美容外科領域での目尻切開，目頭切開，眉毛下皮膚切除術

Lateral Canthoplasty, Medial Epicanthoplasty, and Subbrow Skin Resection in Aesthetic Plastic Surgery

はじめに

　美容外科手術において，通常の保険診療では手術適応とならないような患者のこだわりや，微細な変化の要望に対しても手術適応としなければならないことがある。これらの手術を顕微鏡下で行うことは，肉眼やルーペ下での手術と術式が大きく異なるものではないが，顕微鏡下手術では，その精密度を飛躍的に高めることができる。患者のこだわりの強い要求に応えるためには，手術用顕微鏡は美容外科の眼形成手術において必須のツールであると考える。

　本稿では，顕微鏡下の眼形成手術の中でも，美容外科領域の外眼角形成術（目尻切開），内眼角形成術（内眥形成術，目頭切開），および眉毛下皮膚切除術について詳述する。

　Aesthetic surgery procedures may be performed even for patients who desire minor changes or have specific concerns that would not typically meet the criteria for insurance-covered surgery. While these procedures do not differ significantly from surgeries performed under direct vision or with loupe magnification, the use of an operating microscope allows for a significant enhancement in precision. A surgical microscope is thus an indispensable tool in aesthetic surgery to meet the high demands of patients. This study focuses on the use of a microscope in oculoplastic surgeries within the cosmetic surgery domain — specifically lateral canthoplasty, medial canthoplasty, and sub-brow skin excision.

　Although a microscope is not mandatory for lateral canthoplasties, it has been found to be useful for achieving hemostasis, dissection, and wound closure. In contrast, for medial canthoplasties and sub-brow skin excisions, the use of a microscope is essential for precise skin incisions and meticulous wound closure. The continued adoption of the microscope in aesthetic surgery is expected to lead to improved patient satisfaction and a reduction in the number of patients requiring revision surgery for unsightly scars.