Periorbital Bony Change with Aging in Saggital CT Analysis; Caucasian Vs East Asian
Lower blepharoplasty is very common procedure for midface rejuvenation. In east Asian, even young people have lower eyelid bulging and discoloration. Is bulging and discoloration in lower eyelid a result of aging process in young East Asian? No. It isn’t. It is a result of under growth of maxilla. Maxilla is 3-dimentional bone and it has width, height and anteroposterior length and undergrowth of anteroposterior direction make small orbit and hypoplastic infraorbital rim which make positive vector between eyeball and maxilla in East Asian. Bryan C. Mendelson published “Age Related Changes of the Orbit and Midcheek and the Implications for Facial Rejuvenation” and the result is that anteroposterior lengths of maxilla is not significantly changed with aging and the angle between anterior maxillary wall and orbital floor was found to have a statistically significant decrease with aging. It means infraorbital region bony change is very small and anterior maxilla region bony change is much in Caucasian.
There are differences between Caucasian face and East Asian face therefore age related bony change could be different. Author analysis CT scan images of East Asian by similar method with Bryan C. Mendelson.
Methods/Technique:
We reviewed 55 patients' charts and facial CT images ranging in age group: group A (21-30 years), and group B (41-50) years, and group C (61-70 years). All patients have no congenital or acquired facial deformity and history of facial trauma. The lengths of the orbital roof and floor(anteroposterior length)and the angle of the anterior wall of the maxilla were recorded on parasagittal images through the midline of the orbit for each patient.
Results/Complications:
The lengths of the orbital roof at their midpoints showed significant differences between group A and group B (p<.01). The lengths of the orbital floor showed significant differences between group A and group B (p<.001). The angle between the anterior maxillary wall and the orbital floor was no significant between group A and B. The lengths between group B and C are no significant differences.
Conclusion:
Our result is quite different with results of Bryan C. Mendelson. Racial data of his research is not described but it could be Caucasian data. Our result can explain race differences with bony aging. For midface rejuvenation, author suggest to fat injection under facial muscle or to insert implant on infraorbtial area for restoring volume loss of bone in East Asian and cheek lift to restore ant maxillary wall resorption in Caucasian.