Üst Göz Kapak Blefaroplasti Cerrahi Tekniği ve Komplikayonları
Özet
Üst göz kapağı blefaroplasti (ÜGKP) ameliyatı; cildin işaretlenmesi, lokal anestezi, cilt kesisi, cilt/kas/yağ rezeksiyonu ve sütürasyon aşamalarını içeren, yüksek hasta memnuniyetine sahip estetik ve fonksiyonel bir cerrahi prosedürdür. Ameliyatın ilk ve en kritik basamağı olan cilt işaretlemesinde göz kapak kıvrımı esas alınır; ön lamel hasarını ve ameliyat sonrası gözün açık kalmasını (lagoftalmus) önlemek için kaş alt sınırı ile kirpikli kenar arasında en az 20 mm cilt dokusu bırakılması şarttır. Cerrahi keside bistüri, CO2 lazer veya radyofrekans gibi yöntemler kullanılabilirken, orbiküler kasın korunması ve orbital yağ doku eksizyonunda levator sistemine zarar verilmemesi büyük önem taşır. Prosedür sonrası hastalara ağır kaldırmama, kan sulandırıcı kullanmama, buz uygulama ve güneşten korunma gibi postoperatif tavsiyeler verilir. Dikkatli planlamaya rağmen süreçte yüzeyel veya görmeyi tehdit eden ciddi orbital hematomlar, enfeksiyon, yara açılması, diplopi, kuru göz, lakrimal bez hasarı, pitozis ve belirgin yara izi gibi komplikasyonlar gelişebilir. Başarılı sonuçlar için özenli preoperatif değerlendirme, titiz ölçüm, anatomi bilgisi ve komplikasyonların erken tanı ile hızlı tedavisi gereklidir.
Upper eyelid blepharoplasty (UELB) is an aesthetic and functional surgical procedure with high patient satisfaction, consisting of skin marking, local anesthesia, skin incision, skin/muscle/fat resection, and suturing phases. Skin marking, the first and most critical step, is based on the eyelid crease; to prevent anterior lamellar damage and postoperative lagophthalmos, maintaining at least 20 mm of skin between the lower brow border and the lid margin is mandatory. Scalpel, CO2 laser, or radiofrequency can be utilized for the incision, while preserving the orbicularis muscle and avoiding damage to the levator system during orbital fat resection remain crucial. Postoperatively, patients are advised to avoid heavy lifting and anticoagulants, apply ice, and seek sun protection. Despite careful planning, complications such as superficial or vision-threatening orbital hematomas, infection, wound dehiscence, diplopia, dry eye, lacrimal gland injury, ptosis, and scarring may develop. Achieving successful outcomes necessitates a meticulous preoperative evaluation, precise measurements, thorough anatomical knowledge, and prompt management through early diagnosis of complications.
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