scholarly journals Objective Comparison of Nasojugal Fold Depth and Lower Eyelid Length After Fat Excision Versus Fat Transpositional Lower Blepharoplasty

2019 ◽  
Vol 39 (10) ◽  
pp. 1048-1054 ◽  
Author(s):  
Sathyadeepak Ramesh ◽  
Robert A Goldberg ◽  
Allan E Wulc ◽  
Alan B Brackup
Keyword(s):  
Retrospective Review ◽  
Lower Eyelid ◽  
Level Of Evidence ◽  
Aesthetic Result ◽  
Lower Blepharoplasty ◽  
The World ◽  
Aesthetic Results ◽  
Compare And Contrast

AbstractBackgroundLower blepharoplasty is one of the most commonly performed aesthetic surgeries in the world. However, there are no studies to directly compare patients who had fat excision vs fat transposition.ObjectivesThe authors sought to compare and contrast aesthetic results of fat excisional and fat transpositional lower blepharoplasty.MethodsA retrospective review was conducted of 60 patients (120 eyelids) who underwent transconjunctival lower blepharoplasty, either with fat excision or fat transposition into a preperiosteal plane. Marginal reflex distance-2, lower eyelid length, nasojugal fold depth, and pretarsal orbicularis definition were measured.ResultsMean follow-up was 5.6 months. Mean marginal reflex distance-2 did not significantly differ after either fat excision or fat transposition. Mean lower lid length decreased after fat excision only (P < 0.001), and postoperative fat excision patients had a shorter lower eyelid length than patients who underwent fat transposition (13.5 ± 2.1 mm vs 16.1 ± 1.9 mm, P < 0.0001). Pretarsal orbicularis definition increased after both surgeries (P < 0.001), and the groups did not differ (1.0 ± 0.8 vs 1.1 ± 0.9, not significant). Mean nasojugal fold depth was effaced after surgery in both groups (P < 0.001), although the nasojugal fold was significantly more effaced after fat transposition (1.5 ± 0.7 vs 0.48 ± 0.6, P < 0.001).ConclusionsIn lower blepharoplasty, fat excision resulted in a shorter lower eyelid, and fat transposition resulted in a more effaced lid-cheek junction. Surgeons should be able to balance both techniques to deliver a customized aesthetic result.Level of Evidence: 3

Lateral tarsal strip through osteotomies for recurrent ectropion and eyelid laxity correction

2022 ◽  
pp. 112067212110730
Author(s):  
Amparo M Mora ◽  
Carlos M Córdoba ◽  
Fabio D Padilla ◽  
Diego F Duran
Keyword(s):  
Surgical Technique ◽  
Facial Asymmetry ◽  
Lower Eyelid ◽  
Body Sensation ◽  
Alternative Treatment Option ◽  
Initial Symptoms ◽  
Aesthetic Results ◽  
Lateral Tarsal Strip ◽  
Anophthalmic Socket

Objective to present a surgical technique for treating patients with recurrent ectropion and severe lower eyelid laxity. Methods Lateral tarsal strip and canthal fixation by osteotomy was performed in 6 patients with recurrent ectropion and 1 patient with extreme lower eyelid laxity secondary to an anophthalmic socket. Preoperative and postoperative photographs were evaluated in order to assess the outcomes of the procedure. Patients were followed up 4 weeks, 6 months, 12 months and 24 months of the postoperative period. The initial symptoms of the patients were eye redness, epiphora, foreign body sensation, aesthetic complaints, and facial asymmetry. Symptoms and aesthetic results were assessed by questioning, photographs, and fluorescein and lissamine green stains taken in each visit. Results No postoperative complications were observed. No recurrence episodes were reported during the follow-up period and physical appearance improvement and symptom severity reduction were maintained during the observation. Conclusion Lateral tarsal strip through osteotomies is an effective surgical procedure for treating severe recurrent ectropion cases or lower eyelid laxity and could be considered as an alternative treatment option or even a primary surgical technique in selected difficult cases.

Reconstruction of the transverse and dorsal-oblique amputations of the distal thumb with volar cross-finger flap using the index finger

2014 ◽  
Vol 40 (4) ◽  
pp. 392-400 ◽  
Author(s):  
H. Y. Erken ◽  
I. Akmaz ◽  
S. Takka ◽  
A. Kiral
Keyword(s):  
Retrospective Review ◽  
Index Finger ◽  
Donor Site ◽  
Level Of Evidence ◽  
Reliable Technique ◽  
Flap Loss ◽  
Discrimination Testing ◽  
The Mean ◽  
Donor Site Complication

We performed a retrospective review of 12 patients with dorsal oblique and transverse amputations of the distal thumb who were treated with a volar cross-finger flap from the index finger. The mean patient follow-up period was 28 months postoperatively (range: 19–43 months). There were no instances of flap loss, infection, or donor site complication in our series. The mean Semmes–Weinstein monofilament testing scores on the injured thumb and the donor site were 0.65 g (range: 0.16–2 g) and 0.51 g (range: 0.16–1 g), respectively. The mean 2-point discrimination testing scores on the injured thumb and the donor site were 4.5 mm (range: 3–8 mm) and 4.3 mm (range: 3–7 mm), respectively. This study suggests that the volar cross-finger flap using the index finger is a reliable technique in repairing dorsal oblique and transverse amputations of the distal thumb. Type of study/level of evidence: Therapeutic IV

The K-Wire Fixation Technique for Endoscopic Brow Lift: A Long-Term Follow-Up

2019 ◽  
Vol 40 (10) ◽  
pp. 1051-1060 ◽  
Author(s):  
Paul E Chasan ◽  
Adam T Hauch
Keyword(s):  
Fixation Technique ◽  
Effective Technique ◽  
Level Of Evidence ◽  
Brow Lift ◽  
Wire Fixation ◽  
Aesthetic Results ◽  
Long Term Follow Up ◽  
Endoscopic Brow Lift

Abstract Background Many techniques have been presented for fixation during endoscopic brow lift, but no singular technique has become dominant. Objectives The authors described a technique for fixation for endoscopic brow lift that is inexpensive, easy to use, and versatile and has minimal morbidity. Methods The charts of 284 patients who underwent the K-wire fixation technique between December 1996 and September 2018 were reviewed. This technique employs a transcutaneous K-wire to hold the brow in position until tissue adhesion creates a lasting elevation of the brow. Results A total of 284 patients underwent K-wire fixation for endoscopic brow lifting. Two patients had hematomas and 5 patients (1.8%) required a second unilateral brow lift procedure. Long-term elevation of the brow was maintained in all patients. Conclusions K-wire fixation for endoscopic brow lift is a simple, safe, and effective technique for fixation during endoscopic brow lifting that provides long-term aesthetic results. Level of Evidence: 4

Aesthetic Breast Surgery: What Do the Measurements Reveal?

2019 ◽  
Vol 40 (7) ◽  
pp. 742-752
Author(s):  
Elisa Bolletta ◽  
Ciara Mcgoldrick ◽  
Elizabeth Hall-Findlay
Keyword(s):  
Breast Reduction ◽  
Breast Surgery ◽  
Suprasternal Notch ◽  
Level Of Evidence ◽  
Aesthetic Results ◽  
Measuring Tape ◽  
Nipple Position ◽  
The Right ◽  
Aesthetic Breast

Abstract Background Do plastic surgeons really know what happens to the breast after surgery? We often think that we do, but we have very few measurements to show whether we are on the right track. Objectives Only when the surgeon can predict the changes can she or he achieve consistent outcomes. Measurements lead to understanding; understanding what the measurements show allows us to refine our approach. Methods Consecutive patients in 4 categories were analyzed: breast reduction, mastopexy, augmentation, and mastopexy-augmentation. All procedures were performed by a single surgeon and all measurements were performed by the same surgeon. A standard measuring tape was utilized, and data were collected immediately preoperatively and at each follow-up visit. Only those patients with preoperative and complete 1-year postoperative measurements were included in this review. The parameters measured were clavicle to upper breast border (UBB), UBB to nipple, suprasternal notch (SSN) to nipple, SSN to inframammary fold (IMF), and chest midline to nipple. Results The changes were consistent. The borders of the breast footprint were expanded with the addition of an implant (UBB and IMF) and reduced with the removal of parenchyma (IMF). The existing SSN to nipple position was stretched when volume was added to the breast mound and it remained unchanged from the preoperatively marked position in a breast reduction. Conclusions Although measurements are not necessary to achieve good aesthetic results in breast surgery, surgeons should understand what the measurements show and what happens to the different breast parameters. Level of Evidence: 3

scholarly journals Az alsó szemhéj pótlása tumoreltávolítás után

2021 ◽  
Vol 162 (29) ◽  
pp. 1180-1184
Author(s):  
Zoltán Sohajda ◽  
Levente Juhász
Keyword(s):  
Wound Dehiscence ◽  
Lower Eyelid ◽  
Early Postoperative Period ◽  
Cosmetic Result ◽  
Full Thickness ◽  
Tumor Removal ◽  
Eyelid Reconstruction ◽  
Lower Eyelid Reconstruction ◽  
Aesthetic Results

Összefoglaló. Bevezetés: A tumoreltávolítás miatt végzett teljes alsószemhéj-pótlás összetett feladat lehet. A rekonstrukció célja a kielégítő funkcionális és kozmetikai eredmény elérése. Célkitűzés: A módosított Fricke-lebennyel végzett rekonstrukció tapasztalatainak bemutatása az alsó szemhéj teljes hiánya esetén. Módszer: 2010. január és 2020. december között 7 beteg esetében tumoreltávolítás után végeztünk alsószemhéj-rekonstrukciót módosított Fricke-lebennyel. A lebeny képzése a halántéktájon történt. A betegek átlagéletkora 72,8 év volt. A szövettani eredmény minden esetben basocellularis carcinoma volt. Az átlagos követési idő 1,9 év volt. Eredmények: Minden esetben jó funkcionális és esztétikai eredményt értünk el. Lebenynecrosist, sebelégtelenséget nem tapasztaltunk. A korai posztoperatív szakban átmeneti conjunctiva- és szemhéjoedema volt tapasztalható. 3 beteg esetében könnyezés, 1 beteg esetében érintő szőrök okozta szemszúródást észleltünk. Recidíva nem alakult ki a követési idő alatt. Következtetés: Tapasztalataink szerint a módosított Fricke-lebeny kiváló funkcionális és esztétikai eredményt ad a tumoreltávolítás utáni teljes alsószemhéj-rekonstrukcióban. Orv Hetil. 2021; 162(29): 1180–1184. Summary. Introduction: The full-thickness lower eyelid reconstruction after tumor removal can be a complex challenge. The aim of reconstruction is to reach an appropriate functional and cosmetic result. Objective: To present the retrospective analysis of the reconstruction’s experience with the use of Fricke’s flap in the case of full-thickness lower eyelid defect. Method: Between January 2010 and December 2020, in the case of 7 patient’s after tumor excision on lower eyelid, reconstruction was performed with a modified Fricke’s flap. The Fricke’s flap was fashioned in the temple region. The patients’ average age was 72.8 years. The histological result was basocellular carcinoma in every case. The average follow-up period was 1.9 years. Results: In all cases, good functional and cosmetic result was detected. There were not any flap necrosis and wound dehiscence. In the early postoperative period, temporary edema of the eyelid and conjunctiva was detected. Epiphora occurred in the case of 3 patients and we observed eye irritation caused by skin hair in the case of 1 patient. Tumor recurrence was not detected during the follow-up period. Conclusion: In our experience, the modified Fricke’s flap has excellent functional and aesthetic results in the reconstruction after tumor removal on the lower eyelid. Orv Hetil. 2021; 162(29): 1180–1184.

scholarly journals Endoscopic septotomy as a treatment for leaks after sleeve gastrectomy

2020 ◽  
Vol 08 (01) ◽  
pp. E70-E75 ◽  
Author(s):  
Ramon Diaz ◽  
Leonard K. Welsh ◽  
Juan Esteban Perez ◽  
Andres Narvaez ◽  
Gerardo Davalos ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Total Gastrectomy ◽  
Retrospective Review ◽  
Procedure Time ◽  
Fistula Closure ◽  
Crucial Step ◽  
The World ◽  
Mean Time ◽  
Definitive Management

Abstract Background and study aims Sleeve gastrectomy (LSG) is the most commonly performed bariatric procedure in the world. Leaks are the most feared complications after this procedure. Endoscopic septotomy has been described as a resolution technique that could be useful in the setting of late and chronic leaks. We present our experience in the management of gastric leaks with this advanced endoscopic technique. Patients and methods Retrospective review of patients who have been admitted to our hospital from January 2016 to December 2018. Results Five patients were found. All had their index surgery in outside hospitals. The average age was 51 years (range 40 – 69), and four patients were female. Mean time from LSG to leak presentation was 15 days (range 7 – 25). Mean time from leak presentation to septotomy procedure was 61 days (range 21 – 110). All patients were treated with sleeve dilatation before septotomy using endoscopic achalasia balloons. Mean procedure time was 79 minutes (range 55 – 125). Success was achieved in 80 % of patients, and no complications related to the procedure were identified. One patient underwent total gastrectomy for definitive management. Mean follow-up time was 14.25 months (range 6 – 26), and the average time for fistula closure was 60.25 days. Conclusion Endoscopic septotomy is safe and effective for management of chronic leaks after LSG. Associated non-selective dilatation may be a crucial step to allow distal patency and axis rectification for appropriate leak closure.

Observations on the Tear Trough

2019 ◽  
Vol 40 (9) ◽  
pp. 938-947 ◽  
Author(s):  
Sathyadeepak Ramesh ◽  
Robert Alan Goldberg ◽  
Allan Edward Wulc ◽  
Alan Bart Brackup
Keyword(s):  
Lower Eyelid ◽  
Surgical Patients ◽  
Level Of Evidence ◽  
Erbium Laser ◽  
Laser Resurfacing ◽  
Men And Women ◽  
Lower Blepharoplasty ◽  
Tear Trough ◽  
Midface Lift ◽  
Topographic Structure

Abstract Background The tear trough is a prominent structure of the midface. Many surgical and nonsurgical techniques have been devised to efface this feature. Objectives The aim of this study was to define an aesthetically pleasing tear trough and understand the effect of various surgical procedures on its appearance. Methods We undertook a retrospective review of “ideal” subjects (ie, young men and women as well as male and female models) as well as surgical patients undergoing lower blepharoplasty with fat excision, fat transposition, erbium laser resurfacing of the eyelids and midface, or endoscopic midface lifting. Marginal reflex distance-2, lower eyelid length, and nasojugal fold depth were measured and analyzed for all patients. Results The nasojugal fold was significantly less prominent in ideal female models than in all other groups (P &lt; 0.0001). Lower eyelid length was significantly shorter after fat excisional lower blepharoplasty, laser resurfacing, and midface lift (P &lt; 0.0001), and did not change after fat transpositional lower blepharoplasty. Postsurgical reduction in lower eyelid length was significantly less with fat transpositional lower blepharoplasty than in all other groups (P &lt; 0.0001). The nasojugal fold was significantly effaced after all types of procedures (P &lt; 0.0001), but was significantly more effaced after fat transpositional lower blepharoplasty (P &lt; 0.01) than after all other procedures. Conclusions A slight, medial tear trough is present in youth in many patients. The clinical tear trough is a virtual topographic structure distinct from the anatomic tear trough ligament and can be altered in a variety of ways. Level of Evidence: 4

scholarly journals Hyaluronic Acid Fillers Enriched with Glycine and Proline in Eyebrow Augmentation Procedure

2021 ◽  
Author(s):  
Antonio Scarano ◽  
Biagio Rapone ◽  
Domenico Amuso ◽  
Francesco Inchingolo ◽  
Felice Lorusso
Keyword(s):  
Hyaluronic Acid ◽  
Full Description ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Aesthetic Result ◽  
Study Results ◽  
High Level ◽  
Based Medicine ◽  
Augmentation Procedure

Abstract Background The eyebrow area is a clinically critical district due to the anatomical complexity and the propensity to aging-related atrophy. Hyaluronic acid fillers have been proposed to recover the dermal volume of the facial and lips regions. Aim The aim of the present investigation was to evaluate hyaluronic acid fillers enriched with glycine and proline for the treatment of eyebrow augmentation. Methods A total of 15 healthy patients were treated with eyebrow augmentation procedure. The distance between mid-bipupil to lateral eyebrow and mid-eyebrow to the medial eyebrow was measured before, immediately after treatment and at follow-up of 6 months. Results The healing period was uneventful, and no evidence of inflammation or swelling associated with the treatment was reported. No macroscopical alteration was reported in the surrounding tissues with no evidences of visible wheals or lumps in the treated sites at the follow-up. Before treatment, the angle was equal to 9.32 ± 0.2°, while after treatment it was 11.21 ± 0.4° (p < 0.01); after three and 6 weeks, it was, respectively, 10.66 ± 0.2° (p<0.05) and 10.02 ± 0.3°(p > 0.05). Conclusions The study results suggest that the hyaluronic acid fillers enriched with glycine and proline treatment resulted as being a useful procedure for augmentation, contour and volume definition and elevation of the eyebrow region with a high-level aesthetic result. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

scholarly journals Intralesional Tetracycline Injection, Pinch Technique, and Canthopexy for the Treatment of Severe Festoons: Preliminary Results

2021 ◽  
Vol 4 ◽  
Author(s):  
Sergio Lessa ◽  
João Pontello ◽  
Deilton Duarte ◽  
Diogo Lobão
Keyword(s):  
Retrospective Chart Review ◽  
Lower Eyelid ◽  
Time Interval ◽  
Level Of Evidence ◽  
Preliminary Results ◽  
Initial Injection ◽  
Intralesional Injections ◽  
The Mean ◽  
Board Review

Abstract Background Many techniques have been presented for the treatment of lower eyelid festoons, but no singular technique has become dominant. Objectives The authors describe the safety and efficacy of intralesional tetracycline injection, the pinch technique, and canthopexy for the treatment of severe festoons. Methods Institutional board review approval was obtained, and a retrospective chart review was performed on 15 consecutive patients who had received 2% tetracycline injections to treat lower eyelid large festoons between February 2017 and February 2020. Three months after the last injection, a series of patients underwent the surgical procedure: pinch technique and canthopexy bilaterally. Results Clinical and photographic records were reviewed, and 12 patients were included in the analysis. Three patients did not return for follow-up after the injection series. Of the 12 patients, there were 3 male patients and 9 female patients, with an average age of 66.6 years. The mean volume injected in each festoon was 0.43 mL, and the mean follow-up was 313 days. A series of injections with a 3-month time interval were performed for patients with a partial response to the initial injection. There was no evidence of complications at the site of the injection. Three months after the last injection, these 12 patients underwent complementary surgical treatment, which included pinch resection and canthopexy. Conclusions These preliminary results suggest that intralesional injections of tetracycline 2% may offer a safe option to treat lower eyelid festoons. This noninvasive procedure represents adjunct benefits to complementary surgical therapy. Level of Evidence: 4

Surfing-related renal trauma

2019 ◽  
Vol 12 (6) ◽  
pp. 411-416
Author(s):  
Margaret M Mansbridge ◽  
James Ryan ◽  
David C Hill ◽  
Martin Wullschleger
Keyword(s):  
Health Service ◽  
Retrospective Review ◽  
American Association ◽  
Clinical Suspicion ◽  
Gold Coast ◽  
Renal Trauma ◽  
Trauma Patients ◽  
High Grade ◽  
Level Of Evidence

Objectives:The objective of this study was to describe the prevalence and mechanisms of surfing-related renal trauma in a coastal town, which have not previously been published in the literature.Subjects/patients and methods:A 3 year retrospective review was completed of all renal trauma patients presenting to the Gold Coast Health Service.Results:Five injuries were identified and their mechanisms described, with three directly related to surfboard riding, one secondary to paddle boarding and one secondary to windsurfing. Surfing-related injuries accounted for 6% of the total renal trauma injuries in the study period. Injuries ranged from American Association for the Surgery of Trauma grade I–IV and were all managed non-operatively. One case was complicated by a urinoma, which resolved on interval follow-up imaging. All injuries were in males, and left-sided.Conclusion:Surfing-related activities have the potential to cause high-grade renal injuries. Diagnosis of renal trauma secondary to surfing-related activities requires a high index of clinical suspicion.Level of evidence:Level IV Evidence

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