Halos and Asymmetric Triangles: Designing the Eyelids with Volume Using Fillers and/or Fat

2018 ◽  
Vol 34 (02) ◽  
pp. 173-177
Author(s):  
Samuel Lam
Keyword(s):  
Fat Grafting ◽  
Volume Loss ◽  
Lower Face ◽  
New Models ◽  
The Face ◽  
Principal Method

AbstractPeriorbital aging is mainly a product of volume loss, which can be addressed with fillers and/or fat grafting. This stands in contrast to the lower face where a lifting procedure can be the principal method to improve moderate-to-significant aging. New models to explain these concepts of periorbital rejuvenation to both the surgeon and the prospective patient are outlined herein, namely, three facial halos (around the eyes, around the perimeter of the face, and around the mouth) and asymmetric triangles around the eyes. Specific techniques for fillers and fat grafting are also covered separately in detail in this article.

Periorbital, lower face, and neck

2021 ◽  
pp. 1379-1398
Author(s):  
Norman Waterhouse ◽  
Naresh Noshi ◽  
Niall Kirkpatrick ◽  
Lisa Brendling
Keyword(s):  
Soft Tissue ◽  
Surgical Management ◽  
Soft Tissues ◽  
Lower Eyelid ◽  
Surgical Correction ◽  
Volume Loss ◽  
Lower Face ◽  
The Face ◽  
Upper Face ◽  
Fat Pads

Facial ageing occurs as a consequence of multifactorial changes in both the external skin and underlying tissues. The ageing process may vary dramatically between individual patients and is thus influenced by genetic factors. When assessing the ageing face it is important to consider the skeletal architecture, the soft tissue layers including the anterior fat pads, the osseocutaneous ligament anchors, and finally the overlying skin. Assessment of the external skin incorporates factors such as dermal thinning, solar damage, lifestyle effects such as smoking, and Fitzpatrick skin type. Surgical correction of facial ageing attempts to reverse both gravitational change of soft tissues and also to restore volume loss. There are a variety of methods used to divide the face into regions, but for the purpose of this chapter, the surgical management of facial ageing will be separated into three anatomical areas: (1) upper face, including the upper eyelids, eyebrows, and forehead; (2) midface, including the lower eyelid/anterior cheek continuum; and (3) lower and lateral cheek, neck, and perioral region

scholarly journals Facial Rejuvenation With Fat Grafting and Fillers

2021 ◽  
Vol 41 (Supplement_1) ◽  
pp. S31-S38
Author(s):  
J Sarah Crowley ◽  
Elizabeth Kream ◽  
Sabrina Fabi ◽  
Steven R Cohen
Keyword(s):  
Calcium Hydroxyapatite ◽  
Fat Grafting ◽  
Facial Rejuvenation ◽  
Volume Loss ◽  
Level Of Evidence ◽  
Tissue Replacement ◽  
Dermal Thickness ◽  
The Face ◽  
Modality Approach ◽  
A New Technique

Abstract Facial rejuvenation requires a multi-modality approach to address the sun damage, volume loss, and thinning of skin that occurs with aging. With age, the collagen fibrils that provide strength become fragmented and fibroblasts connections become weak, leading to skin laxity and loss of youthful skin. Fillers can lead to a more youthful appearance by providing volumetric support. Synthetic fillers such as hyaluronic acid products, calcium hydroxyapatite, polylactic acid, and polymethylmethacralate have bio-stimulatory affects, ranging from small effects on fibroblast production to prolonged stimulatory effects on dermal thickness and blood supply. Fat grafting is also an ideal technique for facial rejuvenation because it is readily available, natural, and has regenerative effects. This review describes a new technique of fat grafting for the face called Injectable Tissue Replacement and Regeneration that specifically addresses the different anatomic compartments of the face with volume loss. With this brief review, we aim to evaluate the currents trends of fat grafting and fillers in the management of facial rejuvenation, including the cellular changes that occur with facial aging, the bio-stimulatory effects of fillers, and the anatomic replacement of tissue with fat grafting. >Level of Evidence: 4

scholarly journals Fat Augmentation as Adjunct to CORE Facelift Surgery

2021 ◽  
Author(s):  
Capi C. Wever
Keyword(s):  
Fat Grafting ◽  
Facial Rejuvenation ◽  
Golden Standard ◽  
The Face

AbstractRuling out cases with strong jawlines, well-developed mid-cheek regions, and good fat presence, if done artistically, fat augmentation strongly assists midface definition and can replenish hollowed regions of the face. This is particularly true for candidates with low bodyfat or smaller skull structures. Hence, fat grafting is a strong adjunct to conventional excisional techniques in facial rejuvenation surgery, regardless of experience, technique, or geographical embedding. While CORE facelift techniques remain the golden standard that define the top level of facelift surgery, fat augmentation has its unique place along the full stretch of an individual surgeon's learning scope, as it will potentially improve results regardless of where one stands.

scholarly journals The Future of Fat Grafting

2021 ◽  
Vol 41 (Supplement_1) ◽  
pp. S69-S74
Author(s):  
Summer E Hanson
Keyword(s):  
Adipose Tissue ◽  
Breast Reconstruction ◽  
Fat Grafting ◽  
The Other ◽  
Special Topic ◽  
Autologous Fat Grafting ◽  
Upper Arm ◽  
Future Directions ◽  
Autologous Fat ◽  
The Face

Abstract One of the earliest reported cases of autologous fat grafting (AFG) was by Neuber in 1893 and consisted of the transfer of small lobules of fat from the upper arm for cicatrical depression of the face. He advocated the use of smaller grafts, noting that pieces larger than the size of a bean would form cysts. In 1895, Czerny excised a lumbar lipoma and transplanted it to the chest for breast reconstruction. Since these early reports, the knowledge base around AFG has expanded exponentially, as illustrated by the other papers within this special topic. As we embark on the next phase of AFG in the clinical setting, there are several directions which are near-clinical translation. This paper discusses future directions in fat grafting that build on optimization of our current techniques as clinical indications expand, such as supplementing purified lipoaspirate and the associated regulatory burden, or deconstructing adipose tissue to selectively use adipose graft components for a variety of regenerative indications.

Modern Fat Grafting Techniques to the Face and Neck

2021 ◽  
Vol 148 (4) ◽  
pp. 620e-633e
Author(s):  
Saïd C. Azoury ◽  
Sameer Shakir ◽  
Louis P. Bucky ◽  
Ivona Percec
Keyword(s):  
Fat Grafting ◽  
The Face

Cloud Approach for the Medical Information System

2018 ◽  
pp. 238-261
Author(s):  
Ekaterine Kldiashvili
Keyword(s):  
Cloud Computing ◽  
Information System ◽  
Medical Information ◽  
Healthcare Services ◽  
Healthcare Research ◽  
Effective Field ◽  
Medical Information System ◽  
New Models ◽  
The Face ◽  
Intensive Development

Healthcare informatics is an important and effective field. It is characterized by the intensive development and design of the new models and protocols. The special emphasize is done on medical information system (MIS) and cloud approaches for its implementation. It is expected that this technology can improve healthcare services, benefit healthcare research, and change the face of health information technology. This chapter discusses the application of cloud computing for the medical information system practical usage.

Nonsurgical Redefinition of the Chin and Jawline of Younger Adults With a Hyaluronic Acid Filler: Results Evaluated With a Grid System Approach

2020 ◽  
Author(s):  
Dario Bertossi ◽  
Massimo Robiony ◽  
Andrea Lazzarotto ◽  
Giorgio Giampaoli ◽  
Riccardo Nocini ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Grid System ◽  
Level Of Evidence ◽  
Younger Adults ◽  
Lower Face ◽  
Age Related ◽  
Tissue Edema ◽  
The Face ◽  
The Mean ◽  
And Performance

Abstract Background Aesthetic treatment of the lower face is increasingly in demand, particularly owing to age-related changes in appearance. VYC-25L is a novel hyaluronic acid filler with high G′ and high cohesivity, specifically designed for sculpting and contouring of the chin and jaw. Objectives The aim of this study was to assess the use of a grid traced onto the chin and jaw for guiding treatment with VYC-25L. Methods This was a retrospective, single-center analysis of data from adult patients undergoing treatment of the lower third of the face with VYC-25L. A grid system of horizontal and vertical lines was used to systematize the process of treatment planning and performance. Results Thirty subjects were enrolled (53.3% female; mean [standard deviation] age, 34.4 [2.8] years). The mean quantity of VYC-25L used was 4.0 [0.8] mL. Based on the 5-point Global Aesthetic Improvement Scale, 29 patients (96.7%) rated their appearance at 20 days posttreatment as “much improved” or “very much improved.” The only complications recorded were early transient soft-tissue edema (n = 14; 46.7%) and bruising (n = 6; 20.0%). There were no cases of infection, paresthesia, asymmetry, hematoma, necrosis, or skin discoloration. Conclusions Treatment of the chin and jawline with VYC-25L, with injection locations determined by a standardized grid-based approach, appears to be effective and safe with high rates of patient satisfaction. Injection of this filler offers a potentially high-impact approach for patients across a variety of biological and economic circumstances. Level of Evidence: 4

scholarly journals Preenrichment with Adipose Tissue-Derived Stem Cells Improves Fat Graft Retention in Patients with Contour Deformities of the Face

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Muhammad M. Bashir ◽  
Muhammad Sohail ◽  
Fridoon J. Ahmad ◽  
Mahmood S. Choudhery
Keyword(s):  
Stem Cells ◽  
Adipose Tissue ◽  
Stem Cell ◽  
Patient Satisfaction ◽  
Fat Grafting ◽  
Fat Graft ◽  
Cell Group ◽  
Patient Satisfaction Scores ◽  
The Face ◽  
Tissue Grafts

Quick absorption of adipose tissue grafts makes the outcomes less satisfactory for clinical applications. In the current study, adipose tissue grafts were mixed with adipose tissue-derived stem cells (ASCs) to improve retention of adipose tissue grafts and to make the clinical outcomes of fat grafting more reliable. Adipose tissue was either injected alone (conventional group) or mixed with ASCs (stem cell group) before injection. In both groups, adipose tissue was injected at the site of contour throughout layers of tissues till visual clinical symmetry with the opposite side was achieved. The volume of injected fat graft was measured after 72 hours and 6 months using a B-mode ultrasound device connected with a 12 MH frequency probe. The percentage reduction in the volume of injected fat, physician satisfaction scores (Ph-SCs), and patient satisfaction scores (P-SCs) were also recorded. After 6 months, there was significantly lower fat absorption in the stem cell group as compared to the conventional group. Mean physician and patient satisfaction scores were significantly improved in the stem cell group. No significant adverse effects were noted in any patient. Significantly lower absorption of graft due to the use of ASCs improves the clinical outcomes of conventional fat grafting for contour deformities of the face. The current preenrichment strategy is noninvasive, safe and can be applied to other diseases that require major tissue augmentation such as breast surgery. This trial is registered with NCT02494752.

Filtration-assisted exchange transfusion using alpha alpha Hb, an erythrocyte substitute

1991 ◽  
Vol 70 (4) ◽  
pp. 1639-1644 ◽  
Author(s):  
J. R. Hess ◽  
C. E. Wade ◽  
R. M. Winslow
Keyword(s):  
Hollow Fiber ◽  
Blood Viscosity ◽  
Continuous Flow ◽  
Volume Expansion ◽  
Exchange Transfusion ◽  
Volume Loss ◽  
Intravascular Volume ◽  
Hemodynamic Stability ◽  
The Face ◽  
Hb Concentration

A method for improving the efficiency of exchange transfusion to evaluate hemoglobin- (Hb) based erythrocyte substitutes is described. The method uses a continuous-flow hollow-fiber plasma separation filter to remove the erythrocytes while returning 75% of the plasma. The removed volume was replaced with a 14-g/dl solution of human Hb cross-linked between the alpha-chains with bis(3,5-dibromosalicyl)fumarate (alpha alpha Hb). Filtration of 2.76 blood vol in anesthetized swine resulted in a 95% reduction of hematocrit and produced a plasma Hb concentration of 7.63 g/dl. Hyperoncotic Hb solutions cause volume expansion, which reduces the efficiency of exchange but provides hemodynamic stability in the face of decreasing blood viscosity and subsequent intravascular volume loss with Hb redistribution. Filtration-assisted exchange transfusion is rapid, conserves valuable modified Hb, and ensures continuous adequate oxygen delivery.

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