The 23rd Congress of ISAPS was held at the Miyakomesse Conference Center in Kyoto, Japan from October 23 through 27, 2016. More than 1,650 persons from 89 countries participated and the Congress was a great success. On October 23, basic procedures for aesthetic plastic surgery were presented under the title of ISAPS Course for Residents and Fellows.
Dr Mendelson is in private practice at The Centre for Facial Plastic Surgery in MelbourneAustralia. He graduated from Monash University Medical School, Melbourne, and Interned at the Alfred Hospital Melbourne, then became a Demonstrator in Anatomy at Monash University for a year. In 1971 he moved to the USA to train in general surgery and plastic surgery at the Mayo Clinic, Rochester, Minnesota for six years. There followed a fellowship at the Institute of Reconstructive Plastic Surgery in Manhattan, New York under Doctors Converse, Rees, Aston and others. He is certified by the American Board of Surgery and The American Board of Plastic Surgery.
Extended Transconjunctival Lower Eyelid Blepharoplasty with Release of the Tear Trough Ligament and Fat Redistribution
Background: The transconjunctival lower eyelid blepharoplasty is advantageous for its quick recovery and low complication rates. Conventional techniques rely on fat removal to contour the lower eyelid. This article describes the authors’ extended transconjunctival lower eyelid blepharoplasty technique that takes dissection beyond the orbital rim to address aging changes on the midcheek.
Up until very recently it was thought that tightening the skin was the best method for smoothing out those wrinkles and lines that come with ageing. However this is not necessarily the case. Dr Bryan Mendelson, Plastic Surgeon and internationally recognised authority on facial anatomy and ageing, uses a procedure he calls “Bright Eyes”, or Internal Fixation, being lauded as the most natural and lasting technique around today.
Blepharoplasty has helped thousands of patients restore and refresh the eye area to turn back the clock. The Internal Fixation technique is where the skin is brought back to where it was before it started to sag, creating a more distinct fold above the eye. Not stretching or removing any of your actual surface skin, the skin is gently pulled back to its original position due to the anchoring that occurs underneath the skin. Dr Mendelson says, “The longevity of the Internal Fixation procedure is due to it taking effect beneath the skin, and not on it. Any procedure that pulls or removes excess skin in this area (as all areas on the face), will lead to distortion and short term results, as the skin stretches over time, and is not recommended.”
Facial ageing occurs because of the loosening of muscles and tissues beneath the skin in the deeper layers. As Dr Mendelson says, tightening the skin will only be a temporary solution and is often noticeable and appears “forced”.
Natural Looking Results
The Internal Fixation technique is said to give completely natural looking results as the skin does not appear pulled or overstretched. Dr Mendelson clarifies why, “The natural shape of the eye forms the basis for the internal fixation with the result being that the eyes look bright and full of life. There is only one small incision, carefully concealed in the eyelid crease, which is undetectable within four months, even when the eyes are closed.”
Blepharoplasty, or eye surgery, is one of the best procedures for turning back the clock a few years. Eyes are one of the first areas of the face to show ageing. The procedure can offer other benefits such as: