An Accurate Upper Lid Blepharoplasty: A Key Component of Facial Rejuvenation.

Upper eyelid surgery is a common procedure performed by a variety of subspecialists including facial plastic surgeons, oculoplastic surgeons, general otolaryngologists, and plastic surgeons. Traditionally, a skin incision is marked in the preoperative setting to allow for an excision that eliminates upper eyelid hooding while preventing lagophthalmos. Many different methodologies have been proposed to maximize results and minimize complications. In this article, the authors propose a unique way to safely and effectively address dermatochalasis. The pinch technique allows for an accurate assessment of excess skin and provides a method that requires less operative time than traditional techniques. The use of both local anesthetic with epinephrine and hyaluronidase helps achieve the appropriate plane and attain better hemostasis. Importantly, the presented technique allows for reassessment and revision of the amount of skin excision before incision creation. It is a useful methodology for any surgeon performing upper lid blepharoplasty.

Evolution of Blepharoplasty.

The eyes and periorbital region are central components of facial beauty and harmony, but the periorbital region is also one of the earliest to show signs of aging. Over the past few decades, significant progress has been made in our understanding of the anatomy in this area, as well as the deleterious effects of aging in this region. In turn, surgical philosophy and techniques have evolved to better combat changes in this area to achieve a more youthful, natural appearance.

The Changing Face of Beauty: A Global Assessment of Facial Beauty.

Beauty is difficult to define. The US population becomes more diverse by the day. Thus, traditional stereotypes of beauty in various ethnic groups become less applicable as diversity increases. Often, new and uniquely beautiful facial features and proportions emerge as different ethnicities converge. With the increased diversity in facial appearance comes increased variability in patients' goals. A successful cosmetic surgeon will cultivate an understanding of aesthetic ideals in different ethnic groups, nurture discussions with patients to determine their aesthetic goals, devise a surgical plan for each patient, and develop and refine the necessary surgical skills to perform the procedure.

Epidermal cell proliferation in calorie-restricted aging rats.

Calorie restriction (CR) has been known to produce many beneficial health effects, and lowered cell proliferation from CR has been shown to produce anti-cancer effects in some tissues. In this study the rate of epidermal cell proliferation in aging Fischer 344 rats from ad libitum fed (AL) and CR colonies was assessed in relation to changes in epidermal thickness with age. Proliferating cell nuclear antigen (PCNA) was detected using immunohistochemical method on paraffin sections in the epidermis of dorsal skin and footpad in these animals obtained from the National Institute on Aging. The proliferating cell index was compared with morphometric measurement of epidermis in young, young adult and old animals (six per group). Data were analyzed by Excel and SPSS 14.0 softwares for statistical evaluation. Two-way analysis of variance (ANOVA) was applied to data to test the effects of age, diet, and age-diet interaction. The following significant effects were noted: (I) age and age-diet effects in dorsal skin epidermal width, and PCNA; (II) age, and diet effect on footpad epidermal thickness, and PCNA index. There was a trend of increasing epidermal thickness in the dorsal skin in normally feeding aging rats which was depressed with CR in the two younger groups. PCNA index showed a trend of attrition from young to old. The thickness of epidermis in foot pad showed a curvilinear trend in both AL and CR groups with lowest mean values in the old group, and more predominant effect in CR-exposed animals. The proliferation index in the foot pad demonstrated a trend of reduction in old specimens with lower mean values in each corresponding CR age group. This report agrees with CR-inhibited cell proliferation reported in many organs by other investigators, and the observed results might have been caused by physiological or endocrine mechanisms affecting the epithelium in these calorie-restricted animals.