Special Section Introduction
Over the last few years, certain anatomic structures have gleaned renewed attention. They have, in my opinion, been properly discussed, and yet, the presentations of the anatomy could be clarified. Thus, each key structure will be shown in greater depth here.
7a Inferior Oblique Muscle—Its course and cautions are presented.
7b Lower Lid Retractors—The upswing in fat-sparing lower lid blepharoplasty has focused on two methods:
Fat release via septal incision with redraping of fat over the rim.
Fat retention via solid repair—i.e., suturing the lower lid retractors to the arcus marginalis at the orbital rim. In this mode, the fat is retained inside the rim while a “neo-septum” is made.
LOCKWOOD’S AND WHITNALL’S LIGAMENTS
7c Suspensory Ligaments—The lower Lockwood’s ligament is shown again for review. However, recent anatomic findings regarding Whitnall’s suspensory ligament, which depict it as a “sleeve” rather than a curtain for the levator, will increase understanding.
7d The Orbital Floor—More aggressive floor exposures for replacements with plates, nonabsorable materials, and treatment for enophthalmos justify a review of dissection parameters and the anatomic course of the infraorbital branch prior to exit from the foramen.
7e Medial Orbital Exposure—The treatment of fracture and/or exophthalmic problems, well-treated laterally or inferiorly, have not been shown clearly via the caruncle/fornix exposure, so I felt the surgeon should get a better view of this technique. Further discussion of the orbicularis oculi is included here.
7f The Sphenopalatine Ganglion Block—The lateral nasal wall and its relation to the lacrimal apparatus are presented, followed by the exact method to perform this block so that the surgeon may deal with the posterior septum and turbinates more effectively.
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