procedure for the lower lid). Any muscle festoons of the upper lid are simply excised.
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            Vertical Subperiosteal Mid-face-lift for Treatment of Malar Festoons

            Background Malar mounds may be accentuated by chronic lid edema, with the development from malar edema to malar mounds and finally to malar festoons. Because standard techniques do not seem effective and not specifically proposed for the treatment of malar festoons, subperiosteal vertical upper-midface lift associated with lower blepharoplasty overcomes these shortcomings. Methods Twelve patients (3 males and 9 females, age = 47 ± 6 years) underwent video-assisted endoscopic subperiosteal vertical upper-midface lift (SUM-lift) in conjunction with a lower blepharoplasty between 2006 and 2007 for treatment of malar festoons. This includes simultaneous lower blepharoplasties and video-assisted transtemporal subperiosteal and sub-SMAS tissue release. Results All patients healed uneventfully without any major postoperative problems. The surgical outcome was evaluated according to the analysis of photographs obtained before and after surgery and the analysis of pre- and postoperative measurements. The technique we used (SUM-lift) achieved a significant rejuvenation of the midface and the malar festoons. Conclusion Subperiosteal vertical midface lift resuspends and redrapes the facial network that originates at the level of the orbital rim. It seems to improve the permeability characteristics of the malar septum in the treatment of malar festoons and malar mounds by freeing the cheek tissue from underlying bone and redraping the malar septum. It is a reliable technique to improve malar mounds, palpebral bags, or festoons.
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              Correction of saddlebag deformity of the lower eyelids by superficial suction lipectomy.

              A simple, quick, and safe method for the correction of eyelid saddlebag deformity is presented. Past techniques involved intricate muscle transposition flaps and extensive dissection. Anatomic dissection clearly demonstrates that the saddlebag deformity is caused by an excess of subcutaneous fat in a well-defined space similar to the fat pads of the upper and lower eyelids. This newly described fat pad lies over the preorbital fibers of the orbicularis oculi muscle and at times extends into the malar area. The technique of superficial suction lipectomy for the removal of eyelid saddlebag deformity is simple and done with local anesthesia on an outpatient basis. Results in multiple patients with follow-up ranging from 1 to 7 years are presented.
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                Author and article information

                Journal
                rbcp
                Revista Brasileira de Cirurgia Plástica
                Rev. Bras. Cir. Plást.
                Sociedade Brasileira de Cirurgia Plástica (São Paulo, SP, Brazil )
                1983-5175
                2177-1235
                2014
                : 29
                : 4
                : 486-489
                Affiliations
                [1] orgnameInstituto de Cirurgia Especializada ltda Brasil
                Article
                S1983-51752014000400486 S1983-5175(14)02900400486
                10.5935/2177-1235.2014rbcp0086
                d9157dc8-5af8-4c9e-b82b-114bcf17ffc3

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 01 October 2013
                : 25 January 2015
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 10, Pages: 4
                Product

                SciELO Brazil

                Categories
                Artigo Original

                Eyelid,Blepharoplasty,Festoon,Malar mound,Pálpebra,Blefaroplastia,Bolsa malar

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