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Sample records for blepharoplasty

  1. Simplifying Blepharoplasty.

    Science.gov (United States)

    Zoumalan, Christopher I; Roostaeian, Jason

    2016-01-01

    Blepharoplasty remains one of the most common aesthetic procedures performed today. Its popularity stems partly from the ability to consistently make significant improvements in facial aesthetics with a relatively short operation that carries an acceptable risk profile. In this article, the authors attempt to simplify the approach to both upper and lower lid blepharoplasty and provide an algorithm based on the individual findings for any given patient. The recent trend with both upper and lower lid blepharoplasty has been toward greater volume preservation and at times volume augmentation. A simplified approach to upper lid blepharoplasty focuses on removal of excess skin and judicious removal of periorbital fat. Avoidance of a hollow upper sulcus has been emphasized and the addition of volume with either fat grafting or fillers can be considered. Lower lid blepharoplasty can use a transcutaneous or a transconjunctival approach to address herniated fat pads while blending the lid-cheek junction through release of the orbitomalar ligament and volume augmentation with fat (by repositioning and/or grafting) or injectable fillers. Complications with upper lid blepharoplasty are typically minimal, particularly with conservative skin removal and volume preservation techniques. Lower lid blepharoplasty, conversely, can lead to more serious complications, including lid malposition, and therefore should be approached with great caution. Nevertheless, through an algorithmic approach that meets the needs of each individual patient, the approach to blepharoplasty may be simplified with consistent and predictable results. PMID:26710052

  2. Aging Blepharoplasty

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    Inchang Cho

    2013-09-01

    Full Text Available In performing upper blepharoplasty in the elderly, looking younger and keeping the eyelidsharmonious with the rest of the face have to be achieved at the same time. The most importantgoal in upper blepharoplasty for aging is correcting the drooping upper eyelid skin, and inthis process, the surgeon may or may not create a double eyelid fold. The pros and cons haveto be fully discussed with the patient, but the author personally prefers creating a doublefold unless the patient refuses, because it is efficient in correcting and preventing furtherdrooping of the skin. In most patients, the brow is elevated to compensate for the droopingeyelid, and when the drooping is corrected, brow ptosis may ensue. The surgeon has to preparefor these consequences before performing the procedure, and estimate the exact amountof skin to be excised. In the elderly, the skin and the orbicularis oculi muscle is thin, with adecreased amount of subcutaneous fat and retro-orbicularis oculi fat, and in most cases,excision of the skin alone is enough to correct the deformity. Removing large portions ofsoft tissue may also prolong the recovery period. Unlike younger patients, the lower skinflap should not be stretched too much in the elderly, as it may create an aggressive lookingappearance. A few wrinkles in the lower flap should remain untouched to create a naturallook. In this article, the author’s own methods of performing an aging blepharoplasty aredescribed specifically, with a step-by-step guide and surgical tips.

  3. Aging blepharoplasty.

    Science.gov (United States)

    Cho, Inchang

    2013-09-01

    In performing upper blepharoplasty in the elderly, looking younger and keeping the eyelids harmonious with the rest of the face have to be achieved at the same time. The most important goal in upper blepharoplasty for aging is correcting the drooping upper eyelid skin, and in this process, the surgeon may or may not create a double eyelid fold. The pros and cons have to be fully discussed with the patient, but the author personally prefers creating a double fold unless the patient refuses, because it is efficient in correcting and preventing further drooping of the skin. In most patients, the brow is elevated to compensate for the drooping eyelid, and when the drooping is corrected, brow ptosis may ensue. The surgeon has to prepare for these consequences before performing the procedure, and estimate the exact amount of skin to be excised. In the elderly, the skin and the orbicularis oculi muscle is thin, with a decreased amount of subcutaneous fat and retro-orbicularis oculi fat, and in most cases, excision of the skin alone is enough to correct the deformity. Removing large portions of soft tissue may also prolong the recovery period. Unlike younger patients, the lower skin flap should not be stretched too much in the elderly, as it may create an aggressive looking appearance. A few wrinkles in the lower flap should remain untouched to create a natural look. In this article, the author's own methods of performing an aging blepharoplasty are described specifically, with a step-by-step guide and surgical tips. PMID:24086798

  4. Transconjunctival Lower Blepharoplasty.

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    Pack, Sean; Quereshy, Faisal A; Altay, Mehmet Ali; Baur, Dale A

    2016-09-01

    There is no secret to achieving successful results with lower belpharoplasties; as is the case with any surgical procedure, proper patient evaluation and development of a comprehensive, anatomic-based treatment plan are prerequisites for success. For situations in which a patient has little lid laxity and pseudoherniated periorbital fat, transconjunctival lower blepharoplasty is the treatment of choice. Transconjunctival lower blepharoplasty enables the surgeon to reposition fat, effectively blending the lid-cheek junction and filling the tear trough deformity. In order to better enable clinicians to achieve optimal outcomes, the authors advocate an anatomic-based approach for patient evaluation and treatment planning. PMID:27499473

  5. Lower Eyelid Blepharoplasty.

    Science.gov (United States)

    Branham, Gregory H

    2016-05-01

    The goal of lower eyelid blepharoplasty is to rejuvenate the lower lid while maintaining a natural, unoperated appearance. Successful lower eyelid blepharoplasty depends on knowledge of the anatomy and surgical techniques, accurate preoperative analysis, and attention to detail. Common issues of the lower eyelid such as malar descent, tear trough deformity, pseudoherniated fat, lid laxity, and skin texture changes as well as dermatochalasis and festoons must be recognized. Specific techniques to address these include transcutaneous and transconjunctival approaches, fat excision, fat transposition, orbicularis suspension, lateral canthal tightening, malar suspension, and skin excision/resurfacing. PMID:27105798

  6. [The oculocardiac reflex in blepharoplasties].

    Science.gov (United States)

    Rippmann, V; Scholz, T; Hellmann, S; Amini, P; Spilker, G

    2008-08-01

    The oculocardiac reflex (OCR) is a well-known phenomenon in ophthalmic surgery, but is rarely described in aesthetic blepharoplasty surgery. It was first mentioned in 1908 by Ascher and Dagnini. Since then, ophthalmologists and anaesthesiologists have regarded the onset of the oculocardiac reflex as a significant intraoperative problem, which is undermined by several case reports that describe dysrhythmias which have haved caused morbidity and death. Per definition the OCR is caused by ocular manipulation and involves intraoperative bradycardia by a change of 20 beats/minute compared to the preoperative heart rate or any dysrhythmia during the manipulation via a trigeminal-vagal-mediated reflex arc. Having operated on a 48-year-old, healthy woman in our clinic, who underwent a cardiac arrest during the blepharoplasty procedure, followed by a successful resuscitation, we investigated the onset of the OCR in our blepharoplasty patients within the last 3 years. The onset of the OCR was noted in 22 of 110 (20 %) blepharoplasty patients, mainly affecting younger, low-weighted patients operated under local anaesthesia. Awareness and treatment of this potentially life-threatening oculocardiac reflex are necessary. In most cases the onset of the reflex may be avoided by a gentle operation technique and by refraining from severe traction to the muscle or fat pad. The best treatment of a profound bradycardia caused by the OCR is to release tension to the muscle or fat pad in order to permit the heart rate to return to normal. Intraoperative monitoring is of utmost importance. PMID:18716987

  7. Lacrimal gland fistula after upper eyelid blepharoplasty

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    Mohsen Bahmani Kashkouli

    2011-01-01

    Full Text Available To report the first case of lacrimal gland fistula after upper eyelid blepharoplasty for blepharochalasis. Standard upper blepharoplasty and the hooding excision were performed in a female with blepharochalasis. The patient developed a fistulous tract with tearing from the incision few days after hooding excision. Fistula excision and lacrimal gland repositioning were performed. There were no complications after the repositioning procedure (6 months follow up. Prolapsed lacrimal gland and fistula formation can occur after upper blepharoplasty hooding excision.

  8. Contemporary upper lid blepharoplasty--tissue invagination.

    Science.gov (United States)

    Siegel, R J

    1993-04-01

    Blepharoplasty is the most commonly performed operation to enhance facial appearance. Controversy arises over the need for tissue invagination as opposed to simple tissue excision. This article focuses on advanced invagination-type blepharoplasty, discussing who, what, where, when, why, and how. PMID:8485932

  9. Blepharoplasty

    Science.gov (United States)

    ... Stretch Marks Sun-damaged Skin Unwanted Hair Unwanted Tattoos Varicose Veins Vitiligo Wrinkles Treatments and Procedures Ambulatory ... Stretch Marks Sun-damaged Skin Unwanted Hair Unwanted Tattoos Varicose Veins Vitiligo Wrinkles Treatments and Procedures Ambulatory ...

  10. Immediate reaction to lidocaine with periorbital edema during upper blepharoplasty

    OpenAIRE

    Benjamin Presman; Vincenzo Vindigni; Ilaria Tocco-Tussardi

    2016-01-01

    Introduction: Blepharoplasty is the fourth most commonly performed cosmetic surgery in the US, with 207,000 operations in 2014. Lidocaine is the preferred anesthetic agent for blepharoplasty. Presentation of case: We describe the unusual case of acute periorbital edema following local anesthesia with lidocaine for upper blepharoplasty. At present, only two other reports of periorbital reactions to lidocaine are present in the literature. The reactions observed are significant palpebral swe...

  11. Mechanical oscillopsia after lower eyelid blepharoplasty with fat repositioning.

    Science.gov (United States)

    Thinda, Sumeer; Vaphiades, Michael S; Mawn, Louise A

    2013-03-01

    Blepharoplasty with fat repositioning is a technique used to fill the tear trough in the aging lower eyelid. We describe a patient who underwent transcutaneous lower eyelid blepharoplasty with fat repositioning who subsequently developed mechanical oscillopsia in the right eye exacerbated by facial movement. Surgical exploration revealed cicatrix between the inferior oblique muscle and the anterior superficial musculoaponeurotic system. Excision of the scar bands led to immediate amelioration of symptoms. When performing blepharoplasty with fat repositioning, it is essential to be aware of the anatomic location of the inferior oblique in the anterior inferomedial orbit to avoid incarceration of this muscle. PMID:23222371

  12. Brow Ptosis after Upper Blepharoplasty: Findings in 70 Patients

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    Hassanpour, Seyed Esmail; Khajouei Kermani, Houman

    2016-01-01

    BACKGROUND Brow ptosis is a potential complication after upper eyelid blepharoplasty. The aim of this study was to analyze the effect of upper blepharoplasty on eyebrow position. METHODS In this Between April 2011 and March 2013, eighty three patients (166 eyes with mean age of 49.7 years) underwent upper eyelid blepharoplasty. The patients were assessed using pre- and post-operatively digital photographs, in the primary position of the eye while the distance between the upper lid margin and the brow were measured before surgery. The postoperative degree of brow ptosis was evaluated as being mild (4 mm). RESULTS The postoperative brow position was unchanged in 46 cases (65.8%), and brow depression was noted in 24 cases ( 34.2%), including 7 males (58.3%) , and 17 females (29.3%). CONCLUSION Our study shows that postoperative brow position should be explained to patients before surgery, particularly in male and senile patients as concomitant brow lift or internal brow fixation through the blepharoplasty incision can help to stabilize the eyebrow in the proper position and to prevent this complication. PMID:27308242

  13. Transconjunctival lower lid blepharoplasty with and without fat repositioning.

    Science.gov (United States)

    Davison, Steven P; Irio, Matthew; Oh, Christine

    2015-01-01

    The transconjunctival approach to lower lid blepharoplasty provides access for both fat resection and transposition to soften tear trough deformities and correct infraorbital fat herniation. Overall, there is a paradigm shift that has focused more on enhancing lower lid-cheek shape and contour and preserving orbital volume PMID:25440740

  14. Power of the pinch: pinch lower lid blepharoplasty.

    Science.gov (United States)

    Kim, Elizabeth M; Bucky, Louis P

    2008-05-01

    Lower lid blepharoplasty is performed with great variation in technique. Conventional lower lid blepharoplasty with anterior fat removal via the orbital septum has a potential lower lid malposition rate of 15% to 20%. Lower lid malposition and the stigma of obvious lower lid surgery have led plastic surgeons to continue to change their approach to lower lid rejuvenation. In recent years, some surgeons have come to rely on alternative procedures like laser resurfacing alone or in conjunction with transconjunctival fat removal and canthopexy in an effort to avoid such complications. The pinch blepharoplasty technique removes redundant skin without undermining. This allows for more controlled wound healing, predictable recovery, and potential for simultaneous laser resurfacing. The combination of pinch blepharoplasty with transconjunctival fat removal leaves the middle lamella intact and reduces the chance of scleral show or ectropion. The purpose of this series is to demonstrate that pinch excision of redundant lower eyelid skin can be safely performed and that it can be used with laser resurfacing and/or transconjunctival fat removal for optimal treatment of the aging eye. A retrospective review of 46 consecutive patients who underwent pinch blepharoplasty, either in isolation or with other periorbital procedures was performed. Follow-up was at least 4 months (range of 4-24 months). In addition, we performed a prospective study of 25 consecutive patients to quantify the amount of skin removed and evaluate results and complications. An average of 8 mm of skin was resected (range of 4-12 mm) with the pinch blepharoplasty technique. Of these patients, 5.6% also underwent transconjunctival blepharoplasty, laser resurfacing, and/or fat grafting of the nasojugal groove. Despite the addition of simultaneous laser resurfacing, we did not see an increase in lower lid malposition. Three of the 71 patients had temporary scleral show that resolved with lower lid massage. In

  15. [Blepharoplasty: various technics in surgery of eyelid aging].

    Science.gov (United States)

    Mahé, E; Harfaoui-Chanaoui, T; Chappey, C; Banal, A; Chi, T Q

    1990-01-01

    The authors reviewing their own experience of blepharoplasty (92 cases) over the last ten years, discuss the principal approaches used depending on the age of the patient, the amount of adipose tissue, the lower lid tarsal and muscular laxity and the quality of the skin excess. In the lower eyelid they emphasize the value of the transconjunctival approach in young and or coloured people and the use of a cutaneo-muscular flap in the classical technique. In the upper eyelid, they combine the skin excision with an orbicularis muscle strip and in old people with suspension of the lateral canthus. A wise selection of these various approaches avoids the rare complications (ectropion and scleral show) because blepharoplasty must be considered to be a "variable geometry" operation. PMID:1696086

  16. Eyelid and brow asymmetry in patients evaluated for upper lid blepharoplasty

    OpenAIRE

    Macdonald, Kristian I.; Mendez, Adrian I; Hart, Robert D; Taylor, S Mark

    2014-01-01

    Introduction In evaluation for blepharoplasty, patients often desire improved cosmesis and/or correction of visual field deficits. However, patients are usually unaware of eyelid or brow asymmetry. Furthermore, the prevalence of eyelid and brow asymmetry is infrequently reported in the medical literature. Purpose To determine the prevalence of brow and eyelid asymmetry in patients evaluated for upper lid blepharoplasty. Methods One hundred consecutive patients evaluated for upper lid blepharo...

  17. Blepharoplasty with a Buried Double Twisted Suture Technique to Correct Upper Eyelid Epiblepharon

    OpenAIRE

    Choi, Seung Woo; Goldberg, Robert A; Lew, Helen

    2016-01-01

    Background: The authors evaluated the clinical efficacy of blepharoplasty using a newly developed, buried double twisted suture (BDTS) technique to correct upper eyelid epiblepharon. Methods: This retrospective study was conducted from October 2013 to July 2015 at the Oculoplastic Clinic, Bundang CHA Medical Center, CHA University, Seongnam, Korea. A total of 122 eyes from 61 patients with upper eyelid epiblepharon were enrolled. Blepharoplasty with a BDTS technique was performed on all eyes,...

  18. Evaluation and Treatment of the Tear Trough Deformity in Lower Blepharoplasty*

    OpenAIRE

    Espinoza, Gabriela Mabel; Holds, John Bryan

    2007-01-01

    The tear trough deformity is a natural consequence of the anatomic attachments of the periorbital tissues. A variety of techniques have evolved to address this cosmetic issue including subtractive blepharoplasty techniques, elevation of ptotic eyelid and midface tissues, and the injection or implantation of autogenous or alloplastic materials to diminish its appearance. Greater anatomic understanding of the pathogenesis of the tear trough deformity has led to more anatomically conservative an...

  19. Reshaping the eyebrow by follicular unit transplantation from excised eyebrow in extended infrabrow excision blepharoplasty

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    Ichinose A

    2012-02-01

    Full Text Available Kazuhito Konishi1, Isao Sugimoto2, Hirohiko Kakizaki3, Akihiro Ichinose41Kobe Academia Clinic, 2Division of Aesthetic Medical Science, Department of Plastic Surgery, Kobe University Graduate School of Medicine, 3Department of Ophthalmology, Aichi Medical University, Nagoya, Aichi, Japan; 4Department of Plastic Surgery, Graduate School of Medicine, Kobe University, Kobe, Hyogo, JapanPurpose: We report the reshaping of the eyebrow by follicular unit transplantation from excised eyebrow skin in extended infrabrow excision blepharoplasty.Methods: The method was carried out in two patients with moderate or significant dermatochalasis. The areas to be excised from the infrabrow and intrabrow skin were decided upon and the area of hair transplantation was planned in the suprabrow area and the tail of the eyebrow. The skin was removed and the excised intrabrow skin was dissected into single follicular units. Tiny incisions were made with a scalpel, and grafts were inserted using fine forceps.Results: Almost all transplanted eyebrow follicles took successfully, resulting in eyebrows of a desirable shape as planned preoperatively. The reshaped eyebrows had a natural appearance since the transplanted hairs were similar to those of the original eyebrow. The eyelids still looked youthful rather than operated-on. Finally, the evidence of blepharoplasty was hardly visible and patient satisfaction was quite high. The patients felt more ease in opening their eyes and obtained a wider visual field.Conclusion: Our study demonstrated excellent results with hair transplantation from eyebrow to eyebrow, a finding which, to our knowledge, has not been previously reported. Our method can be used for selected patients, especially men, with moderate to severe dermatochalasis, who find a reduction or change in the shape of the eyebrow unacceptable.Keywords: blepharoplasty, dermatochalasis, follicular unit transplantation, eyebrow reconstruction

  20. Modified Double-Eyelid Blepharoplasty Using the Single-Knot Continuous Buried Non-Incisional Technique

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    Kyung-Chul Moon

    2013-07-01

    Full Text Available Background Buried non-incisional double-eyelid blepharoplasty is a popular aesthetic procedure. Although various modified continuous suture techniques have been used to create a more natural appearance and to reduce downtime, complications such as loosening of the double fold, asymmetry, and foreign body reactions have been observed.Methods This study included 250 patients who underwent double-eyelid blepharoplasty between March 1997 and November 2012 using a modified single-knot continuous buried non-incisional technique. With 4 stab incisions in the upper eyelids, one of two needles loaded with double-armed 7-0 nylon was passed in one direction alternately through the dermis and the conjunctiva, while the other needle was passed subconjunctivally in the opposite direction. Both ends of the sutures were knotted within a lateral stab incision of the upper eyelids and were buried in the orbicularis oculi muscle.Results Most patients displayed satisfactory aesthetic results, and no significant complications occurred. There was no obvious regression of the double fold; however, 3 patients required reoperation to correct loosening of the fold on one side during the follow-up period. One patient presented with the suture knot subcutaneously, and the knot was removed in the clinic.Conclusions The modified single-knot continuous buried non-incisional technique is a simple and less time-consuming method for a durable double fold and provides satisfactory aesthetic results.

  1. The value of tear film breakup and Schirmer's tests in preoperative blepharoplasty evaluation.

    Science.gov (United States)

    McKinney, P; Byun, M

    1999-08-01

    The authors published their article on the value of tear film breakup and Schirmer's tests in preoperative blepharoplasty evaluation in 1989. The purpose of this update is to expand the original article in light of refinements and experiences in subsequent years. It was concluded in the 1989 article that the abnormal tear film breakup and Schirmer's tests were not good predictors of possible postblepharoplasty dry eye complications. It was concluded in the review that the anatomy and the history including scleral show, lagophtholmus, negative vector, snap test, previous surgery, increased blinking, dryness, grittiness and pain were more important predictors of postoperative dry eye problems than the ocular tests. The authors' opinion remains so, and they do less preoperative tear film testing and place more emphasis on the history and the anatomy as predictors of potential problems. In this follow-up to the 1989 article, the authors include a survey from several surgeons as to how they evaluate their patients for elective aesthetic blepharoplasty, which in large measure confirms the authors' practice. PMID:10654706

  2. Blepharoplasty with a Buried Double Twisted Suture Technique to Correct Upper Eyelid Epiblepharon

    Science.gov (United States)

    Choi, Seung Woo; Goldberg, Robert A.

    2016-01-01

    Background: The authors evaluated the clinical efficacy of blepharoplasty using a newly developed, buried double twisted suture (BDTS) technique to correct upper eyelid epiblepharon. Methods: This retrospective study was conducted from October 2013 to July 2015 at the Oculoplastic Clinic, Bundang CHA Medical Center, CHA University, Seongnam, Korea. A total of 122 eyes from 61 patients with upper eyelid epiblepharon were enrolled. Blepharoplasty with a BDTS technique was performed on all eyes, followed by evaluation of clinical outcomes and complications. After surgery, success was defined as the persistence of a double eyelid and the upper eyelid eyelashes not touching the cornea under slit lamp examination. Results: The 61 patients were composed of 29 females and 32 males. The average age was 9.0 ± 7.7 years, and the average follow-up period was 7.3 ± 5.2 months. After surgery, the margin reflex distance increased from 2.0 ± 1.0 to 3.2 ± 0.9 mm (P effective for correction of epiblepharon with a low rate of complications. This technique can be applied to double eyelid surgery based on the excellent cosmetic outcomes. PMID:27200247

  3. Dimensões palpebrais antes e após blefaroplastia superior: avaliação quantitativa Eyelid measures before and after upper blepharoplasty: quantitative evaluation

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    Silvana Artioli Schellini

    2005-02-01

    Full Text Available OBJETIVO: Quantificar, usando o sistema de imagem digital, medidas palpebrais antes e após a cirurgia de blefaroplastia superior. MÉTODOS: Foram avaliadas 18 pálpebras de 9 pacientes atendidas no HC da FMB - UNESP, com idade entre 40 a 75 anos, do sexo feminino, portadoras de dermatocálase. Foram obtidas fotografias das pacientes antes e após 60 dias da blefaroplastia da pálpebra superior. As imagens foram transferidas para um computador e analisadas pelo programa Scion Image Frame Grabber. Os parâmetros avaliados foram: a altura da fenda palpebral em posição primária do olhar, altura do sulco palpebral superior e o ângulo palpebral lateral antes e depois de 60 dias da realização da cirurgia de blefaroplastia superior. RESULTADOS: Após a cirurgia, houve aumento da altura da fenda palpebral e do sulco palpebral superior. Contudo, o ângulo palpebral lateral não se alterou. CONCLUSÃO: A posição palpebral se altera após a blefaroplastia e o processamento de imagens digitais possibilita quantificar estas alterações, mensurando os resultados obtidos com a cirurgia.PURPOSE: To evaluate eyelid measures before and after upper blepharoplasty surgery using a digital image system. METHODS: Eighteen eyelids of 9 patients with dermatochalasis were evaluated at the Hospital das Clínicas de Botucatu - UNESP regarding eyelid measures before and after upper blepharoplasty. All patients were female, aged between 40 and 75 years. The images were acquired by a photographic camera, transferred to a computer and then analyzed by the Scion Image Frame Grabber program. The evaluated parameters were upper eyelid position in primary gaze position, upper palpebral sulcus and lateral eyelid angle. The measures were obtained before and after 60 days of upper dermatochalasis surgery. RESULTS: After the surgery, there was an increase of upper eyelid position and upper palpebral sulcus; the lateral palpebral angle did not show any alteration. CONCLUSION

  4. Blefaroplastia inferior: poderia a cirurgia proporcionar satisfação aos pacientes? Lower blepharoplasty: would the surgery provide satisfaction to the patient?

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    Giovanni André Pires Viana

    2012-12-01

    Full Text Available OBJETIVO: Foi realizado um estudo prospectivo com objetivo de avaliar os resultados de cinquenta pacientes submetidos a blefaroplastia inferior transcutânea, visando a análise do resultado clínico e a satisfação dos pacientes na Universidade Federal de São Paulo, entre abril de 2005 e maio de 2007. MÉTODOS: Os pacientes foram alocados aleatoriamente em dois grupos cirúgicos. O Grupo Cirúrgico 1 (Grupo Controle foi composto por 25 pacientes submetidos a blefaroplastia inferior tradicional e cantopexia lateral de rotina. O Grupo Cirúrgico 2 (Grupo Experimental foi composto por 25 pacientes submetidos a blefaroplastia inferior com transposição das bolsas adiposas e cantopexia lateral de rotina. Para avaliar os resultados obtidos foi utilizado a avaliação da autoestima dos pacientes, por meio da Escala de Autoestima de Rosenberg UNIFESP/EPM. O outro método utilizado foi solicitar a participação de três cirurgiões independentes que avaliaram as fotografias de pré e pós-operatório e com auxílio de uma escala topográfica, quantificaram os resultados. RESULTADOS: A média de idade foi de 48,8 anos, com predomínio do sexo feminino (96%. A análise das fotografias mostrou que 96% dos pacientes apresentaram melhora significativa. A autoestima melhorou de um escore médio no pré-operatório de 5,1 (desvio padrão = 4,1 para um valor médio de 3,6 (desvio padrão = 3,5 após 6 meses da cirurgia (p=0,001. CONCLUSÃO: Os autores concluíram que ambos os procedimentos seriam seguros e eficazes, com baixo índice de complicação, apresentando melhora da autoestima, visível após seis meses da cirurgia.PURPOSE: The purpose of this study was to analyze prospectively fifty patients submitted to lower eyelid blepharoplasty at the Federal University of São Paulo, between April 2005 and May 2007. METHODS: Fifty patients were assigned to interventions into two surgical groups by using random allocation. The Surgical Group1 (control group

  5. Safety and efficacy of a growth factor and cytokine-containing topical product in wound healing and incision scar management after upper eyelid blepharoplasty: a prospective split-face study

    Science.gov (United States)

    Murdock, Jennifer; Sayed, Mohamed S; Tavakoli, Mehdi; Portaliou, Dimitra M; Lee, Wendy W

    2016-01-01

    Purpose To evaluate the efficacy and safety of a topical product containing a mixture of growth factors and cytokines on the incision scar following upper eyelid blepharoplasty. Methods This is a prospective, single-blinded, and split-face study on patients who underwent bilateral upper eyelid blepharoplasty. Two weeks after surgery, one eye of each subject was randomized to receive Lumière Bio-Restorative Eye Cream on one eyelid incision for 12 weeks and no treatment on the other eyelid. Subjects returned at the postoperative weeks 6, 10, and 14. At each visit, patients and the investigator (who was blinded to the treated eyelid) evaluated the scar through specified questionnaires. Results A total of 20 subjects with a mean age of 66.3±9.2 years completed the study. Minor side effects were noted in three subjects. At all-time points, all subjects thought eyelids treated with Lumière had a better scar and overall appearance than fellow eyelids (P<0.5); and 60% of patients strongly encouraged others to use the product. The investigator assessment of erythema and pigmentation revealed less erythema and pigmentation in treated eyes at the weeks 6 and 10, although the difference was statistically insignificant. Investigator assessment also revealed a better scar appearance at week 10 in treated eyes (P=0.04). All evaluation parameters were similar in both eyes at the last visit. Conclusion Lumière eye cream shows an excellent safety profile and minimal effects on features of the incision scar following upper lid blepharoplasty. It may hasten the wound healing process considering the higher outcomes at the first weeks of application. PMID:27418806

  6. “等腰三角形去皮法”在经皮睑袋切除术中的应用%Application of isosceles trangle skin excision in transcutaneous lower eyelid blepharoplasty

    Institute of Scientific and Technical Information of China (English)

    薛紫涵; 曾玮; 陶然; 李桂珍; 韩岩

    2015-01-01

    0bjective To introduce the experience of transcutaneous lower eyelid blepharoplasty by isosceles trangle skin excision. Methods A total of 36 cases were recruited in this study and received lower eyelid blepharoplasty with isosceles trangle skin excision. Stitches were removed one week after surgery. Results All patients were satisfied during a follow-up period between 1-24 months. The tear trough deformity was obviously improved with mild mid-face rejuvenation. The eyelid shape was good with no hematoma, ectropion, depression or retraction. Conclusion The application of isosceles trangle skin excision in lower eyelid blepharoplasty was simple,safe and effective.%目的:介绍“等腰三角形去皮法”睑袋切除术的经验和体会。方法:对36例(72眼)下睑皮肤松弛、睑袋明显的患者进行“等腰三角形去皮法”睑袋切除术,术后1周拆除切口缝线。结果:36例患者术后下睑皮肤松弛、睑袋形成均得到满意的修复,术后随访1~24个月,未出现术后血肿或眼睑外翻,下睑皮肤平展、切口愈合好,切口上下皮肤无皱褶、猫耳朵、瘢痕隐蔽,并且不同程度合并有面中部提升的效果,患者均对术后效果满意。结论:等腰三角形去皮法睑袋切除术方法简便、安全、效果良好。

  7. Midazolam oral como medicação pré-anestésica em blefaroplastias Oral sedation with midazolam in blepharoplasty

    Directory of Open Access Journals (Sweden)

    Rejane Dantas Rodrigues Gonçalves

    2009-10-01

    Full Text Available OBJETIVO: Avaliar a eficácia e a segurança do emprego oral de midazolam (15 mg como medicação pré-anestésica em pacientes submetidos a blefaroplastias. MÉTODOS: Foi desenvolvido um ensaio clínico prospectivo, duplo cego, randomizado, controlado com 42 pacientes, risco ASA I e II, divididos em três grupos de 14 pacientes: grupo M (midazolam 15 mg, grupo P (placebo e grupo SM (sem medicação. Os pacientes foram avaliados quanto ao grau de sedação e dor intraoperatórias e variação entre os períodos pré e transoperatórios da ansiedade, pressão arterial sistólica e diastólica, frequência respiratória e pulso. RESULTADOS: A análise de variância unifatorial com teste de Tukey mostrou que a administração de midazolam ocasionou uma redução significativa da pressão arterial sistólica e da frequência respiratória no período transoperatório em relação aos pacientes que utilizaram placebo ou não fizeram uso de medicamento. Esses efeitos foram discretos e acompanhados de diminuição na percepção da dor, discreta sedação e redução da ansiedade. CONCLUSÃO: A sedação via oral com midazolam em pacientes submetidos a cirurgias palpebrais demonstrou ser eficiente de fácil aplicação e com mínimos efeitos sistêmicos.PURPOSE: To evaluate the safety and usefulness of the use of oral sedation with midazolam (15 mg in patients submitted to blepharoplasty. METHODS: Randomized double-blind prospective study of 42 patients (surgical risk ASA I and II divided into three groups of 14 patients each: Group M (midazolam 15 mg, group P (placebo and group SM (no medication. All patients were evaluated according to the degree of sedation and pain during surgery and the variation of anxiety between the preoperative and intraoperative period, arterial pressure (systolic-SAP and diastolic-DAP, respiratory frequency (RF and pulsation. RESULTS: Unifatorial variance analysis with Tukey test demonstrated that the use of midazolam

  8. Avaliação do olho seco no pré e pós-operatório da blefaroplastia Evaluation of dry eye in the preoperative and postoperative period of blepharoplasty

    Directory of Open Access Journals (Sweden)

    Carlos Gustavo de Melo Gonçalves de Lima

    2006-06-01

    Full Text Available OBJETIVOS: Avaliar a importância dos exames objetivos, da história ocular, além da anatomia orbitária e periorbitária, na identificação dos pacientes com risco de desenvolver olho seco no pós-operatório da blefaroplastia. MÉTODOS: Foi realizado estudo prospectivo em 29 pacientes com dermatocálase, que foram avaliados antes e três meses após a blefaroplastia. Mudanças nos sintomas oculares, no exame físico e nos testes objetivos (teste de Schirmer, tempo de quebra do filme lacrimal e coloração com rosa bengala, foram avaliadas. RESULTADOS: Não foram encontradas alterações estatisticamente significativas nos resultados dos testes objetivos, à exceção do teste de Schirmer II, entre o pré e o pós-operatório. Em relação às modificações na anatomia palpebral, foram observadas alterações na fenda palpebral e na excursão do músculo levantador da pálpebra superior, que foram estatisticamente significativas no pós-operatório. CONCLUSÕES: Podemos afirmar que as modificações da fenda palpebral acontecem com elevada freqüência nos pacientes submetidos à blefaroplastia estética. Pode-se concluir ainda que, no presente estudo, os exames objetivos para a avaliação do olho seco não demonstraram alterações significativas no pós-operatório, à exceção do teste de Schirmer II.PURPOSES: To evaluate the importance of objective examinations in conjunction with ocular history and orbital and periorbital anatomy, to identify patients at risk of developing a post-blepharoplasty dry eye complication. METHODS: A prospective study was peformed on 29 patients with dermatochalasis who were studied before and three months after blepharoplasty. Changes in ocular symptoms, physical examination and in objective tests, like Schirmer's test, tear film break-up time and rose Bengal coloration were evaluated. RESULTS: No statistically significant alteration in results of objective tests, except Schirmer II test, was found between

  9. Blepharoplasty and periorbital surgical rejuvenation

    Directory of Open Access Journals (Sweden)

    Milind Naik

    2013-01-01

    Full Text Available The periorbital region forms the epicenter of facial aging changes and receives highest attention from physicians and patients. The concern about visual function, clubbed with the need for hidden incisions, makes the periocular region a highly specialized surgical area, most appropriately handled by an ophthalmic plastic surgeon. The article provides an overview of cosmetic eyelid and facial surgery in the periocular region. Common aesthetic surgical procedures as well as ocular side-effects of commonly performed periocular injections are discussed from the dermatologist′s point of view.

  10. Blepharoplasty and periorbital surgical rejuvenation

    OpenAIRE

    Milind Naik

    2013-01-01

    The periorbital region forms the epicenter of facial aging changes and receives highest attention from physicians and patients. The concern about visual function, clubbed with the need for hidden incisions, makes the periocular region a highly specialized surgical area, most appropriately handled by an ophthalmic plastic surgeon. The article provides an overview of cosmetic eyelid and facial surgery in the periocular region. Common aesthetic surgical procedures as well as ocular side-effects ...

  11. Correction of lower eyelids tear trough deformity via multiple techniques used synthetically in lower blepharoplasty%多技术综合应用下睑成形术矫正下睑泪槽畸形

    Institute of Scientific and Technical Information of China (English)

    刘志坤; 蒋晟; 杨锋; 蒋斌; 肖霞; 惠品香

    2013-01-01

    Objective To investigate the feasibility of correction of lower eyelids tear trough deformity via multiple techniques used synthetically in lower blepharoplasty, and to summarize operation skills and experience. Methods Through skin incision muscle -skin flap operation approach,arcus marginalis orbital septum fat release,orbital fat preservation, orbital septum tighten and reset, fascia ligament of orbicularis lifting suspension combined operation method. Results In 56 patients.no obvious bleeding, petechiae in postoperative,without eyelid ball separation, ectropion complications. Follow up of 2 months to 30 months,lower eyelid skin was smooth, the tear trough deformity was significantly improved, patients perceived appearance satisfaction. Conclusion Correction of lower eyelids tear trough deformity via multiple techniques used synthetically in lower blepharoplasty, was a effective operation method to obtain the mid-face rejuvenation.%目的:探讨多项技术综合应用下睑成形术矫正下睑泪槽畸形的可行性,总结手术操作技巧及经验.方法:经皮肤肌皮瓣手术入路,采用弓状缘眶隔脂肪释放、眶内脂肪保留、眶隔紧缩重置技术及眶肌筋膜韧带提紧悬吊相结合的综合手术方法. 结果:本组56例患者,术后无明显出血、瘀斑,无睑球分离、下睑外翻等并发症出现.随访2~30个月,下睑部皮肤平整,泪槽畸形明显改善,患者自感外观效果满意.结论:多项技术综合应用下睑成形术矫正下睑泪槽畸形是获得面中部年轻化的行之有效的手术方法.

  12. Corrección de ptosis palpebral por la incisión de blefaroplastia Upper eyelid ptosis treatment using blepharoplasty incision

    Directory of Open Access Journals (Sweden)

    A. Novo Torres

    2006-09-01

    y por tanto la recuperación es mas rápida; posibilita también la cirugía de rescate en caso de correcciones insuficientes y evita el problema de sobrecorrección con exceso de resección de tejido conjuntival. En resumen se trata de una modificación quirúrgica que facilita la técnica, disminuye las complicaciones postoperatorias, mejora la recuperación y evita la sensación de cuerpo extraño intraocular de una resección conjuntivalBlepharoptosis is the abnormally low of the top eyelid during the direct look. Best results are obtained by resection or advance of the elevator muscle or aponeurosis, whenever the elevator has a suitable function. We present a modification to the Blaskovics´s technique for correction of moderate blepharoptosis, with good function of the elevator muscle. We present a serie of 10 cases where we used a variant of Blaskovics’s technique of resection of the elevator for surgical correction of ptosis. Seven were bilateral cases and 3 unilateral ones. In all the cases the elevator function was between 4 and 8 mm and ptosis was major than 4mm with visual field decrease in the direct look. Surgical technique included a cutaneous horizontal incision of Blepharoplasty, wide exhibition of elevator muscle and aponeurosis, respecting orbicular fatty bags and separating it from the palpebral conjunctive. In all the cases correction of the ptosis were obtained. The grade of asymmetry was lower than 0,3 cm. One case presented in the inmediate postoperatory opening of the suture in his medial side and had to be re-taken after 10 days. The palpebral postoperative edema was solved between 2 – 8th day allowing evaluation in that moment. Patient’s satisfaction was good or very good and the visual field was complete in all patients Classic surgical techniques and its modifications for correction of ptosis keep on being valid. With this modification that respects conjuctive we avoid to add morbidity to the surgical process. We think that

  13. Avaliação do impacto da blefaroplastia superior na qualidade de vida utilizando questionário padronizado (Qblefaro: estudo piloto Assessing the impact of upper blepharoplasty on quality of life with a standardized questionnaire (QBleflaro: a pilot study

    Directory of Open Access Journals (Sweden)

    Maurício Pedreira Paixão

    2008-02-01

    Full Text Available FUNDAMENTOS: Há escassa literatura sobre a avaliação dos resultados cirúrgicos e do impacto da cirurgia de blefaroplastia superior na qualidade de vida dos pacientes. OBJETIVO: Avaliar o impacto na qualidade de vida dos pacientes submetidos à cirurgia de blefaroplastia superior. MÉTODOS: Estudo prospectivo com questionário padronizado, em mulheres adultas submetidas à blefaroplastia superior e avaliadas após 90 dias para estimativa do impacto cirúrgico na qualidade de vida e de complicações. RESULTADOS: Foram avaliadas 41 mulheres adultas saudáveis (idade mediana 53 anos no período de junho de 2005 a março de 2006. O questionário apresentou alta consistência interna. O elemento de qualidade de vida de maior impacto na primeira semana foi relacionado à percepção da aparência física, e o de menor impacto foi relacionadoà convivência com as pessoas próximas. A cicatrização hipertrófica foi a principal complicação tardia. O grau de satisfação com a cirurgia relacionou-se significativamente com a ausência de efeitos indesejados (pBACKGROUND: There is scarce literature on assessing surgical results and the impact of upper blepharoplasty on quality of life of patients. OBJECTIVE: To evaluate the impact on quality of life of patients submitted to upper blepharoplasty. METHODS: A prospective study using a standardized questionnaire applied to adult women submitted to upper blepharoplasty and evaluated 90 days later to estimate the surgical impact on quality of life and complications. RESULTS: Forty-one healthy adult females (median age of 53 years were evaluated from June 2005 to March 2006. The questionnaire showed high internal consistency. The quality of life element with greater impact on the first postoperative week was related to physical appearance perception and that of lesser impact was associated to relationship with relatives and close friends. Hypertrophic scar was the main late complication. Satisfaction

  14. 应用眶隔脂肪疝折叠缝合法的睑袋整复术%Application of plicating suture of orbital septum adipocele in blepharoplasty

    Institute of Scientific and Technical Information of China (English)

    徐苗; 张敬德; 邢新

    2013-01-01

    目的 介绍睑袋整复术中处理眶隔及眶隔脂肪并矫正泪槽和睑颊沟的新方法.方法 2010年1月至2012年4月,共有12例患者接受眶隔脂肪疝折叠缝合法行睑袋整复术.术中完整显露眶隔后,向下推挤冗余的眶隔及眶隔内脂肪,使眶隔在眶下缘折叠并包裹眶隔内脂肪形成局限于眶下缘下方的疝囊,以保持上方的眶隔紧致平坦.行水平褥式缝合眶下缘平面的双层眶隔形成疝环,并固定于骨膜上,将折叠形成的眶隔脂肪疝填充于眶下缘的骨膜肌肉间隙内.结果 本组共12例患者,术后随访3~12个月,睑袋畸形及泪槽、睑颊沟显现等体征均得以矫正,中面部较术前明显年轻,无下睑凹陷、外翻或巩膜过分显露、睑球分离等并发症发生,效果满意.结论 眶隔脂肪疝折叠缝合法操作简单、设计合理,适用于修复伴有泪槽、睑颊沟显现的重度睑袋求美者.%Objective To explore a new method of handling orbital septum fat and correcting tear trough and palpebromalar groove for lower lid blepharoplasty.Methods From January 2010 to April 2012, totally 12 patients with lower eyelid pouches were treated by using folding suture of orbital septum.During the operation, handling orbital septum was exposed completely and the redundant orbital septum and fat were pushed downward and the septum was folded on the infraorbital margin to wrap the fat to form hernial sac under the infraorbital margin which kept the superior orbital septum tight and flat.The hernial ring formed by double-deck orbital septum on the the infraorbital margin was performed horizontally mattress suture and then was fixed on the periosteum, the folded adipocele of orbital septum was filled into the interspace of periosteum and muscle.Results After 3 to 12 months postoperative follow-up performed on 18 patients, the lower eyelid tear trough and palpebromalar groove were corrected.All cases were satisfied with midface rejuvenation and

  15. 眶隔脂肪释放转移技术在下睑整复术中的应用%The orbital septum fat releasing and transfering during the lower blepharoplasty

    Institute of Scientific and Technical Information of China (English)

    庄(飚); 付小卒; 曾高; 路会; 才杰; 马海欢

    2013-01-01

    Objective:To investigate the efficacy of orbital septum fat releasing and transfering during the lower blepharoplasty.Methods:Forty patients with lower eyelid fat prolapse and tear trough deformity underwent orbital septum fat releasing and transfering via supraperiosteal dissection and fixation.Postoperative complications were recorded.Results:After the one-year postoperative follow-up,the 40 patients were satisfied with the resuhs.No diplopia or evidence of granuloma formation in the lower eyelid.The depression of infra-orbital and tear trough disappeared.Conclusion:The shape of the lower lid could be fully restored.This method was a safe and effective method to create a youthful midface appearance.%目的:探讨眶隔脂肪释放转移技术在下睑整复术中的作用.方法:在40例行常规下睑整复术的患者中,运用眶隔脂肪释放转移技术来填充眼部凹陷.眶隔脂肪行骨膜上固定于眶下缘和泪沟等处.结果:40例患者伤口均一期愈合,无感染及眶内血肿情况发生.所有患者经过1年的随访,效果满意.眼袋无复发.结论:该技术最大程度上恢复了下睑的解剖学结构,为远期效果的维持提供了可靠的保证,值得在临床上广泛推广.

  16. 个性化下睑袋整形术2057例临床经验总结%Clinical experience of individulized lower eyelid blepharoplasty in 2057 cases

    Institute of Scientific and Technical Information of China (English)

    王太玲; 薛文丽; 王佳琦; 郭鑫; 于浩; 郑行跃; 宋维铭; 杨文爽; 吴佳君; 邹翀

    2011-01-01

    Objective To review the clinical experience of lower eyelid blepharoplasty in 2057 cases, and summary the individualized operation plans for different patients. Methods According to the relaxation of skin and orbicularis oculi,the fullness of pre-tarsal orbicularis oculi, the protrusion of orbital fat and the concavity of tear trough, we adopted different techniques to correct the baggy eyelids. 2057 patients were treated from 2001 to 2010. Results The follow-up period ranged from 2 to 84 months. Remarkable improvements in lower eyelid contours were achieved. No complications appeared. The satisfaction rate is 99.76%. Conclusions It is very necessary to adopt individulized techniques for different baggy eyelids.%目的:回顾2 057例下睑袋整形术的临床经验,总结针对不同患者的个性化下睑袋整形手术方案.方法:根据下睑皮肤和眼轮匝肌松弛度、睑板前眼轮匝肌肥厚度、眶隔脂肪膨出程度、泪沟凹陷程度不同,有针对性地采用不同的手术技术,改善患者的下睑袋.2001~2010年临床应用2057例.结果:本组患者随访2~84个月,下睑袋改善效果明显,无并发症,满意率达99.76%.结论:针对不同类型下睑袋采用个性化的技术方法十分必要.

  17. The application of undermining orbicularis oculi muscle from orbital rim for the correction of tear trough deformity and palabromalar groove in lower blepharoplasty%剥离弓状缘眼轮匝肌在伴有泪槽和睑颊沟的眼袋整复中的应用

    Institute of Scientific and Technical Information of China (English)

    郑亚荣; 刘凯; 李青峰; 李锋; 洪素庄

    2012-01-01

    Objective To evaluate the role of undermining orbicularis oculi muscle from Orbital rim for the correction of tear trough deformity and palabromalar groove in lower blepharoplasty.Methods 56 cases of lower eye baggy deformity with tear trough deformity and palabromalar groove were treated with the procedure of stripping eye orbicularis oculi muscle from orbital rim by a transcutaneous approach in lower blepharoplasty.The orbital septum was opened along the arcus marginalis for releasing the orbital fat.Some orbital fat was removed if necessary.Then the inferior edge of the orbital septum fat was reset over the orbital rim so as to smooth the infraorbital groove.Results 56 patients were available for 6 to 18 month' s follow-up.54 patients were quite satisfied with the cosmetic result.One developed lower eyelid retraction and another one showed asymmetrical subcutaneous local uneven after 1 month' s.They were all corrected by the second operation after 3 months.Conclusions Stripping orbicularis oculi muscle from orbital rim plays an important role for the correction of tear trough deformity and palabromalar groove in lower blepharoplasty.%目的 探讨伴有明显泪槽和睑颊沟的眼袋整形手术方法.方法 2007年1月至2011年6月,对56例眼袋伴泪槽和睑颊沟畸形者,在术中充分剥离松解弓状缘眼轮匝肌,尤其是附着在内侧泪槽处眶下缘骨膜面的眼轮匝肌,将眶隔脂肪释放重置并缝合固定于眶下缘下方4 ~6 mm处骨膜面上,进行泪槽和睑颊沟充填.结果 术后随访3 ~18个月,54例眼袋消失,无下睑凹陷、不平整等;1例术后1个月出现下睑皮下局部凹凸不平,3个月后经结膜入路修复后改善;1例出现下睑缘轻度退缩,经局部理疗后睑缘退缩消失.结论 剥离松解弓状缘眼轮匝肌,行眶隔重置,对矫正伴有泪槽及睑颊沟畸形的眼袋效果良好.

  18. Observation of the Clinical Effect of Modified Myocutaneous Flap Method Combined with Orbital Septum Fixation on Lower Blepharoplasty%改良肌皮瓣法结合眶隔固定术进行眼袋整形的临床效果观察

    Institute of Scientific and Technical Information of China (English)

    郑凯

    2014-01-01

    目的:探讨改良肌皮瓣法结合眶隔固定术进在行眼袋整形的临床效果。方法:选取来我院进行眼袋整形的患者80例,将其进行随机分组,分为观察组和对照组两组,每组各40例患者。对照组40例患者应用传统肌皮瓣法进行眼袋整形,观察组患者应用改良肌皮瓣法联合眶隔固定术进行眼袋整形。结果:观察组患者眼袋整形术后,美容效果满意率为97.5%,对照组患者眼袋整形术后,美容效果满意率为82.5%,两组患者的美容效果满意度比较差异具有显著性(P<0.05)。观察组患者眼袋整形过程中患者发生瘀斑、轻度睑外翻、结膜炎等并发症的发生率为2.5%,对照组患者眼袋整形过程中患者发生瘀斑、轻度睑外翻、结膜炎等并发症的发生率为12.5%,两组患者并发症发生率比较差异具有显著性(P<0.05)。结论:改良肌皮瓣法结合眶隔固定术进行眼袋整形具有安全、可靠,患者美容效果满意度较高的临床优势,值得在临床中进行推广应用。%Objective:To investigate the clinical effect of modified myocutaneous flap method combined with orbital septum fixation on lower blepharoplasty. Methods:80 patients in the hospital for eye surgery were randomly divided into the observation group and the control group, with 40 patients in each group. 40 patients in the control group used traditional myocutaneous flap method for eye surgery, and the patients in observation group applied muscle skin flap method combined with orbital septum fixation on lower blepharoplasty. Results:Cosmetic satisfactory rate of the patients with eye plastic surgery in the observation group was 97.5%, and cosmetic satisfactory rate of patients in the control group was 82.5%. There was significant difference between the satisfaction of cosmetic effect of two groups (P<0.05). The occurrence rate of ecchymosis, patients with lower eyelid blepharoplasty in mild

  19. Anatomy for blepharoplasty and brow-lift.

    Science.gov (United States)

    Ridgway, James M; Larrabee, Wayne F

    2010-08-01

    The eyelids and eyebrows provide communicative, emotional, and protective functions through a complex interplay of muscles, tendons, and other local soft tissues. A surgical intervention involving these regions are renowned for their deceptive simplicity and notable complications. With these challenges in mind, this article provides the reader with a detailed and systematic review of the eyelid and brow anatomy. PMID:20524165

  20. Upper blepharoplasty and lateral wound dehiscence

    Directory of Open Access Journals (Sweden)

    Mohsen Bahmani Kashkouli

    2015-01-01

    Conclusion: In the presence of wound tension on skin closure (intraoperative assessment, tension relieving buried orbicularis/subcutaneous 6-0 polyglactin suturing of the lateral UB incision could prevent LWD.

  1. Immediate reaction to lidocaine with periorbital edema during upper blepharoplasty

    Directory of Open Access Journals (Sweden)

    Benjamin Presman

    2016-01-01

    Conclusion: In clinical practice, we recommend that patient should be informed about the possibility of recurrence of an adverse reaction in case of re-exposure to lidocaine, even in the vast majority of cases where true allergy could not be proven. In case of further need for local anesthesia with history of an adverse event, a different agent may be chosen even from the same class (another amide as cross-reactions in the amide group are rare. Otherwise, an anesthetic from the ester group can also be safely used.

  2. Reshaping the eyebrow by follicular unit transplantation from excised eyebrow in extended infrabrow excision blepharoplasty

    OpenAIRE

    Konishi, Kazuhito

    2012-01-01

    Kazuhito Konishi1, Isao Sugimoto2, Hirohiko Kakizaki3, Akihiro Ichinose41Kobe Academia Clinic, 2Division of Aesthetic Medical Science, Department of Plastic Surgery, Kobe University Graduate School of Medicine, 3Department of Ophthalmology, Aichi Medical University, Nagoya, Aichi, Japan; 4Department of Plastic Surgery, Graduate School of Medicine, Kobe University, Kobe, Hyogo, JapanPurpose: We report the reshaping of the eyebrow by follicular unit transplantation from excised eyebrow skin in ...

  3. Use of Kaolin-impregnated Gauze for Improvement of Intraoperative Hemostasis and Postoperative Wound Healing in Blepharoplasty

    Science.gov (United States)

    Czyz, Craig N.; Stacey, Andrew W.; Cahill, Kenneth V.; Foster, Jill A.

    2016-01-01

    Purpose: Kaolin is a mineral shown to be effective in controlling hemorrhage when combined with standard gauze and applied to wounds. This study investigates the application of kaolin to control intraoperative bleeding and promote wound healing in eyelid surgery. Methods: This prospective, randomized, double-blind study recruited patients who underwent eyelid surgery. Following skin incision, kaolin-impregnated gauzewas placed in one eyelid wound bed and cotton gauze in the other, then removed. Distinct, individual areas of bleeding were recorded. Standardized photographs were obtained postoperatively on Day 1, 4, and 7. Photographs were graded for edema and ecchymosis by four blinded observers. Patients also completed a survey inquiring which side had more bruising, swelling, and pain at each return visit. Results: A total of 46 patients completed the study. The number of intraoperative bleeding sites for kaolin versus plain gauze was not significantly different (p=0.96). Photographic grading by blinded observers did not identify any statistically significant differences in postoperative edema at any time point between lids. There was a statistically significant difference for ecchymosis at postoperative Day 4 (p=0.009) and Day 7 (p=0.016). Patient surveys did not show any difference in perceived edema, ecchymosis, or pain between lids. Conclusion: Intraoperative hemostasis was not affected by the use of kaolin-impregnated gauze. The effectiveness of kaolin in wound healing showed improved ecchymosis at Days 4 and 7 when assessed by blinded observers. Patients did not notice any improvement in postoperative edema, ecchymosis, or pain. PMID:27386052

  4. 眼轮匝肌瓣在睑袋手术中矫治泪沟畸形的应用%Application of orbicularis oculi musculus flap in correction of tear trough deformity in blepharoplasty

    Institute of Scientific and Technical Information of China (English)

    张翰理; 阮庆玲; 吴文兵; 余曼利; 钟书霞; 应胜华

    2014-01-01

    目的:介绍睑袋成形术中利用眼轮匝肌矫正泪沟畸形的方法.方法:在常规睑袋成形术中,利用切下的眼轮匝肌组织瓣,平铺于泪沟凹陷处的骨膜上,适当固定,填充泪沟局部凹陷,达到平坦,过渡自然的外观.结果:本组共施行手术71例,术后随访3~21个月,泪沟畸形及睑袋畸形、睑颊沟显现等体征均得以矫正,中面部较术前明显年轻,无下睑凹陷、外翻或巩膜过分显露、睑球分离等并发症发生,效果满意.结论:利用眼轮匝肌瓣法矫治泪沟畸形的睑袋成形术操作简单、设计合理,适用于修复伴有泪沟、睑颊沟显现且眶隔脂肪不多的睑袋求美者.

  5. Application of the three-step lower blepharoplasty in correcting the tear trough and palabromalar groove%三步法睑袋整形术矫正泪槽和睑颊沟的临床应用

    Institute of Scientific and Technical Information of China (English)

    靳海涛; 黄挺; 黄江山; 赵柏程; 欧阳霞; 谭朝中; 王志敏; 郭璐

    2014-01-01

    目的 探讨一种矫正泪槽和睑颊沟的睑袋整形术的方法及疗效.方法 对36例睑袋伴有泪槽和睑颊沟畸形者采用三步法睑袋整形术,包括保留完整的眼轮匝肌眶隔脂肪切除术、选择性释放眼轮匝肌支持韧带、去除多余的皮肤.结果 本组共36例患者,术后均得到眶下区年轻化改善.随访3 ~18个月,下睑缘形态自然,无眼睑外翻发生,切口瘢痕隐蔽,患者对外观效果满意.结论 采用三步法睑袋整形术对矫正伴有泪槽和睑颊沟畸形的患者,疗效确切,不良反应少,可恢复眶区年轻化效果,值得临床推广应用.

  6. Lower Lid Ectropion in Hypohidrotic Ectodermal Dysplasia

    Directory of Open Access Journals (Sweden)

    Xiaoyun Zhang

    2015-01-01

    Full Text Available We report a case of a lower lid ectropion with ectodermal dysplasia and ectropion blepharoplasty surgery experience. A 14-year-old Han nationality male patient with typical characteristics of hypohidrotic ectodermal dysplasia presented to our clinic for his right lower lid eversion. The patient was diagnosed as having hypohidrotic ectodermal dysplasia and underwent an uneventful blepharoplasty surgery. The lower lid maintained normal position during the 10-month follow-up period. Patients with ectodermal dysplasia could firstly visit ophthalmologist for their ectropion and blepharoplasty surgery could be useful for the disease.

  7. Ear Plastic Surgery

    Science.gov (United States)

    ... receive light-weight earrings. Does Insurance Pay for Cosmetic Ear Surgery? Insurance usually does not cover surgery solely for ... republication strictly prohibited without prior written permission. Ears Cosmetic Surgery, Facelift, Rhinoplasty, Blepharoplasty ... Get Involved Professional Development Practice ...

  8. Eyelid lift

    Science.gov (United States)

    Eyelid lift surgery is done to repair sagging or drooping upper eyelids ( ptosis ). The surgery is called blepharoplasty. Sagging ... An eyelid lift is needed when eyelid drooping reduces your vision. You may be asked to have your eye doctor test ...

  9. Study on blepharoplasty stripping arcuate margin of orbicularis oculi muscle used in patients with tear trough and palpbromalar groove%应用剥离弓状缘眼轮匝肌整复伴有泪槽和睑颊沟的眼袋疗效观察

    Institute of Scientific and Technical Information of China (English)

    蒋学金

    2014-01-01

    Objective To explore divest arcuate edge orbicularis muscle surgery reconstructive treatment of the symptoms of clinical efficacy and recovery.Methods 80 patients with tear trough and palphromalar groove pouch,according to the operation method,were divided into group A and group B.The patients received stripped arcuate margin of orbicularis oculi muscle operation and true orbital fat too much fat operation,operation treatment,respectively.The satisfaction and revisit the rebound rate of the two groups after surgery were compared.Results Of 40 patients in A group,37 cases (92.5%)were satisfied with the treatment,general satisfaction in 3 cases (7.5%),0 case (0.0%) was not satisfactory.In B group,28 cases (62.5%)were satisfied with the treatment,general satisfaction in 9 cases (22.5%),3 cases (15.0%)were not satisfactory.The clinical efficacy between the two groups was significantly different(Z =18.481,P < 0.01).During follow-up,in A group,one case (2.5%)relapsed.In B group,7 cases (17.5%) relapsed after 2 years.The postoperative recurrence rate between the two groups had significant difference (Z =7.314,P < 0.05).Conclusion For patients with tear trough and palpbromalar groove pouch,treatment by stripping arcuate margin of orbicularis oculi muscle operation method can effectively correct the tear trough and palabromalar groove deformity postoperative reduction performance,has high degree of satisfaction,the recurrence rate is low,the clinical effect is significant,it is worthy of further clinical application and research.%目的 探讨剥离弓状缘眼轮匝肌手术整复伴有泪槽和睑颊沟的眼袋临床效果.方法 对80例伴有泪槽和睑颊沟的眼袋患者,按照手术方法不同分为A组与B组各40例,分别进行剥离弓状缘眼轮匝肌手术与真性眶内脂肪过多去脂手术,进行整复治疗,对比分析两组患者的手术后整复满意度以及回访复发率.结果 治疗后,A组满意37例(92.5%),基本满意3例(7.5%),不满意0例(0.0%);B组满意28例(62.5%),基本满意9例(22.5%),不满意3例(15.0%),两组临床疗效差异有统计学意义(Z=18.481,P<0.01).随访:A组出现复发1例(2.5%),B组2年后出现复发7例(17.5%),两组术后复发率差异有统计学意义(Z=7.314,P<0.05).结论 采用剥离弓状缘眼轮匝肌手术法整复伴有泪槽和睑颊沟的眼袋,术后整复满意度高,复发率低,值得临床上进一步推广应用.

  10. Clinical Effect of Improved Hamra Blepharoplasty for Patients Having Both Eyelid Bags and Obvious Tear Trough Deformity%改良Hamra眼袋手术对眼袋伴发泪槽沟畸形患者的临床疗效

    Institute of Scientific and Technical Information of China (English)

    常太平

    2013-01-01

    目的:探讨改良Hamra眼袋手术对眼袋伴发泪槽沟畸形病人的治疗效果.方法:收集2010年1月-2012年1月期间接受改良Hamra眼袋手术治疗眼袋伴发有泪槽沟畸形的病人12名,分别于手术前后、术后随访第1、3、6、12个月进行拍照对比,同时统计病人的满意度.结果:全部病人眼袋症状消失或基本消失,且泪槽沟畸形也得到明显的矫正,疗效评定为满意者11人,为基本满意者1人,整体满意度达100%.术后无一例病人出现血肿、感染、瘢痕增生或下睑外翻等并发症.术后随访满意度高达91.67% (11/12),且未发现远期并发症.结论:改良Hamra眼袋手术治疗眼袋伴发泪槽沟畸形的临床效果理想,弥补了传统Hamra整形术对泪槽沟矫正不足的缺点,不仅能有效消除眼袋,还能明显改善伴发的泪槽沟畸形症状,使患者的整体形象年轻化,尤其适用于泪槽沟最低处与眶缘距离在5m以上的病人.

  11. 眶肌筋膜韧带和眶肌支持韧带松解在下睑年轻化中的作用%Studies about the fascia ligament of orbicularis oculi and orbital retainning ligament and application to their release in lower blepharoplasty

    Institute of Scientific and Technical Information of China (English)

    王卫峻; 谢峰; 王炜

    2010-01-01

    目的 研究眶肌支持韧带与眶肌筋膜韧带(王韧带)解剖的异同,及对其松解在下眼睑年轻化手术中的作用.方法 复习眶颧区韧带解剖的文献,与王氏韧带进行尸体解剖研究和组织学观察对比,并对501例王氏韧带松解和提紧下睑年轻化手术进行回顾和分析.结果 王韧带是纤维结缔组织结构,位于下睑外侧眼轮匝肌的深层,连结下睑外侧眼轮匝肌和下外侧眶嵴缘的骨膜,韧带长(13.5±2.5)mm,宽(11.0±2.0)mm.眶肌支持韧带,是眼轮匝肌和整个眶缘骨膜联结的支持韧带.松解王韧带,可以多切除下睑松弛皮肤3~6 mm或更多,相比于松解眶肌支持韧带手术,其具有操作容易、创伤小等优点.结论 在下睑年轻化手术中,松解或提紧王韧带,使下睑眼轮匝肌、皮肤的张力平衡,手术创伤小,眶区年轻化的效果好,可维持较长时间的美容效果.

  12. The combination of releasing and sling of Wang's ligament (fascia ligament of orbital muscle) for lower eyelid blepharoplasty%眶区年轻化策略--王韧带松解及提紧的睑袋整形术(待续)

    Institute of Scientific and Technical Information of China (English)

    王炜; 王卫峻; 祁佐良; 林晓曦; 方建蔺; 林李嵩; 邹丽剑

    2005-01-01

    目的研究眶区老化改变的动态解剖,下睑眶区筋膜韧带功能和睑袋手术方法的改进.方法通过尸体解剖和数千例睑袋手术的临床实践,阐明眶肌筋膜韧带(王韧带)的解剖,及其在睑袋手术中的应用;结合文献复习,对下睑眶区韧带的作用进行了比较性研究,并进行了下睑老化的分类和睑袋手术方法的改进.结果在眶区老化中,皮肤、皮下组织、肌肉的松弛较韧带的松弛明显.采用眶肌筋膜韧带(王韧带) 的松解、提紧是眶区年轻化的有效手段.眶肌筋膜韧带位于眼外眦韧带内下方,眼轮匝肌外侧1/3的深面.起于眼轮匝肌外1/3的深面,和下睑板外侧1/3下缘,止于上颌骨眶下缘的外下1/4骨膜,长约12~15 mm,宽约10~12 mm.眶肌筋膜韧带松解、提紧睑袋整形术,较其他手术方法更能提紧下睑松弛皮肤3~5 mm.不仅提紧了下睑皮肤,而且可提紧颧眶区松弛的组织.结论王韧带松解、提紧睑袋整形术,其方法创伤小,能够有效地矫正下睑松弛,使眶区达到年轻化的效果.

  13. The combination of releasing and sling of Wang's ligament (fascia ligament of orbital muscle) for lower eyelid blepharoplasty%眶区年轻化策略王韧带松解及提紧的睑袋整形术(续)

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    @@ 2 睑袋的分类 睑袋的分类多以下睑皮肤松弛的程度为依据[12].笔者认为,睑袋的分类应以如下四要素为依据:①下睑皮肤及肌肉的松弛程度.②眶隔脂肪的疝出程度.

  14. The Explore of the Clinical Effect for Skin Flap Lower Lid Blepharoplasty Combined with Orbital Fat Replacement%眶隔脂肪重置合并皮瓣法下睑成形术的临床疗效探讨

    Institute of Scientific and Technical Information of China (English)

    张建光; 路志兴; 郑文涛; 廖清; 沙汹涛

    2012-01-01

    Objective: To investigate a skin flap method with resetting orbital septum fat for lower eyelid baggy plastic conforming to the medical aesthetic requirements. Methods: A total of 187 patients were recruited in this study. The method of skin flap with resetting orbital septum fat was adopted through palpebral margin incision. Then the excessive skin was removed. Results: All the patients experienced a quick recovery form the surgery. The excess skin at the lateral canthus was completely removed, the incision was sutured under moderate tension, and the eyelid skin was flattened. No lid-retraction or lower eyelid ectropion was observed in the 3 to 6 months postoperative follow-up. The lateral incision scar was hidden and the operation outcome was satisfactory. Conclusions: The skin flap method of repairing baggy deformity with resetting orbital septum fat could not only solve problem of eye bags which produces a more desirable appearance, but also meet aesthetic requirements and rejuvenative appearance.%目的:讨论眶隔脂肪重置结合皮瓣法下睑成形术改善眶周外形,以获得符合美学标准的手术效果.方法:对178例下睑袋成形术者,采用下睑缘切口,经皮瓣法释放眶隔脂肪,并将其部分固定于下睑缘凹陷处骨膜上,随后切除过多的皮肤.结果:术后恢复快,下睑皮肤平展,外眦部皮肤去除充分,眼台轮廓饱满,曲线自然.术后随访3个月到6个月观察,无睑退缩、下睑外翻,随访效果满意.结论:眶隔脂肪重置合并皮瓣法下睑成形可较好改善眶周外形,术后效果满意,达到下睑年轻化矫治的目的.

  15. Management of Cosmetic Eyelid Surgery Complications

    OpenAIRE

    Klapper, Stephen R.; Patrinely, James R.

    2007-01-01

    There is a broad spectrum of complications that can occur following cosmetic eyelid surgery. The experienced eyelid surgeon should be able to avoid most serious complications through proper patient selection, a comprehensive preoperative assessment and surgical plan, meticulous surgical technique, and appropriate postoperative care. The aesthetic eyelid surgeon must counsel a patient contemplating blepharoplasty surgery regarding typical expectations including edema, eyelid numbness, dry eyes...

  16. Smoking in Relation to Age in Aesthetic Facial Surgery

    OpenAIRE

    Deliaert, An E. K.; van den Elzen, M. E. P.; Van den Kerckhove, E.; Fieuws, Steffen; van der Hulst, R. R. W. J.

    2012-01-01

    Background Smoking is a major cause of premature facial aging. Skin aging in general, often accompanied by wrinkling and furrowing, plays a significant role in the decision to undergo aesthetic surgery. Smoking may therefore be related to the demand for cosmetic surgery. This study aimed to compare smoking habits with respect to a standard cosmetic procedure (blepharoplasty) in the general population and to evaluate whether the age at surgery differs between smokers and nonsmokers. Methods A ...

  17. Current Update in Asian Rhinoplasty

    OpenAIRE

    Clyde H. Ishii, MD, FACS

    2014-01-01

    Summary: There has been a tremendous growth of cosmetic surgery among Asians worldwide. Rhinoplasty is second only to blepharoplasty in terms of popularity among Asians regarding cosmetic surgical procedures. Most Asians seek to improve their appearance while maintaining the essential features of their ethnicity. There are considerable ethnic nasal and facial variations in this population alone. Successful rhinoplasty in Asians must take into account underlying anatomic differences between As...

  18. Aponeurosis of the levator palpebrae superioris in Chinese subjects

    Science.gov (United States)

    Pan, Er; Nie, Yun-Fei; Wang, Zhen-Jun; Peng, Li-Xia; Wu, Yan-Hong; Li, Qin

    2016-01-01

    Abstract An accurate understanding of the anatomy of the levator palpebrae superioris aponeurosis (LPSA) is critical for successful blepharoplasty of aponeurotic ptosis. We investigated the macroscopic and microscopic anatomy of the LPSA. This prospective live gross anatomy study enrolled 200 adult Chinese patients with bilateral mild ptosis undergoing elective blepharoplasty. Full-thick eyelid tissues and sagittal sections from the eyelid skin to the conjunctiva were examined with Masson trichrome staining or antismooth muscle actin (SMA) immunohistochemistry. Gross anatomy showed that the space between the superficial and deep layers of the LPSA could be accessed after incising the overlying superficial fascia, by retracting the white line. Adipose layers were clearly observed in 195 out of 200 patients with bilateral mild ptosis, among which 180 cases had the superficial layer connected to the uncoated adipose. Fifteen cases had the superficial layer connected to the smoothly coated layer, and 5 cases had the superficial layer directly connected to the deep loose fiber, almost without adipose. In previously untreated patients, the LPSA space was located beneath the intact orbital septum. In those with previous surgeries, it was beneath the superficial layer of the LPSA, underlying the destructed orbital septum. Cadaveric histology showed that the deep layer of the LPSA extended into the anterior layer of the tarsal plate and the superficial layer reflexed upward in continuity with the vertical orbital septum. An occult space existed between the 2 layers of the LPSA, with a smooth lining on the deep layer. The superficial layer of the LPSA was SMA-immunonegative but the deep layer was slightly immunopositive for SMA. An occult anatomic space exists between the superficial and deep layers of the LPSA, in proximity to the superior tarsal plate margin. Recognition of the more anatomically significant LPSA deep layer may help improve the aesthetic outcome of

  19. Aponeurosis of the levator palpebrae superioris in Chinese subjects: A live gross anatomy and cadaveric histological study.

    Science.gov (United States)

    Pan, Er; Nie, Yun-Fei; Wang, Zhen-Jun; Peng, Li-Xia; Wu, Yan-Hong; Li, Qin

    2016-08-01

    An accurate understanding of the anatomy of the levator palpebrae superioris aponeurosis (LPSA) is critical for successful blepharoplasty of aponeurotic ptosis. We investigated the macroscopic and microscopic anatomy of the LPSA.This prospective live gross anatomy study enrolled 200 adult Chinese patients with bilateral mild ptosis undergoing elective blepharoplasty. Full-thick eyelid tissues and sagittal sections from the eyelid skin to the conjunctiva were examined with Masson trichrome staining or antismooth muscle actin (SMA) immunohistochemistry.Gross anatomy showed that the space between the superficial and deep layers of the LPSA could be accessed after incising the overlying superficial fascia, by retracting the white line. Adipose layers were clearly observed in 195 out of 200 patients with bilateral mild ptosis, among which 180 cases had the superficial layer connected to the uncoated adipose. Fifteen cases had the superficial layer connected to the smoothly coated layer, and 5 cases had the superficial layer directly connected to the deep loose fiber, almost without adipose. In previously untreated patients, the LPSA space was located beneath the intact orbital septum. In those with previous surgeries, it was beneath the superficial layer of the LPSA, underlying the destructed orbital septum. Cadaveric histology showed that the deep layer of the LPSA extended into the anterior layer of the tarsal plate and the superficial layer reflexed upward in continuity with the vertical orbital septum. An occult space existed between the 2 layers of the LPSA, with a smooth lining on the deep layer. The superficial layer of the LPSA was SMA-immunonegative but the deep layer was slightly immunopositive for SMA. An occult anatomic space exists between the superficial and deep layers of the LPSA, in proximity to the superior tarsal plate margin. Recognition of the more anatomically significant LPSA deep layer may help improve the aesthetic outcome of blepharoplasty

  20. Avoiding and managing complications in the periorbital area and midface.

    Science.gov (United States)

    Undavia, Satyen; Yoo, Donald B; Nassif, Paul S

    2015-05-01

    The eyes play a central role in the perception of facial beauty. The goal of periorbital rejuvenation surgery is to restore youthful proportions and focus attention on the eyes. Blepharoplasty is the third most common cosmetic procedure performed today. Because of the attention placed on the periorbital region, preventing and managing complications is important. Obtaining a thorough preoperative history and physical examination can significantly reduce the incidence of many of the complications. This article focuses on the preoperative evaluation as it relates to preventable complications, followed by common intraoperative and postoperative complications and their management. PMID:25921575

  1. Comprehensive periorbital rejuvenation with resorbable endotine implants for trans-lid brow and midface elevation.

    Science.gov (United States)

    Sclafani, Anthony P

    2007-05-01

    Periorbital rejuvenation can enhance a patient's appearance, with changes of only a few millimeters making a significant impact. Many patients undergoing blepharoplasty often have mild brow or midfacial changes for which they are unwilling to undergo additional concurrent forehead or midface procedures, however, because these procedures may be associated with an unacceptable postoperative recovery and may not provide adequate tissue fixation. This article describes limited incision procedures capable of providing excellent elevation and support to the brow and midface that can be incorporated easily into a comprehensive periorbital rejuvenation treatment plan using semi-permanent subperiosteal fixation devices. PMID:17544943

  2. Tear trough deformity: review of anatomy and treatment options.

    Science.gov (United States)

    Stutman, Ross L; Codner, Mark A

    2012-05-01

    The lower eyelid can be a challenging area in facial rejuvenation. While lower eyelid bags are commonly the reason that patients present for lower eyelid rejuvenation, a separate entity known as a tear trough deformity may occur in conjunction with lower eyelid bags or alone. In this article, the authors outline the current understanding of the tear trough anatomy; describe multiple classification systems, which provide an objective means of evaluating the deformity and aid the surgeon in choosing appropriate treatment options; and review surgical and nonsurgical techniques for correcting the tear trough deformity. Treatment options include hyaluronic acid filler, fat grafting, skeletal implants, and fat transposition. Each procedure is associated with advantages and disadvantages, and each should be considered more complex than traditional lower blepharoplasty alone. While lower blepharoplasty removes excess fat and may tighten the anterior lamella, tear trough procedures require the addition of volume to the underlying depression. These procedures requiring release of the ligamentous structures and orbicularis (of which the tear trough is composed), as well as fat transposition or fat grafting, are associated with additional complications, which are also reviewed. PMID:22523096

  3. Release of orbicularis retaining ligament: an improved method of orbicularis oculi muscle supension blepharo-plasty%眼轮匝肌悬吊法睑袋成形术的改进

    Institute of Scientific and Technical Information of China (English)

    顾云鹏; 郭鑫; 于浩; 王太玲; 王佳琦

    2010-01-01

    Objective To study a improved technique by releasing the orbicularis retaining ligament in orbicularis oculi muscle supension blepharoplasty. Release of the orbicularis retaining ligament could cut off the contact between orbitomalar skin and periosteum at inferior orbital rim, and carry the point of tightening orbitomalar skin in orbicularis oculi muscle supension blepharoplasty. Methods There were 409 patients with apparent orbitmalar fold. The methods of releasing orbicularis retaining ligament and orbital septum fixation were added to improve the orbicularis oculi muscle supension blepharoplasty. Results 409 cases were treated using this method over the past 3 years. All results were satisfactory. No complications were observed. Conclusion This improved method of orbicularis oculi muscle supension blepharoplasty is useful for orbitomalar skin rolling, especially for orbitmalar fold. The release allows effective redraping and upward mobilization of the orbicularis of the lower lid and the premalar soft tissues. This method is a simple, safe and effective procedure for the correction of tear trough deformity and well-demarcated lid/cheek junction in lower eyelid belpharoplasty. It is one of the best choices for lower eyelid blepharoplasty.%目的 探讨在眼轮匝肌悬吊法睑袋成形术中,通过眼轮匝肌支持韧带完全松解,使附着在眶缘骨膜上松弛的皮肤、皮下组织得以充分释放,以达到下睑组织和眶颧组织整体提紧效果的改良手术方法.方法 对409例具有较明显沟槽畸形的患者,在行眼轮匝肌悬吊法睑袋成形术过程中,增加了眼轮匝肌支持韧带离断、韧带断端上提与眶隔筋膜固定的操作,对眼轮匝肌悬吊法进行改进.结果 经术后随访1~3年,全部受术者沟槽畸形改观明显,无1例出现并发症,得到比较满意的疗效.结论 改良的眼轮匝肌悬吊法睑袋成形术,松解了眶颧部皮肤,有利于恢复睑颊复合体的平整自然,对改

  4. Standard guidelines for electrosurgery with radiofrequency current

    Directory of Open Access Journals (Sweden)

    Mutalik Sharad

    2009-08-01

    Full Text Available Definition: Radiofrequency (RF induces thermal destruction of the targeted tissue by an electrical current at a frequency of 0.5 MHz (RF. As the electrode tip is not heated, there is minimal thermal damage to the surrounding tissues, producing good esthetic results. Therefore, RF ablation is also known as cold ablation or "coblation." Modality: It has three modes of operation: (a Cut, (b cut and coagulate and (c coagulate. Therefore, it can be used for various purposes like incision, ablation, fulguration, shave excision and coagulation. Because of the coagulation facility, hemostasis can be achieved and operation becomes easier and faster. Indications: It is effective in treating various skin conditions like dermatosis papulosa nigra, warts, molluscum contagiosum, colloid milia, acquired junctional, compound and dermal melanocytic nevi, seborrheic keratosis, skin tags, granuloma pyogenicum, verrucous epidermal nevi, xanthelesma, rhinophyma, superficial basal cell carcinoma and telangiectasia. It can also be used for cosmetic indications such as resurfacing, earlobe repair and blepharoplasty. Anesthesia: The procedure is accomplished either under topical anesthesia eutactic mixture of local anesthetics or local injectable anesthesia, under all aseptic precautions. Procedure: While operating, only the tip of the electrode should come in contact with the tissue. Actual contact of the electrode with the tissue should be very brief in order to prevent excessive damage to the deeper tissues. This can be accomplished by moving the electrode quickly. Complications: Complications are uncommon and mainly occur due to an improper technique. The treating physician should be aware of the contraindications of the procedure as listed in these guidelines. Physician qualification: RF surgery may be performed by a dermatologist who has acquired adequate training during post-graduation or through recognized fellowships and workshops dedicated to RF surgery. He

  5. Transconjunctival subperiosteal fat reposition for tear trough deformity: pedicled fat redraping versus septal reset.

    Science.gov (United States)

    Youn, Seungki; Shin, Jong In; Kim, Jeong Tae; Kim, Youn Hwan

    2014-11-01

    Fat-preserving lower blepharoplasty techniques are increasingly common, but to date there has been insufficient data comparing the results of fat repositioning and septal reset. The authors compared the aesthetic results of the 2 methods using statistical analysis. A total of 120 patients, who had undergone transconjunctival subperiosteal fat repositioning from February 2008 to April 2009, were included. Group 1 (71 patients) underwent fat reposition with pedicled infraorbital fat redraping. Group 2 (49 patients) underwent septal reset to reposition the underlying fat. Documentation of the results with grading (grade 0-III) by 2 surgeons was done, and the results were evaluated for clinical improvement.Septal reset showed statistical significance on grade improvement compared to direct fat manipulation methods in the patients with grade II and grade III deformities. Septal reset also showed a trend for a higher degree of improvement compared to the latter. There were no major postoperative complications. PMID:23722575

  6. Current Update in Asian Rhinoplasty

    Directory of Open Access Journals (Sweden)

    Clyde H. Ishii, MD, FACS

    2014-04-01

    Full Text Available Summary: There has been a tremendous growth of cosmetic surgery among Asians worldwide. Rhinoplasty is second only to blepharoplasty in terms of popularity among Asians regarding cosmetic surgical procedures. Most Asians seek to improve their appearance while maintaining the essential features of their ethnicity. There are considerable ethnic nasal and facial variations in this population alone. Successful rhinoplasty in Asians must take into account underlying anatomic differences between Asians and whites. Due to ethnic variations, cultural differences, and occasional language barriers, careful preoperative counseling is necessary to align the patient’s expectations with the limitations of the procedure. This article will review the many facets of Asian rhinoplasty as it is practiced today.

  7. Perspectives in the selection of hyaluronic acid fillers for facial wrinkles and aging skin

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    Hannah E John, Richard D Price

    2009-07-01

    Full Text Available Hannah E John, Richard D PriceDepartment of Plastic and Reconstructive Surgery, Addenbrookes Hospital, Cambridge University Teaching Hospitals NHS Trust, Cambridge, UKAbstract: Aesthetic surgery is, in the USA at least, no longer a taboo subject. Outside North America, public acceptance continues to grow as more procedures are performed each year. While there appears, anecdotally, to be a decrease in patients undergoing cosmetic treatments because of the global financial crisis, the overall trend remains upward. Although popular television programs espouse the benefits of surgery, it is nonsurgical procedures that account, numerically, for the majority of procedures performed; in the USA, there was a 48% growth from 2000 to 2008 in nonsurgical treatments undertaken by women, and 64% in men and while the average surgeon might perform 60 blepharoplasty operations in 2007, (she would also undertake 375 botulinum injections, and almost 200 filler injections of varying sorts. Clearly there is enthusiasm for nonsurgical treatments, and this trend appears to be rising. With this in mind, we present an overview of the commonest filler injection material, hyaluronic acid. We present the mechanism of action, the purported risks and benefits, and briefly discuss technique.Keywords: hyaluronic acid, filler injection, nonsurgical procedures, technique

  8. Perspectives in the selection of hyaluronic acid fillers for facial wrinkles and aging skin.

    Science.gov (United States)

    John, Hannah E; Price, Richard D

    2009-01-01

    Aesthetic surgery is, in the USA at least, no longer a taboo subject. Outside North America, public acceptance continues to grow as more procedures are performed each year. While there appears, anecdotally, to be a decrease in patients undergoing cosmetic treatments because of the global financial crisis, the overall trend remains upward. Although popular television programs espouse the benefits of surgery, it is nonsurgical procedures that account, numerically, for the majority of procedures performed; in the USA, there was a 48% growth from 2000 to 2008 in nonsurgical treatments undertaken by women, and 64% in men and while the average surgeon might perform 60 blepharoplasty operations in 2007, (s)he would also undertake 375 botulinum injections, and almost 200 filler injections of varying sorts. Clearly there is enthusiasm for nonsurgical treatments, and this trend appears to be rising. With this in mind, we present an overview of the commonest filler injection material, hyaluronic acid. We present the mechanism of action, the purported risks and benefits, and briefly discuss technique. PMID:19936165

  9. Beauty is in the eye of the beholder: body dysmorphic disorder in ophthalmic plastic and reconstructive surgery.

    Science.gov (United States)

    McConnell, Lindsay K; Lee, Wendy W; Black, Donald W; Shriver, Erin M

    2015-01-01

    Despite the fact that up to 15% of patients in an aesthetic surgery practice have body dysmorphic disorder (BDD), little has been written about the condition in the oculoplastic literature. The authors describe 3 patients with suspected BDD who presented with perceived periocular defects. To appear "Asian," a 39-year-old Hispanic woman underwent over 30 surgeries. She developed disfiguring scars and lagophthalmos with corneal scarring, remained unsatisfied, and tragically committed suicide. A 52-year-old woman with moderate dermatochalasis underwent a blepharoplasty to improve her vision and appearance and help her gain employment. Despite a good outcome, she remained dissatisfied and blamed the surgeon for her unemployment. Finally, a 73-year-old woman presented demanding treatment for brow rhytids causing severe emotional distress. She was denied intervention due to unrealistic expectations. These patients are suspected to be suffering from BDD. Increased awareness is critical as BDD patients often remain unsatisfied after surgical intervention and are in need of psychiatric care. PMID:24833442

  10. Markers of Inflammation and Fibrosis in the Orbital Fat/Connective Tissue of Patients with Graves’ Orbitopathy: Clinical Implications

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    Przemyslaw Pawlowski

    2014-01-01

    Full Text Available Purpose. To assess FGF-β, TGF-β, and COX2 expression and immunocompetent cells in the orbital tissue of patients with severe and mild Graves’ orbitopathy. Patients and Methods. Orbital tissue was taken from 27 patients with GO: (1 severe GO (n=18, the mean clinical activity score (CAS being 8.5 (SD 2.5; and (2 mild GO (n=9, the mean CAS being 2.2 (SD 0.8, and from 10 individuals undergoing blepharoplasty. The expression of CD4+, CD8+, CD20+, and CD68 and FGF-β, TGF-β, and COX2 in the orbital tissue was evaluated by immunohistochemical methods. Results. We demonstrated predominant CD4+ T cells in severe GO. CD68 expression was observed in the fibrous connective area of mild GO and was robust in severe GO, while the prominent TGF-β expression was seen in all GO. Increased FGF-β expression was observed in the fibroblasts and adipocytes of severe GO. No expression of COX2 was found in patients with GO. Conclusions. Macrophages and CD4 T lymphocytes are both engaged in the active/severe and long stage of inflammation in the orbital tissue. FGF-β and TGF-β expression may contribute to tissue remodeling, fibrosis, and perpetuation of inflammation in the orbital tissue of GO especially in severe GO.

  11. Surgeon point-of-view recording: Using a high-definition head-mounted video camera in the operating room

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    Akshay Gopinathan Nair

    2015-01-01

    Full Text Available Objective: To study the utility of a commercially available small, portable ultra-high definition (HD camera (GoPro Hero 4 for intraoperative recording. Methods: A head mount was used to fix the camera on the operating surgeon′s head. Due care was taken to protect the patient′s identity. The recorded video was subsequently edited and used as a teaching tool. This retrospective, noncomparative study was conducted at three tertiary eye care centers. The surgeries recorded were ptosis correction, ectropion correction, dacryocystorhinostomy, angular dermoid excision, enucleation, blepharoplasty and lid tear repair surgery (one each. The recorded videos were reviewed, edited, and checked for clarity, resolution, and reproducibility. Results: The recorded videos were found to be high quality, which allowed for zooming and visualization of the surgical anatomy clearly. Minimal distortion is a drawback that can be effectively addressed during postproduction. The camera, owing to its lightweight and small size, can be mounted on the surgeon′s head, thus offering a unique surgeon point-of-view. In our experience, the results were of good quality and reproducible. Conclusions: A head-mounted ultra-HD video recording system is a cheap, high quality, and unobtrusive technique to record surgery and can be a useful teaching tool in external facial and ophthalmic plastic surgery.

  12. Expressão de marcadores de proliferação celular e apoptose no carcinoma espinocelular de pele e ceratose actínica Expression of cell proliferation and apoptosis biomarkers in skin spinocellular carcinoma and actinic keratose

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    Marilho Tadeu Dornelas

    2009-10-01

    in patients with squamous cell carcinoma and actinic keratosis. METHOD: We studied samples from 30 patients, ten patients of squamous cell carcinoma, ten with actinic keratosis and ten lesion-free samples from blepharoplasty. RESULTS: p53 protein was expressed in all cases with different quantitative patterns. Bcl-2 was expressed at low intensity in six cases of actinic keratosis in the skin from blepharoplasty and negative in cases of squamous cell carcinoma. PCNA showed intense expression in all samples. Ki-67 showed variable expression in cases of keratosis and carcinoma and negative in the skin from the eyelid. CONCLUSION: The high expression of Ki-67 associated with low expression of Bcl-2 indicates proliferation in the carcinoma group. Thus, expression of p53 and Bcl-2 in patients with actinic keratosis indicates cell immortalization.

  13. Cosmetics for the eye area after cosmetic surgical procedures.

    Science.gov (United States)

    Ogden-West, N

    1999-01-01

    Cosmetic enhancement of the eye area after esthetic surgery allows the patient to get back into the mainstream of life faster. It also improves their psychic state by blocking out discoloration, helping to disguise incision scars and artistically coloring the face to enhance the results of the surgery. The patients automatically feel better, when they look better. After a surgical procedure, there are temporary and permanent structural changes that appear with blepharoplasty and laser surgery. Although these surgeries will take away loose skin, puffy fat deposits and wrinkles, they do not change the bone structure or eye placement. Before starting a makeup application, analyzation of the eyes for their structural features help the artist know the value of colors to be used. The measuring points of the brow along with the importance of framing the eye will also be discussed. Once the brows and the eyes have been analyzed, the artist needs to take into consideration the personality of the patient. This helps the artist decide on the colors, value, intensity and design which will be applied to the patient. Before eye makeup can be applied, the use of primers, concealers and/or camouflage creams will be used to block out any discoloration in the eye area. We will look at concerns in formulation of products that will go around the eyes after surgery. The application of cosmetic products should be used as an accessory. Women have a variety of dress styles: casual, business or evening. The style of makeup application should work in conjunction with what they are wearing and how they are feeling at the time. Just as there are many facets to a woman, there are various styles of application to fit her personality. PMID:10393519

  14. Operative treatment of functional facial skin disorders

    Directory of Open Access Journals (Sweden)

    Rettinger, Gerhard

    2005-09-01

    Full Text Available The skin is the principal interface between the body and the surrounding world and thus serves as a protective barrier against trauma, temperature extremes and radiation. With receptors for pressure, movement, heat and cold, it also acts as sensory organ and through sweat secretion plays a role in thermoregulation and electrolyte metabolism. Not all of these functions are relevant to facial skin, however, cosmetic aspects are of vital importance.Disorders primarily affect the protective skin function in defect and scar areas. For operative correction, the following principles should be applied: Minimization of scar development by adherence to indicated incision lines in the face, preferred use of local skin flaps for defect coverage in order to obtain optimal results regarding texture, complexion and sensitivity of skin, as well as consideration of aesthetic units. Recent developments in this field are tissue culture, occlusive dressings, and the use of growth factors.Age-related skin changes with impairment of cosmetic function are characterized by the development of creases and looseness of skin. Rejuvenation has become an important segment of skin surgery. For surface treatment, especially of creases and acne scars, various types of laser treatment are employed. Deeper lines can be filled with filler materials. The integration of the superficial musculoaponeurotic system (SMAS into face lift procedures has lead to more viable and natural results. Due to protruding tissue, blepharoplasty of the upper lid is often carried out in combination with forehead lift and eyebrow lift procedures. The optimized use of growth factors and synthetic materials, which serve as a matrix, are aimed at skin replacement which mimics the quality and functions of skin as closely as possible. On the whole, however, the reconstruction of defect through local tissue transfer is still considered as the treatment of choice.

  15. 《美容整形外科》(Aesthetic Plastic Surgery)2001年第25卷第4期目录

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Aesthetic Plastic Surgery Volume 25 , Number 4, 2001 249 The Value of a New Filler Material in Corrective and Cosmetic Surgery: DermaLive and DermaDeep Catherine Bergeret-Galley , Xavier Latouche , Yves-Gérard Illouz 256 Fat Transplantation for Soft Tissue Augmentation in the Lower Limbs M. Stampos, P. Xepoulias 262 The Effect of Reduction of the Peripheral Fat Content by Liposuction-Assisted Lipectomy (SAL) on Serum Leptin Levels in the Postoperative Period: A Prospective Study Ran Talisman, Nik Belinson, Dalit Modan-Moses, Hana Canti, Arie Orenstein, Zohar,Barzilai, Gideon Parret 266 Short Columella Nasolabial Complex in Aesthetic Rhinoplasty A. Aldo Mottura 273 Nasal Reconstruction After Epithelioma Salvador Rodriguez-Camps 278 PVP Breast Implants After Two Years: Initial Results of a Prospective Study Henrik Menke , H. GrUbmeyer, E. Biemer, R. R. Olbrisch 283 Mammographic Findings Following Reduction Mammoplasty Dimitrios Danikas, Spero J. V. Theodorou, George Kokkalis, Katerina Vasiou, Konstantina K yriakopoulou 286 Unsatisfactory Results of Periareolar Mastopexy With or Without Augmentation and Reduction Mammoplasty: Enlarged Areola With Flattened Nipple Cihat N. Baran, Fatih Peker , Turgut Ortak , Omer Sensoz , Namik K. Baran 290 Postoperative Compression After Breast Augmentation Bassem Nathan, Shiva Singh 292 Breast Augmentation with Fresh-Frozen Homologous Fat Grafts J. Haik, R. Talisman, J. Tamir, J. Frand, E. Gazit, J. Schibi, A. Glicksman, A. Orenstein 295 Upper Eyelid Mycobacterial Infection Following Oriental Blepharoplasty in a Pulmonary Tuberculosis Patient Samuel H. T. Chen, Chun-Hua Wang, Hung-Chi Chen, George C. J. Weng, Paul-Yann Lin, Fu-Chan Wei 299 Clinical Facial Photography in a Small Office:Lighting Equipment and Technique Fabio Meneghini 307 Specific Requirements for Preoperative and Postoperative Photos Used in Publication Irene Talamas and Luis Pando 311 Announcements

  16. V-Y and rotation flap for reconstruction of the epicanthal fold.

    Science.gov (United States)

    Shin, Yong Ho; Hwang, Pil Joong; Hwang, Kun

    2012-07-01

    Epicanthoplasty is commonly performed on Asian eyelids. Consequently, overcorrection may appear. The aim of this study was to introduce a method of reconstructing the epicanthal fold and to apply this method to the patients. A V flap with an extension (eagle beak shaped) was designed on the medial canthal area. The upper incision line started near the medial end of the double-fold line, and it followed its curvature inferomedially. For the lower incision, starting at the tip (medial end) of the flap, a curvilinear incision was designed first diagonally and then horizontally along the lower blepharoplasty line. The V flap was elevated as thin as possible. Then, the upper flap was deeply undermined to make it thick. The lower flap was made a little thinner than the upper flap. Then, the upper and lower flaps were approximated to form the anteromedial surface of the epicanthal fold in a fashion sufficient to cover the red caruncle. The V flap was rotated inferolaterally over the caruncle. The tip of the V flap was sutured to the medial one-third point of the lower margin. The inferior border of the V flap and the residual lower margin were approximated. Thereafter, the posterolateral surface of the epicanthal fold was made. From 1999 to 2011, 246 patients were operated on using this method. Among them, 62 patients were followed up. The mean intercanthal distance was increased from 31.7 to 33.8 mm postoperatively. Among the 246 patients operated on, reoperation was performed for 6 patients. Among the 6 patients reoperated on, 3 cases were due to epicanthus inversus, 1 case was due to insufficient reconstruction, 1 case was due to making an infold, and 1 case was due to reopening the epicanthal fold.This V-Y and rotation flap can be a useful method for reconstruction of the epicanthal fold. PMID:22801149

  17. Borrowed beauty? Understanding identity in Asian facial cosmetic surgery.

    Science.gov (United States)

    Aquino, Yves Saint James; Steinkamp, Norbert

    2016-09-01

    This review aims to identify (1) sources of knowledge and (2) important themes of the ethical debate related to surgical alteration of facial features in East Asians. This article integrates narrative and systematic review methods. In March 2014, we searched databases including PubMed, Philosopher's Index, Web of Science, Sociological Abstracts, and Communication Abstracts using key terms "cosmetic surgery," "ethnic*," "ethics," "Asia*," and "Western*." The study included all types of papers written in English that discuss the debate on rhinoplasty and blepharoplasty in East Asians. No limit was put on date of publication. Combining both narrative and systematic review methods, a total of 31 articles were critically appraised on their contribution to ethical reflection founded on the debates regarding the surgical alteration of Asian features. Sources of knowledge were drawn from four main disciplines, including the humanities, medicine or surgery, communications, and economics. Focusing on cosmetic surgery perceived as a westernising practice, the key debate themes included authenticity of identity, interpersonal relationships and socio-economic utility in the context of Asian culture. The study shows how cosmetic surgery of ethnic features plays an important role in understanding female identity in the Asian context. Based on the debate themes authenticity of identity, interpersonal relationships, and socio-economic utility, this article argues that identity should be understood as less individualistic and more as relational and transformational in the Asian context. In addition, this article also proposes to consider cosmetic surgery of Asian features as an interplay of cultural imperialism and cultural nationalism, which can both be a source of social pressure to modify one's appearance. PMID:26983846

  18. Direct brow lifting: Specific indications for a simplified approach to eyebrow ptosis

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    Michele Pascali

    2016-01-01

    Full Text Available Context: Brow lifting is an essential element in the rejuvenation of the ageing face. Various surgical techniques have been described. Among these, the direct brow lifting is an easy and effective technique that is often neglected because the scar can remain visible. Thus, this approach is usually reserved for elderly patients and males, with thick bushy brows. Aims: The authors present their result from a series of fifty consecutive patients treated over 2 years with direct brow lift. The aim is to demonstrate when the hairline is high or temporal alopecia is present and whether this technique is the best in bald patients, when some surgical steps are carefully adhered to. In these cases, the scar is less visible, hidden in the brow and is a good solution in women too. Subjects and Methods: Between January 2011 and January 2013, fifty patients underwent direct brow lift surgery. All were men. In all the cases, brow lifting was undertaken together with an upper blepharoplasty. The amount of brow elevation produced was assessed by comparing the vertical distances between the superior eyebrow hairline and the inter-pupillary line, pre- and post-operatively. The result and the scar quality were assessed both by the patient and the surgeon. Statistical Analysis Used: The paired t-test. Results: The authors obtained statistically significant results in brow elevation in 98% of the patients after a 12-month follow-up. The main complication associated with this procedure was visibility of the scar in two patients. Conclusions: The direct brow lift technique in bald men and with a high anterior hairline provides excellent and long-lasting results.

  19. Peri-orbital and mid-facial rejuvenation%眶周及中面部联合提紧术

    Institute of Scientific and Technical Information of China (English)

    蔡群; 林琳; 陈龙; 熊世文

    2012-01-01

    目的:根据眶周及中面部老年性改变特征,探讨眶周及中面部联合提紧的方法和效果.方法:采用下睑缘入路行中面部软组织分离提紧,并固定于眶缘骨膜上,同时结合抬眉术矫正眶周及中面部软组织松垂,并整复睑袋.结果:本组587例,经1~5年随访,除3例术后下睑下方出现凹陷,经颗粒脂肪移植充填满意外,无其他并发症,效果满意,结论:中面部提紧结合抬眉手术能有效改变眶周及中面部老化现象.手术操作简单,创伤小,并发症少,而且面部年轻化美容效果良好.%Objective To evaluate a new technique for peri-orbital and mid-facial rejuvenation. Methods The mid-facial soft tissue were suspended upward and fixed to the orbital bone membrane by direct transblepharoplasty approach, the peri-orbital soft tissue was also lifted by brow incisions.Blepharoplasty was carried at the same time. Results All 587 cases treated by this technique were followed up for 1 to 5 years.Good results were achieved.Except orbital depression appeared in two cases.no other complication occurred. Conclusions This technique is safe and effective for Peri-orbitaland mid-facial rejuvenation.

  20. Potential dangers of oxygen supplementation during facial surgery.

    Science.gov (United States)

    Greco, R J; Gonzalez, R; Johnson, P; Scolieri, M; Rekhopf, P G; Heckler, F

    1995-05-01

    The use of local anesthesia and intravenous sedation has made same-day outpatient surgery a viable option for many aesthetic and reconstructive procedures. These procedures often include the use of supplemental oxygen. Oxygen-enriched environments increase the combustibility of most materials, and "oxygen pooling" has been suspected to play an integral role in intraoperative fires. A personal experience with an intraoperative explosion and fire during a cosmetic blepharoplasty compelled us to explore the potential danger inherent in the use of supplemental oxygen as well as potential strategies to minimize that danger. This study systematically examines the microenvironment created by the use of oxygen both in the operative field and beneath the surgical drapes under conditions simulating routine facial surgery and various recommended modifications of its delivery. With the use of oxygen supplementation, oxygen concentration beneath the drapes was found to be consistently elevated when compared with ambient air (20.9 percent) and reached levels as high as 53.5 percent. Oxygen concentration in the operative environment was mildly but not significantly elevated. Although criteria for the use of oxygen supplementation are not clear, when administration is deemed necessary, the use of a posterior pharyngeal catheter for its delivery had no advantage over nasal prongs. However, appropriate alternatives include the use of "open face" draping techniques, the use of compressed air beneath the drapes as a substitute for oxygen supplementation in unsedated patients, and cessation of oxygen supplementation for 60 seconds prior to the use of a possible ignition source with oxygen flow rates of less than 3 liters per minute. PMID:7732145

  1. "Oriental anthropometry" in plastic surgery

    Directory of Open Access Journals (Sweden)

    Senna-Fernandes Vasco

    2008-01-01

    Full Text Available Background : According to Chinese medicine, the acupuncture-points′ (acupoints locations are proportionally and symmetrically distributed in well-defined compartment zones on the human body surface Oriental Anthropometry" (OA. Acupoints, if considered as aesthetic-loci, might be useful as reference guides in plastic surgery (PS. Aim: This study aimed to use aesthetic-loci as anatomical reference in surgical marking of Aesthetic Plastic Surgery. Method: This was an observational study based on aesthetic surgeries performed in private clinic. This study was based on 106 cases, comprising of 102 women and 4 men, with ages varying from 07 to 73 years, and with heights of between 1.34 m and 1.80 m. Patients were submitted to aesthetic surgical planning by relating aesthetic-loci to conventional surgical marking, including breast surgeries, abdominoplasty, rhytidoplasty, blepharoplasty, and hair implant. The aesthetic-surgical-outcome (ASO of the patients was assessed by a team of plastic surgeons (who were not involved in the surgical procedures over a follow-up period of one year by using a numeric-rating-scale in percentage (% terms. A four-point-verbal-rating-scale was used to record the patients′ opinion of therapeutic-satisfaction (TS. Results: ASO was 75.3 ± 9.4% and TS indicated that most patients (58.5% obtained "good" results. Of the remainder, 38.7% found the results "excellent", and 2.8% found them "fair". Discussion and Conclusion : The data suggested that the use of aesthetic-loci may be a useful tool for PS as an anatomical reference for surgical marking. However, further investigation is required to assess the efficacy of the OA by providing the patients more reliable balance and harmony in facial and body contours surgeries.

  2. Application of biepharomalar by moving down the orbital septum fat through percutoneous external skeletal fixation%眶隔脂肪下移经皮外固定在睑袋整复术中的应用

    Institute of Scientific and Technical Information of China (English)

    侯勇; 李茂玉; 刘唯; 高锦越; 熊艳; 薛美思

    2012-01-01

    目的:探讨眶隔脂肪下移经皮外固定在伴睑颊沟凹陷畸形睑袋整复术中的应用效果.方法:常规行睑袋整复术的同时,沿下眶骨缘向下在骨膜表面充分剥离术前标记的睑颊沟凹陷范围,形成一囊腔,并将眶隔脂肪修整成脂肪垫使眶隔脂肪尽量平整铺于囊腔,并用尼龙线外固定.结果:本组119例,均进行了3~12个月的随访,随诊观察下睑袋及泪眶沟均消失,下睑形态自然,曲线圆滑,效果稳定,受术者自觉外观满意.结论:眶隔脂肪下移经皮外固定用于伴睑颊沟凹陷畸形的睑袋整形术,能解决常规睑袋整形术后下睑局部凹陷而不圆润的问题.此法既能使下睑袋及泪眶沟均消失,又能恢复下睑曲线圆滑的自然形态,且效果稳定.%Objective To discuss the practical effect of blepharomalar with concave palabromalar groove deformity by moving down the orbital septum fat through percutaneous external skeletal fixation. Methods Stripping thoroughly the marked range of concave palabromalar groove preoperative along periosteal surface of orbital margin to form a cyst packed with trimmed orbital septumfat smoothly and fixed with silk thread when conducting a conventional blepharoplasty. Results According to the follow-up report,it has found that all patients in 119 cases being satisfied with the efficacy and stability in the follow-up period ranging from 3 to 12 months.The Follow-up observations shows that the tarsus inferior and tear trough have disappeared.The tarsus inferior and smooth curve can be formed naturally. Conclusion Moving down the orbital septumfat through percutaneous external skeletall fixation with concave palabromalar groove deformity can improve the top-concave and rough surface of lower tarsus.lt not only makes inferior and tear trough disappear, but also restores the smoothness of the lower tarsus curve naturally with stable effect.

  3. Application of improved plastic surgery for eyelid bag in senile eyelid bag with tear trough and eyelid buccal groove%改良睑袋整形术在伴有泪槽和睑颊沟的中老年下睑袋中的应用

    Institute of Scientific and Technical Information of China (English)

    师军涛; 刘亚丽

    2014-01-01

    目的:使用改良的睑袋整形手术方法,达到改善伴有泪槽和睑颊沟的中老年下眼袋的术后效果。方法延长睑缘内则切口过泪点至内眦部;在传统眼袋整形手术过程中将眶肌筋膜韧带提紧固定于外眦韧带上或眶外侧壁上,眼轮匝肌切口上、下缘部分叠合缝合加固,将疝出的脂肪以“脂肪瓣”的形式间断缝合于眶下缘骨膜处。结果根据156例随访资料,132例满意,24例基本满意。结论使用改良后的睑袋手术方法,能明显改善睑袋术后的效果。%Objective To improved plastic surgery for eyelid bag in order to improve postoperative effect of senile eyelid bag with tear trough and eyelid buccal groove. Methods Extend inside the eyelid incision through lacrimal punctum to the inner canthus;in the traditional process of plastic surgery blepharoplasty, fascia ligament of orbital muscle was tightly fixed on the outer canthus ligament or lateral orbital wall, and the two edges of the orbicularis oculi muscle incision were partly reinforced by overlapping suture,and the herniated fat was interrupted suture in inferior orbital rim periosteum in the form of "fat flap". Results According to the follow-up, 156 patients, 132 cases of satisfaction, 24 cases of basic satisfaction, According to the follow-up visit on 156 cases. 132 cases were satisfied. 24 cases were satisfied basically. Conclusion Modified surgical methods for eyelid bag can significantly improve the effect of eye bags.

  4. El ojo hermoso The beautiful eye

    Directory of Open Access Journals (Sweden)

    O. M. Ramírez

    2007-06-01

    Full Text Available Como cirujanos estéticos siempre nos esforzamos por alcanzar resultados hermosos que sean agradables a los sentidos. Esto es particularmente cierto en el terreno del rejuvenecimiento periorbitario. Según la estadística de la Sociedad Americana de Cirujanos Plásticos la blefaroplastia estética es uno de los procedimientos mas frecuentes y su frecuencia va en aumento tanto en hombres como en mujeres. El rejuvenecimiento periorbitario adecuado debería restaurar la percepción interior del paciente respecto a belleza y juventud de sus ojos, así como proporcionar un aspecto externo que sea "estético" o agradable a los sentidos. Para lograr este objetivo, se requiere una comprensión de la estética facial, tanto en términos subjetivos como objetivos. Los investigadores han demostrado que la percepción del atractivo o la belleza en la cara de un individuo es relativamente constante entre observadores independientes, desafiando el dicho popular de que "la belleza está en el ojo del espectador." Presentamos una actualización del tema y una amplia iconografía. La información recogida de la literatura y de años experiencia clínica debería permitir al lector desarrollar una mayor sensibilidad estética, para obtener resultados óptimos en el rejuvenecimiento periorbitario.As aesthetic surgeons we are always striving to achieve beautiful results that are pleasurable to the senses. This is particularly certain in the land of the periorbital rejuvenation. According to the statistics of the American Society of Plastic Surgeons, aesthetic blepharoplasty is one of the procedures most commonly performed and goes in increase its so much frequency in men as in women. Successful periorbital rejuvenation should restore the patient"s inner sense of beauty and youthfulness as well as provide an outward appearance that is ‘aesthetic" or pleasurable to the senses. To accomplish this lofty goal, the aesthetic surgeon must strive to create "the beautiful

  5. Rejuvenecimiento mini-invasivo subgaleal del tercio superior facial: informe preliminar The minimally invasive subgaleal upper facelift: preliminary report

    Directory of Open Access Journals (Sweden)

    W.E. Bukret

    2012-06-01

    between February 2008 and April 2010. The minimally invasive subgaleal upper face lift was performed in conjunction with a middle face lift through the same temporal incisions in 17 cases, with blepharoplasty in 15 cases, rhinoplasty in 6 cases, neck liposuction 1 case, and with a full face and neck lift in 9 cases. The lifting technique included 4 or 5 small incisions in the scalp, wide subgaleal elevation, selective myotomies of the depressor muscles, anchoring of the frontalis muscle with percutaneous sutures to a polypropylene mesh covered by frontal periosteum, and suturing of the superficial temporal fascia to the deep temporal fascia. The mean follow-up was 14 months (range from 3 to 26 months. The signs of aging were significantly reduced, and most of the patients expressed a high degree of satisfaction. Complications were minor and transitory. In conclusion, the minimally invasive subgaleal approach of the upper third of the face is a rejuvenation procedure that gives excellent results, with minimal and transitory complications. More studies are necessary to determine long term efficacy.

  6. Differentiation potential of human Orbicularis oculi muscle-derived stem cells towards Schwann cells phenotype%诱导人眼轮匝肌来源肌源干细胞向许旺细胞样细胞的分化

    Institute of Scientific and Technical Information of China (English)

    丁维进; 张文俊; 孙美庆; 苏志达; 李翠; 刘安堂; 江华

    2011-01-01

    BACKGROUND: Muscle derived stem cells (MDSCs) can be isolated from human orbicularis oculi muscle and be differentiated to a Schwann cell phenotype which could eventually provide functional benefits for peripheral nerve repair. OBJECTIVE: To induce the differentiation of MDSCs into Schwann cell phenotype. METHODS: ①Under the support of microscope, we collected the discarded human Orbicularis oculi muscle resected in the upper eyelid blepharoplasty and isolate human-MDSCs within it with aid of tri-enzyme digestion and pre-plating technique, and then identify the cells by immunohistochemistry method. ②We isolated Schwann cells and identify the cells by immunohistochemistry method. Through half-harvest method, we would like to prepare conditioned medium from Schwann cell culture. ③We co-culture human-MDSCs with Schwann cell conditioned medium and the transdifferentiated cell morphology was investigated daily under microscope. The common used marker, S-100, GFAP and p75 were stained to identify Schwann cell phenotype with use of immunohistochemistry method. RESULTS AND CONCLUSION: ①We collected human Orbicularis oculi muscle sample from three young female volunteer with their consensus. Human-MDSCs were isolated from Orbicularis oculi muscle and have their desmin positively stained and Sca-1 was positively expressed. ②Schwann cells were isolated and identified with S-100 positively stained at the rate of (97.4±0.7)%. ③The isolated human-MDSCs were successfully transdifferentiated into Schwann cell-like cells with positive expression of S100, GFAP and p75, which would serve as a unanimous evidence of Schwann cell phenotype. Human-MDSCs could be transdifferentiated into Schwann cell-like cells when co-cultured within Schwann cell conditioned medium, which would serve as an alternative candidate for commonly studied Schwann cells in tissue engineering nerve graft.%背景:肌源干细胞的优越性引导学者们尝试从人眼轮匝肌中分离该细胞,同

  7. Preliminary clinical observations on autologous cultured skin fibroblasts transplantation to treat the facial soft tissue deficiencies%自体成纤维细胞移植充填面部凹陷的初步临床观察

    Institute of Scientific and Technical Information of China (English)

    曾玮; 魏子人; 刘岱; 柴密; 赵玉明

    2013-01-01

    Objective To observe the effect and safety of autologous cultured skin fibroblasts transplantation for treating depressed facial skin defects.Methods A total of 19 patients were treated from Jan,2010 to Oct,2010.Autologous skin fibroblasts were separated from postauricular skin biopsy or resected skin tissue in other surgeries such as blepharoplasty.They were cultured and expanded with exclusive method.Cells (2 × 107/ml) within three passages were injected intradermally at the site of skin depression three times at one-month interval.Adverse events were observed and recorded.Clinical effects were evaluated and graded by two unrelated physicians before and 6 months after the first injection.Results Cells from 16 patients were successfully cultured at the first time.The other 3 patients underwent a second harvest.A total amount of 6 × 108 cells could be reached within three passages in 45 days.16 out of 19 patients accomplished the whole course of this study.Minor adverse events were observed in two patients including small ulcer caused by over injection in one patient and slightly redness and swelling in the other.The redness disappeared after a week without any treatment.No serious complications were observed.Significant difference was noticed between the scores obtained before and after the treatment.Conclusions From this study,neither serious complications nor excessive cell proliferation or scar formation was found after cell injection.The effect of using autologous fibroblast transplantation was obvious and long-lasting,which provides a new choice for the treatment of depressed facial skin defects.%目的 观察自体成纤维细胞移植治疗面部痤疮、瘢痕等软组织凹陷的临床安全性和有效性.方法 2010年1月至11月,通过自体成纤维细胞移植,对19例患者进行面部软组织凹陷治疗.皮肤标本选用耳后皮肤或其他手术中切除的皮肤组织,利用特殊的培养方法体外培养扩