Kỹ thuật này như sau: • Ước tính trọng lượng qui định của cấy ghép có trọng lượng kiểm tra khó khăn để da nắp trên gần với lông mi. Trọng lượng chính xác cho phép đóng cửa hoàn toàn của nắp trên và dưới, nhưng không quá một ptosis nhẹ khi mắt mở. Đặt mô cấy vàng của trọng lượng chính xác. | PLASTIC and ORBITAL SURGERY a Figure a Gold weight placed between the tarsal plate and orbicularis muscle b orbicularis muscle sutured to tarsal plate over the gold weight. Tarsal plate 4 L Orbicularis muscle Tarsal plate -------------- Orbicularis muscle sutured to 1I - tarsal plate b The technique is as follows Estimate the required weight of the implant with test weights stuck to the upper lid skin close to the lashes. The correct weight allows complete closure of the upper and lower lids but no more than a slight ptosis when the eyes are open. Order the gold implant of the correct weight. Make a skin crease incision deepen it to the tarsal plate and dissect inferiorly deep to the orbicularis muscle on the surface of the tarsal plate almost to the lid margin. Suture the gold weight to the tarsal plate close to the lid margin Figure . Close the orbicularis muscle of the inferior wound edge to the tarsal plate with continuous 6 0 or 7 0 absorbable suture. This covers the gold weight implant Figure . Close the skin with continuous 6 0 or 7 0 suture. Prescribe prophylactic systemic antibiotics for five days. Complications - migration or extrusion may occur over several months. Resite the implant if necessary. Direct brow lift Figure The principle is to raise the brow by the excision of an ellipse of skin and frontalis Suture closing deep layers up to dermis L .Goodskin apposition with single subcutaneous suture Figure Deep sutures inserted in direct brow lift. muscle fixing it to the periosium of the forehead. The technique is as follows Mark the ellipse of tissue to be excised mark first the superior border of the brow across its full width. Now manually lift the brow to the intended position note the position and allow the brow to fall again. Mark on the forehead skin the intended position of the superior border of the brow. Aim to over-correct slightly. Complete the marking of the ellipse with curved lines which join at the medial and .
