How do you avoid the Infraorbital Lymph Nodes when doing a deep infraorbital incision to reach the rim?

Question

How do you avoid the lymph nodes located there when doing any type of infraorbital/subciliary incision to reach the periosteum? Also how are the midface muscles affected by an infraorbital incision? Thank you!

Kenneth D. Steinsapir, MD · Answer

The infraorbital lymph node is a a subcutaneous lymph node that is irregular present in the face. That means some people have one and some people do not have one. When present it is located well below the orbital rim and nowhere close to the lower eyelid skin incision performed for blepharoplasty. It is also nowhere close to the surgery to access the orbital rim from behind the eyelid through the conjunctiva.

Bradford A. Bader, MD · Answer

The lymph nodes of the midface are in close relationship with the infraorbital neurovascular bundle. This structure is carefully identified and left undisturbed during lower eyelid and midface surgery. The subciliary incision does divide the orbicularis oculi muscle and there are studies that show this causes denervation of the muscle and loss of support for the lower eyelid. That's why this approach is rarely used amongst surgeons who perform a high volume of lower eyelid surgery. The transconjunctival incision is preferred because it leaves the muscle completely intact, has a lower rate of post-op eyelid malposition and the scar is not visible.

Amit Gupta, MD - Account Suspended · Answer

Any surgeon who's going to handle a Blepharoplasty kind of a surgery in order to reach the rim will be careful about this & you don't have to worry about any damage to muscle as long as the surgeon that you have selected have adequate training in plastic surgery. I hope this helps.

How do you avoid the Infraorbital Lymph Nodes when doing a deep infraorbital incision to reach the rim?

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