In performing any oculofacial procedure, the surgeon should be intimately knowledgeable of the anatomical structures, and their interrelations to other tissue planes, in order to maintain eyelid stability and lacrimal function while optimizing the aesthetic outcome. Variations in anatomy, as well as ethnic and age differences, may influence the surgical approach and technique. Local infiltrative anesthesia, regional nerve blocks, and injection of dermal fillers require knowledge of the complex facial neurovascular network. This chapter will present the following areas, in conjunction with pertinent clinicoanatomic correlations, to minimize iatrogenic injury: cutaneous landmarks of the upper face, sensory and motor innervation of the upper face, superficial musculature of the face, arterial supply and venous drainage of the eyelids, lacrimal excretory system, sinus and endonasal landmarks, and eyelid and orbital anatomy.
Eyelid anatomy Orbital anatomy Endonasal Facial muscles SMAS Orbital fat SOOF ROOF Lacrimal Sensory nerve Facial vasculature
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This chapter is revised from the Manual of Oculoplastic Surgery, 4th Edition. We acknowledge the contributions of the previous chapter authors: Jacques G. H. Lasudry, MD; Bradley N. Lemke, MD; John G. Rose, Jr., MD; and Richard K. Dortzbach, MD.
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