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1.
Clin Plast Surg ; 49(1): 123-136, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782130

RESUMO

An understanding of anatomy and pathophysiology of the cleft nasal deformity is crucial to its management, including selection of correct surgical techniques for repair. Timing of intermediate and definitive rhinoplasty should be considered carefully, with definitive rhinoplasty occurring after management of facial skeletal deformities. At the time of definitive rhinoplasty, the septum, external and internal nasal valves, alar base malposition (and corresponding bony deficiency), and position and shape of the lower lateral cartilage and the columella all must be individually considered. Thorough knowledge of rhinoplasty techniques is crucial to address the cleft nasal deformity with optimal functional and aesthetic outcomes.


Assuntos
Fenda Labial , Rinoplastia , Cartilagem , Fenda Labial/cirurgia , Estética , Humanos , Septo Nasal/cirurgia , Nariz/cirurgia
2.
Plast Reconstr Surg ; 148(5): 979-988, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34529598

RESUMO

BACKGROUND: The muscular hypothesis explanation of the pathophysiology behind paramedian platysmal bands does not seem to provide a sufficient explanation for the clinical presentation of these platysmal bands in aged individuals with cervical soft-tissue laxity. The purpose of this study was to investigate the fascial relationships of the anterior neck to enhance appropriate surgical treatment. METHODS: Retrospective analysis of computed tomographic scans of 50 Caucasian individuals (mean age, 55.84 ± 17.5 years) and anatomical dissections of 20 Caucasian and 10 Asian body donors (mean age, 75.88 ± 10.6 years) were conducted. Fascial adhesions were classified according to platysma fusion types, and platysma mobility was tested during dissection procedures. RESULTS: Fusion between the left and right platysma muscles occurred in 64 percent in the suprahyoid region and in 20 percent at the thyroid cartilage, and in 16 percent, the platysma attached to the mandible without fusion. In the absence of muscular fibers, a fascial adhesion zone with limited mobility was observed where the superficial cervical fascia fused with the investing layer of the deep cervical fascia. CONCLUSIONS: Muscular contraction of the platysma results in elevation of the most medial platysma muscle fibers, which are not attached in the fascial adhesion zone. The presence of a fatty layer deep to the platysma enables platysmal movement and anterior and inferior gliding of the skin and platysma when cervical soft-tissue laxity exists. Surgical treatments should include transection of the fascial adhesion; this could potentially prevent the recurrence of paramedian platysmal bands.

3.
Aesthet Surg J ; 2021 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-33751048

RESUMO

BACKGROUND: A global approach to facial rejuvenation involves multiple treatment modalities. OBJECTIVES: This study evaluated the impact of multimodal facial aesthetic treatment on self-reported psychological and social outcomes. METHODS: HARMONY, a prospective, multicenter, 4-month study, enrolled patients aged 35 to 65 years to receive on-label treatment with a combination of hyaluronic fillers (VYC-20L, HYC-24L, and/or HYC-24L+), onabotulinumtoxinA, and bimatoprost. Fillers were injected on day 1, with touch-ups performed on day 14. OnabotulinumtoxinA was injected at month 3 into glabellar lines and/or crow's feet lines. Patients applied bimatoprost to eyelashes once daily for 17 weeks. Mean change from baseline on FACE-Q Psychological Well-being and Social Confidence Scales, FACE-Q Aging Appearance Appraisal Scale, and FACE-Q Age Appraisal Visual Analog Scale were assessed. RESULTS: Of 100 patients treated, 93 were evaluated at 4 months posttreatment. Significant improvement vs baseline was observed on the FACE-Q Scales for Psychological Well-being (mean change, -19.9; p < 0.00001), Social Confidence (mean change, -18.2; p < 0.00001), and Aging Appearance (mean change, -28.5; p < 0.0001). On average, patients' self-assessed age was 0.1 year older than actual age at baseline and 4.5 years younger at month 4 (p < 0.001 vs baseline). Forty-two patients experienced adverse events, all mild to moderate. CONCLUSIONS: Multimodal, full facial aesthetic treatment improves patients' self-reported psychological well-being, social confidence, aging appearance, and perceptions of chronologic age.

4.
Facial Plast Surg Clin North Am ; 28(4): 461-468, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33010864

RESUMO

Patient satisfaction is the ultimate measure of success in cosmetic facial plastic surgery. A successful outcome depends on patient selection, technical performance, and postoperative care. Patient perception can be influenced by physician-patient interactions. Surgical training focuses on diagnosis-identifying variations in physical condition and treatment. Although these skills are essential to a well-trained and successful facial plastic surgeon, the importance of proper patient selection, management of expectations, and empathetic communication in cosmetic surgery are often overlooked in education and cannot be understated. This article outlines the contributing factors to difficult physician-patient relationships and strategies for mitigating these situations.


Assuntos
Ira , Técnicas Cosméticas/psicologia , Satisfação do Paciente , Relações Médico-Paciente , Transtornos Dismórficos Corporais/diagnóstico , Transtornos Dismórficos Corporais/psicologia , Criança , Maus-Tratos Infantis/psicologia , Comunicação , Humanos , Imperícia/legislação & jurisprudência , Motivação , Seleção de Pacientes , Personalidade , Recusa do Médico a Tratar
5.
Facial Plast Surg Clin North Am ; 28(3): 243-251, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32503712

RESUMO

The relationship of the skin, the superficial and deep fat compartments, and the ligaments that connect these structures is key to performing any rhytidectomy. In order to successfully mobilize, elevate, and reposition the facial soft tissues, a detailed understanding of facial anatomy is required. This article details the anatomy of the midface and neck that is essential to understanding and performing the face-lift operation.


Assuntos
Face/anatomia & histologia , Ritidoplastia , Pele/anatomia & histologia , Gordura Subcutânea/anatomia & histologia , Tela Subcutânea/anatomia & histologia , Artérias/anatomia & histologia , Nervo Facial/anatomia & histologia , Fáscia/anatomia & histologia , Testa/anatomia & histologia , Humanos , Ligamentos/anatomia & histologia , Sistema Musculoaponeurótico Superficial/anatomia & histologia , Veias/anatomia & histologia
6.
Dermatol Clin ; 38(2): 261-268, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32115136

RESUMO

The sexual identity of an individual is obvious to most observers with a glance or when only noticing a portion of the face. The overall appearance of the male face is quite different from the female face. Differences in facial structures-such as brow bone, chin, nose, or lips-can be quite small. It is the sum of these differences that creates the obvious dimorphism in facial appearance. This article outlines sexual differences between facial features and discusses surgical procedures designed to alter facial appearance and sexual identity. The diagnosis of facial dimorphism and limitations of these techniques are outlined.


Assuntos
Técnicas Cosméticas , Ossos Faciais/cirurgia , Cirurgia de Readequação Sexual/métodos , Feminino , Humanos , Masculino , Rinoplastia/métodos , Cartilagem Tireóidea/cirurgia , Pessoas Transgênero
7.
Facial Plast Surg ; 35(2): 164-171, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30943561

RESUMO

The chin is a crucial landmark and mandates careful consideration for facial appearance. Optimal chin appearance requires evaluation and treatment in three dimensions: anteroposterior, transverse, and vertical planes. The optimization of chin deficiencies requires understanding of bony anatomy as well as the relationship of the adjacent facial structures including the lip, teeth, and nose. The practitioner should be familiar with techniques in injection, placement of alloplastic implants, as well bony genioplasty.


Assuntos
Queixo , Face , Mentoplastia , Próteses e Implantes , Queixo/anatomia & histologia , Humanos , Injeções
8.
Aesthet Surg J ; 39(12): 1380-1389, 2019 11 13.
Artigo em Inglês | MEDLINE | ID: mdl-30239596

RESUMO

BACKGROUND: The impact of facial aesthetic treatments not only enhances physical appearance but also psychological well-being. Accordingly, patient-reported outcomes are increasingly utilized as an important measure of treatment success. Observer-reported outcomes are a relevant yet often overlooked measure of treatment benefit. OBJECTIVES: The authors aimed to evaluate the impact of panfacial aesthetic treatment on the perception of an individual in a variety of social contexts. METHODS: A total 2000 men and women (aged 18-65 years) participated in an online study designed to capture the blinded observer's social perception of pretreatment and posttreatment patients who received panfacial aesthetic treatment in the HARMONY study. Perceptions relevant to character traits, age, attractiveness, and social status were evaluated. Observers were divided into 2 groups. Single image respondents (n = 1500) viewed 6 single, randomized patient images (3 pretreatment, 3 posttreatment), and paired image respondents (n = 500) viewed 6 pretreatment and posttreatment image pairs. RESULTS: Single image respondents reported significantly (P < 0.05) higher levels of agreement that posttreatment subjects appeared to possess more positive character traits (eg, healthy and approachable), were more socially adept, younger, more attractive, more successful at attracting others, and possessed a higher social status. Paired image respondents also reported a higher level of agreement for posttreatment images being aligned with positive character traits, representative of a younger and more attractive individual, and one with a higher social status. CONCLUSIONS: The results suggest that the positive impact of minimally invasive panfacial treatment extends beyond enhancing physical appearance and highlights the importance of social perception and observer-reported outcomes in aesthetic medicine.


Assuntos
Técnicas Cosméticas/psicologia , Estética/psicologia , Percepção Social , Adolescente , Adulto , Idoso , Face , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medidas de Resultados Relatados pelo Paciente , Adulto Jovem
9.
Plast Reconstr Surg ; 143(1): 53-63, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30589776

RESUMO

BACKGROUND: Injection of soft-tissue fillers into the facial fat compartments is frequently performed to ameliorate the signs of facial aging. This study was designed to investigate the functional anatomy of the deep facial fat compartments and to provide information on the effects of injected material in relation to age and gender differences. METHODS: Forty fresh frozen cephalic specimens of 17 male and 23 female Caucasian body donors (mean age, 76.9 ± 13.1 years; mean body mass index, 23.6 ± 5.3 kg/m(2)) were investigated. Computed tomographic and magnetic resonance imaging procedures were carried out using colored contrast-enhanced materials with rheologic properties similar to commercially available soft-tissue fillers. Anatomical dissections were performed to guide conclusions. RESULTS: No statistically significant influences of age or gender were detected in the investigated sample. Increased amounts of injected contrast agent did not correlate with inferior displacement of the material in any of the investigated compartments: deep pyriform, deep medial cheek, deep lateral cheek, deep nasolabial (located within the premaxillary space), and the medial and lateral sub-orbicularis oculi fat. CONCLUSIONS: Increasing volume in the deep midfacial fat compartments did not cause inferior displacement of the injected material. This underscores the role of deep soft-tissue filler injections (i.e., in contact with the bone) in providing support for overlying structures and resulting in anterior projection.


Assuntos
Face/anatomia & histologia , Ossos Faciais/anatomia & histologia , Imageamento Tridimensional , Gordura Subcutânea/anatomia & histologia , Idoso , Idoso de 80 Anos ou mais , Cadáver , Preenchedores Dérmicos/administração & dosagem , Dissecação , Feminino , Humanos , Injeções Subcutâneas , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
10.
Plast Reconstr Surg ; 141(6): 1351-1359, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29750762

RESUMO

BACKGROUND: The superficial (subcutaneous) facial fat compartments contribute to the signs of facial aging, but a comprehensive anatomical description of their location and their functional behavior during the application of soft-tissue fillers remains elusive. METHODS: The authors investigated 30 fresh frozen cephalic specimens from 13 male and 17 female Caucasian body donors (age, 78.3 ± 14.2 years; body mass index, 23.1 ± 5.3 kg/m(2)). Upright-position, contrast-enhanced computed tomographic scanning, and additional magnetic resonance imaging were performed. Three-dimensional reconstruction-based measures were conducted to evaluate the position of the applied contrast agent in each compartment separately. Successive anatomical dissections were performed to confirm the imaging findings. RESULTS: Positive correlations were detected between the amounts of injected material and the inferior displacement for the superficial nasolabial (rp = 0.92, p = 0.003), middle cheek (rp = 0.70, p = 0.05), and jowl (rp = 0.92, p = 0.03) compartments but not for the medial cheek (rp = 0.20, p = 0.75), lateral cheek (rp = 0.15, p = 0.75), or the superior (rp = -0.32, p = 0.41) or inferior superficial temporal compartment (rp = -0.52, p = 0.29). CONCLUSION: This study confirms the presence of distinct subcutaneous fat compartments and provides evidence for an individual behavior when soft-tissue fillers are applied: inferior displacement of the superficial nasolabial, middle cheek, and jowl compartments, in contrast to an increase in volume without displacement (i.e., an increase in projection) of the medial cheek, lateral cheek, and both superficial temporal compartments.


Assuntos
Face/anatomia & histologia , Gordura Subcutânea/anatomia & histologia , Idoso , Idoso de 80 Anos ou mais , Cadáver , Corantes/administração & dosagem , Feminino , Humanos , Injeções , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
11.
Aesthet Surg J ; 38(5): 540-556, 2018 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-29244069

RESUMO

Background: Individuals seeking aesthetic treatment have concerns regarding multiple facial areas. Objectives: Assess the aesthetic impact and satisfaction achieved with a multimodal approach to aesthetic treatment using a combination of minimally invasive treatments. Methods: Prospective, multicenter, rater-blinded, 4-month HARMONY study evaluated patient satisfaction and aesthetic impact of a combination of fillers (VYC-20L, HYC-24L, and HYC-24L+), onabotulinumtoxinA, and bimatoprost. Males and females aged 35 to 65 years received on-label, staged treatment with fillers, as needed per investigator assessment, on day 1, with touch ups allowed on day 14. Bimatoprost was self-administered once daily for 17 weeks. OnabotulinumtoxinA was injected into glabellar lines, crow's feet lines, or both at month 3. Primary effectiveness measure was mean change from baseline on the FACE-Q 10-item Satisfaction with Facial Appearance Overall Scale. Results: Of 100 patients treated, 93 underwent at least the 4-month posttreatment assessment and were assessed for efficacy. The FACE-Q Satisfaction with Facial Appearance Overall Scale total score increased from baseline (41.2) to month 4 (72.9; P < 0.00001; effect size, 2.7). Improvement following multimodal treatment was observed on FACE-Q individual items. Self-perceived age decreased from 0.2 years older than actual age at baseline to 4.6 years younger at month 4. Nearly all patients (99%) rated themselves as improved or much improved on the Global Aesthetic Improvement Scale. Investigator assessments also demonstrated improvement. Mild to moderate adverse events occurred in 42 patients. Conclusions: Minimally invasive, multimodal treatment resulted in improvements in FACE-Q scores and perceived age, indicating a high degree of patient satisfaction and a younger facial appearance.


Assuntos
Bimatoprost/administração & dosagem , Toxinas Botulínicas Tipo A/administração & dosagem , Técnicas Cosméticas , Preenchedores Dérmicos/administração & dosagem , Rejuvenescimento , Adulto , Terapia Combinada/métodos , Estética , Face , Feminino , Humanos , Injeções Intramusculares , Injeções Subcutâneas , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Estudos Prospectivos , Autoimagem , Envelhecimento da Pele , Resultado do Tratamento
13.
J Craniofac Surg ; 28(5): 1278-1281, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28582310

RESUMO

OBJECTIVES: There are limited data on the effect of otoplasty on health-related quality of life (HRQoL) in prominent ears. There are no data on the effect of otoplasty on Glasgow Benefit Inventory (GBI) of otoplasty using hybrid techniques in adult patients. METHODS: This study involved 28 patients who underwent otoplasty using combined procedures. We chose the GBI because it is a sensitive tool for detecting changes in health status following an intervention. Patients older than 13 years received the GBI, being retrospective well-validated questionnaires for measuring the effect of otorhinolaryngologic interventions, and particularly plastic surgery procedures, on HRQoL. An individual questionnaire was created by the standard GBI. We combined posterior auricular skin excision, Mustarde suture technique, and conchomastoid suture techniques for maximizing the cosmetic improvements. RESULTS: According to the results of this study, good outcomes with patient satisfaction were achieved with this hybrid procedure. We found a conspicuous improvement in GBI total score as well as in the general health subscale after otoplasty. This indicates the beneficial impact on the healthy self-perception of this surgical procedure with prominent ears. CONCLUSIONS: In our retrospective assessment, GBI turned out to be a very useful and valuable tool in the evaluation of otoplasty. We demonstrated a long-lasting improvement in HRQoL after otoplasty for the prominent ears. Hybrid techniques are effective and satisfying treatment methods with high success rates for patients with prominent ears.


Assuntos
Pavilhão Auricular/anormalidades , Pavilhão Auricular/cirurgia , Procedimentos Cirúrgicos Otológicos/métodos , Satisfação do Paciente , Técnicas de Sutura , Adolescente , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Qualidade de Vida/psicologia , Estudos Retrospectivos , Autoimagem , Inquéritos e Questionários , Adulto Jovem
14.
Plast Reconstr Surg ; 139(6): 1346-1353, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28538555

RESUMO

BACKGROUND: Anatomical knowledge of the facial vasculature is crucial for successful plastic, reconstructive, and minimally invasive procedures of the face. Whereas the majority of previous investigations focused on facial arteries, the precise course, variability, and relationship with adjacent structures of the facial vein have been widely neglected. METHODS: Seventy-two fresh frozen human cephalic cadavers (32 male and 40 female cadavers; mean age, 75.2 ± 10.9 years; mean body mass index, 24.2 ± 6.6 kg/m; 99 percent Caucasian ethnicity) were investigated by means of layer-by-layer anatomical dissection. In addition, 10 cephalic specimens were investigated using contrast agent-enhanced computed tomographic imaging. RESULTS: The facial vein displayed a constant course in relation to the adjacent anatomical structures. The vein was identified posterior to the facial artery, anterior to the parotid duct, and deep to the zygomaticus major muscle. The angular vein formed the lateral boundary of the deep medial cheek fat and the premaxillary space, and the medial boundary of the deep lateral cheek fat and the sub-orbicularis oculi fat. The mean distance of the inferior and superior labial veins, of the deep facial vein, and of the angular vein from the inferior orbital margin was 51.6 ± 3.1, 42.6 ± 2.3, 27.4 ± 3.0, and 4.2 ± 0.7 mm, respectively. CONCLUSIONS: This work provides detailed information on the course of the facial vein in relation to neighboring structures. The presented clinically relevant anatomical observations and descriptions of landmarks will serve as helpful information for plastic, reconstructive, and aesthetic surgeons.


Assuntos
Face/irrigação sanguínea , Procedimentos Cirúrgicos Reconstrutivos/métodos , Ritidoplastia/métodos , Cirurgia Plástica/métodos , Veias/anatomia & histologia , Idoso , Idoso de 80 Anos ou mais , Cadáver , Dissecação/métodos , Face/anatomia & histologia , Feminino , Humanos , Masculino , Tomografia Computadorizada por Raios X , Veias/diagnóstico por imagem
15.
Plast Reconstr Surg ; 139(4): 864e-872e, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28350656

RESUMO

BACKGROUND: The forehead is one of the most frequent locations for neuromodulator and soft tissue filler applications; however, the underlying anatomy is still poorly understood. Thus far, the presence of deep forehead compartments has not been confirmed. METHODS: Twenty Caucasian cephalic specimens, 15 fresh frozen (six female and nine male) and five with formalin-phenol embalmment (three female and two male) were investigated using contrast-enhanced computed tomographic scans, dye injections, and anatomical dissections. RESULTS: Three superficial (one central and two lateral) and three deep (one central and two lateral) forehead compartments were identified. The superficial fat compartments were found within the subcutaneous fat tissue (layer 2) and measured 2.1 × 4.6 mm for the superficial central forehead compartments and the right superficial lateral forehead compartments and 2.6 × 3.2 cm for the left superficial lateral forehead compartments, with a mean volume of 2.5, 3.1, and 3.4 cc, respectively. The deep fat compartments were identified deep to the frontalis muscle but superficial to the periosteum with an extent of 6.4 × 5.9 cm for the deep central forehead compartments, 2.6 × 5.8 cm for the right deep lateral forehead compartments, and 2.7 × 5.8 cm for the left deep lateral forehead compartments, and a mean volume of 9.1, 1.6, and 1.4 cc, respectively. CONCLUSIONS: The results presented in this study increase the understanding of the forehead anatomy. Understanding the presence of the superficial and the deep forehead compartments allows one to change the signs of frontal aging. The deep forehead compartments are in general avascular planes and permit blunt dissection for access to the supraorbital region.


Assuntos
Testa/anatomia & histologia , Idoso , Cadáver , Feminino , Testa/diagnóstico por imagem , Humanos , Imageamento Tridimensional , Masculino , Tomografia Computadorizada por Raios X
17.
J Drugs Dermatol ; 16(1): 43-46, 2017 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-28095531

RESUMO

Deoxycholic acid (KybellaTM, Allergan Pharmaceuticals, Irvine, CA) is a novel injectable treatment used for the cosmetic reduction of redundant submental fat. By inducing adipose cell lysis, the soft tissue alteration induces subsequent contour change and sharpening of the cervicomental angle.The safety and efficacy have been well established in several prospective clinical trials and subsequent FDA approval for this purpose. This has provided an effective and less invasive alternative to surgical liposuction with virtually no recovery time and less overall discomfort. Given its success for use in this context, a logical step would be to extrapolate to other regions of the body where cosmetic deformity is caused by excessive adipose tissue. In the current article, the authors propose potential options for further use in various targeted areas where subcutaneous fat may be amenable to reduction with deoxycholic acid injection, understanding that such uses would be off-label and require an understanding of the regional anatomy and possible complications. J Drugs Dermatol. 2017;16(1):43-46.


Assuntos
Técnicas Cosméticas/tendências , Ácido Desoxicólico/administração & dosagem , Uso Off-Label , Gordura Subcutânea/efeitos dos fármacos , Tecido Adiposo/efeitos dos fármacos , Tecido Adiposo/metabolismo , Tecido Adiposo/patologia , Colagogos e Coleréticos/administração & dosagem , Ensaios Clínicos como Assunto/métodos , Previsões , Humanos , Injeções Subcutâneas , Gordura Subcutânea/metabolismo , Gordura Subcutânea/patologia
18.
JAMA Facial Plast Surg ; 19(1): 7-14, 2017 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-27631534

RESUMO

Importance: Aesthetic eye treatments can dramatically change a person's appearance, but outcomes are rarely measured from the patient perspective. The patient perspective could be measured using an eye-specific patient-reported outcome measure. Objective: To describe the development and psychometric evaluation of FACE-Q scales and an adverse effect checklist designed to measure outcomes following cosmetic eye treatments. Design, Setting, and Participants: Pretreatment and posttreatment patients 18 years and older who had undergone facial aesthetic procedures were recruited from plastic surgery clinics in United States and Canada and completed FACE-Q scales between June 6, 2010, and July 14, 2014. We used Rasch Measurement Theory, a modern psychometric approach, to refine the scales and to examine psychometric properties. Main Outcomes and Measures: The FACE-Q Eye Module, which has 4 scales that measure appearance of the eyes, upper and lower eyelids, and eyelashes. Scale scores range from 0 (worst) to 100 (best). The module also includes a checklist measuring postblepharoplasty adverse effects. Results: Overall, 233 patients (81% response rate) 18 years and older participated. Adverse effects included being bothered by eyelid scars, dry eyes, and eye irritation. In Rasch Measurement Theory analysis, each scale's items had ordered thresholds and good item fit. Person Separation Index and Cronbach α were greater than or equal to 0.83. Higher scores on the eye scales correlated with fewer adverse effects (range, -0.26 to -0.36). In the pretreatment group, older age correlated with lower scores (range, -0.42 to -0.51) on the scales measure appearance of the eyes and upper and lower eyelids. Compared with the pretreatment group, posttreatment participants reported significantly better scores on the scales measuring appearance of eyes overall, as well as upper and lower eyelids. Conclusions and Relevance: The FACE-Q Eye Module can be used in clinical practice, research and quality improvement to collect evidence-based outcomes data. Level of Evidence: NA.


Assuntos
Blefaroplastia/psicologia , Satisfação do Paciente , Psicometria/estatística & dados numéricos , Inquéritos e Questionários , Adulto , Idoso , Blefaroplastia/efeitos adversos , Lista de Checagem , Medicina Baseada em Evidências , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Resultado do Tratamento
19.
Dermatol Surg ; 42 Suppl 1: S275-S281, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27787267

RESUMO

ATX-101 (deoxycholic acid injection; Kybella in the United States and Belkyra in Canada; Kythera Biopharmaceuticals, Inc., Westlake Village, CA [an affiliate of Allergan plc, Dublin, Ireland]) is the first aesthetic injectable approved for reduction of submental fat. In February 2014, an injection practicum was conducted in the anatomy laboratory at the University of Texas Southwestern Medical Center to explore the proper injection technique for ATX-101 and the importance of its appropriate, safe anatomical placement within the submental area. Subsequent to the injection practicum, a structured roundtable discussion was conducted in which potential implications of the various injection protocols evaluated during the practicum were reviewed. Furthermore, the faculty had the opportunity to provide additional perspectives based on their clinical experience with facial injectables and ATX-101 specifically. In this article, the findings from the injection practicum and roundtable discussion are reported.


Assuntos
Ácido Desoxicólico/administração & dosagem , Fármacos Dermatológicos/administração & dosagem , Injeções Subcutâneas/métodos , Gordura Subcutânea/efeitos dos fármacos , Queixo , Técnicas Cosméticas , Humanos
20.
Dermatol Surg ; 42 Suppl 1: S282-S287, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27787268

RESUMO

In 2015, ATX-101 (deoxycholic acid injection; Kybella in the United States and Belkyra in Canada; Kythera Biopharmaceuticals, Inc., Westlake Village, CA [an affiliate of Allergan plc, Dublin, Ireland]) was approved as a first-in-class injectable drug for reduction of submental fat. Use of a pharmacologic/injectable therapy within the submental region requires a thorough understanding of cervicomental anatomy to ensure proper injection technique and safe administration. To this end, an anatomy laboratory was conducted to review key external landmarks and important internal anatomic structures that characterize the lower face and anterior neck. External landmarks that define the boundaries of the cervicomental and submental regions were identified including the inferior mandibular border, the anterior border of the sternocleidomastoid muscle, the antegonial notch, the submental crease, the thyroid notch, and the hyoid bone. Relevant internal anatomic structures, including preplatysmal submental fat (the target tissue for ATX-101) and the platysma muscle as well as critical neurovascular and glandular tissues were revealed by dissection. Of particular interest was the marginal mandibular branch of the facial nerve because it typically courses along the inferior mandibular border near the proposed treatment area for ATX-101.


Assuntos
Anatomia/educação , Queixo/anatomia & histologia , Pescoço/anatomia & histologia , Adulto , Idoso , Cadáver , Dissecação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
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