Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.406
Filtrar
1.
Plast Reconstr Surg ; 151(2): 325-328, 2023 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-36696314

RESUMO

SUMMARY: Surgical treatments to the upper eyelid have evolved along with a better understanding of the aging upper eyelid anatomy and development of solutions that are aesthetically pleasing and that defy detection. It is not uncommon for patients to present before or after upper blepharoplasty with perceived deformities of the medial canthus. Epicanthal folds are sometimes a concern. Approaches to the varied presentations of epicanthal folds have derived from the belief that they relate to a dermal or orbicular (muscle) issue, and solutions have primarily involved traditional approaches to altering skin and muscle tension by means of complex flaps. Complications or unfavorable outcomes that relate to this approach mainly involve scarring or nonresolution. The author describes a novel and simple surgical approach for the treatment of mild to moderate epicanthal folds or medial canthal webbing that is in line with the goals of the balance of aesthetics, resolution, and undetectability.


Assuntos
Blefaroplastia , Humanos , Pálpebras/cirurgia , Pele , Cicatriz/etiologia , Cicatriz/prevenção & controle , Cicatriz/cirurgia , Resultado do Tratamento
2.
Facial Plast Surg ; 39(1): 2-7, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36706742

RESUMO

In the present report, a comprehensive approach on the assessment of the lower eyelid for blepharoplasty is provided. Important items such as anatomical key areas and surgical factors are discussed. Proper management of lower eyelid deformities requires an understanding of both intrinsic and extrinsic anatomical factors resulting in the unfavorable outcome.


Assuntos
Blefaroplastia , Humanos , Blefaroplastia/métodos , Prognóstico , Pálpebras/cirurgia , Transplante de Pele , Atenção
3.
Facial Plast Surg ; 39(1): 28-46, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36706744

RESUMO

Lid retraction is a feared complication of lower blepharoplasty. Anatomical variations like negative orbital vector, horizontal lid laxity, and preexisting lid retraction are more prone to lid malpositions. Meticulous and precise execution of a series of surgical steps is key to preventing complications. This includes minimizing surgical trauma, meticulous hemostasis, preserving innervation to the medial lid and pretarsal orbicularis, safe method of fat excision, septal tightening while maintaining lid traction, and conservative and titrated skin excision. Canthal fixation addresses lid laxity and maintains the lid stretched vertically while postoperative healing and fibrosis are taking place. Post-blepharoplasty lid retraction may occur due to failure to address lid laxity and the occurrence of middle lamellar fibrosis. Excessive skin excision may also result in anterior lamellar deficiency. The "sag and drag" concept is useful to evaluate the post-blepharoplasty retracted lid. The treatment of the retracted lid includes lid massage, replacing the anterior lamella, or releasing the middle lamellar fibrosis or a combination of techniques. In conclusion, understanding the mechanisms of lid retraction, careful preoperative assessment, and surgical precision will help surgeons to prevent and manage this complication.


Assuntos
Blefaroplastia , Doenças Palpebrais , Humanos , Blefaroplastia/efeitos adversos , Blefaroplastia/métodos , Pálpebras/cirurgia , Doenças Palpebrais/etiologia , Doenças Palpebrais/prevenção & controle , Doenças Palpebrais/cirurgia , Transplante de Pele , Fibrose
5.
Facial Plast Surg ; 39(1): 20-27, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36706743

RESUMO

Aesthetic surgical management of the inferior periorbital region should include an approach to volume augmentation of the midface and infraorbital hollow, reduction of fat pseudoherniation in the lower eyelids, and treatment of the overlying skin. A combined approach using volume augmentation with fat grafting, a transconjunctival approach to the lower eyelid fat pads, and conservative management of the lower eyelid skin can produce optimal aesthetic results while minimizing complications. Fat harvest from the thigh and abdominal region allows for ample grafting material to the lateral cheek, midface, and orbital rim. The treatment paradigm is to restore volume optimally while minimizing fat resection in the lower eyelids. Volume augmentation is used to restore youthful contours, as well as to counter deflation and laxity in the periorbital and midfacial regions.


Assuntos
Blefaroplastia , Ritidoplastia , Humanos , Blefaroplastia/métodos , Bochecha/cirurgia , Estética Dentária , Pálpebras/cirurgia , Ritidoplastia/métodos , Tecido Adiposo/transplante
6.
Artigo em Inglês | MEDLINE | ID: mdl-36674313

RESUMO

The aim of this study was to assess changes in headaches, eyebrow height, and electromyographic (EMG) outcomes of the frontalis and orbicularis oculi muscles, after an upper blepharoplasty with or without resecting a strip of orbicularis oculi muscle. In a randomized controlled trial, 54 patients received an upper blepharoplasty involving either only removing skin (group A) or removing skin with an additional strip of orbicularis muscle (group B). Preoperative, and 6 and 12 months postoperative headache complaints were assessed using the HIT-6 scores and eyebrow heights were measured on standardised photographs. Surface EMG measurements, i.e., electrical activity and muscle fatigue, were assessed for the frontalis and orbicularis oculi muscles preoperatively and 2, 6, and 12 months postoperatively. Significantly fewer headaches were reported following a blepharoplasty. The eyebrow height had decreased, but did not differ between groups. Regarding the surface EMG measurements, only group A's frontalis muscle electrical activity had decreased significantly during maximal contraction 12 months after surgery (80 vs. 39 mV, p = 0.026). Fatigue of both the frontalis and the orbicularis oculi muscles did not change significantly postoperatively compared to baseline. EMG differences between groups were minor and clinically insignificant. The eyebrow height decreased and patients reported less headaches after upper blepharoplasty irrespective of the used technique.


Assuntos
Blefaroplastia , Humanos , Blefaroplastia/métodos , Sobrancelhas , Pálpebras/fisiologia , Pálpebras/cirurgia , Cefaleia
9.
J Craniofac Surg ; 33(8): 2613-2618, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36409844

RESUMO

BACKGROUND: Single eyelids of many individuals seek incision-based blepharoplasty to construct double eyelids. However, excessive tissue damage is still a common problem after this surgery. Much of the tissue injury incurred during blepharoplasty results from damage to vertical blood vessels in the superficial and deep layers, so we designed a new modified incisional-based blepharoplasty method that preserves superficial and deep blood vessels. PURPOSE: To evaluate the efficacy and safety of this preservation of superficial and deep blood vessels approach to incisional-based blepharoplasty. METHODS: We retrospectively examined the outcomes of 462 consecutive patients receiving this new method from January 2015 to December 2019. The surgical methods were designed to preserve superficial and deep blood vessels to the greatest extent possible. All patients were followed up for 6 to 40 months. Postoperative evaluations were performed and patients graded results at final follow-up as excellent, good, fair, or poor. The combined proportion of excellent, good, and fair was deemed the satisfaction rate. RESULTS: The overall satisfaction rate was 94.16% (435/462). Postoperative swelling regressed significantly during the first week and disappeared by 4 weeks postsurgery for patients without ptosis or with mild ptosis, whereas swelling regressed in 2 to 5 weeks for patients with moderate ptosis. Fourteen patients (3.03%, 14/462) displayed obvious bruising after surgery. CONCLUSIONS: This new blepharoplasty method yielded a high satisfaction rate, rapid dissipation of swelling, low bruising, and low complication rate. This effective and safe surgical method warrants wider use for single eyelid and mild/moderate ptosis.


Assuntos
Blefaroplastia , Blefaroptose , Ferida Cirúrgica , Humanos , Blefaroplastia/métodos , Estudos Retrospectivos , Pálpebras/cirurgia , Blefaroptose/cirurgia , Ferida Cirúrgica/cirurgia
10.
J Craniofac Surg ; 33(8): 2602-2605, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36409877

RESUMO

BACKGROUND: Upper blepharoplasty is 1 of the most popular cosmetic procedures in Asia. As people become older, they develop soft tissue atrophy and multiple folds due to a sunken upper eyelid. Furthermore, people with thin upper eyelid skin are more likely to develop multiple folds, even at a young age. The authors investigated the effectiveness of a transverse mattress suture technique to prevent recurrence during upper blepharoplasty in patients with primary multiple folds. PATIENTS/METHODS: Data on 656 patients with primary multiple folds who underwent upper blepharoplasty from March 2017 to January 2020 were retrospectively reviewed. The authors compared the operative time, patients' satisfaction, panel assessment, and complications according to whether the suture technique was used. RESULTS: Among 656 patients, 228 were lost to follow-up or had incomplete data; therefore, the files of 428 patients were analyzed. In total, 199 patients did not undergo the suture technique, whereas 229 patients did. Statistically significant differences were found between the 2 groups in patients' satisfaction, aesthetic results, and recurrence. However, between-group difference was not significant in terms of symmetry or complications such as hematoma and swelling. CONCLUSIONS: People with thin upper eyelid skin or slightly protruding eyes are more likely to develop multiple folds at a young age, even in their teens or 20s. The authors performed a skin suture during upper blepharoplasty, and then performed a transverse mattress suture on the spots where multiple folds are expected. Patients who underwent the suture technique showed better aesthetic results and a significantly lower recurrence rate.


Assuntos
Blefaroplastia , Estética Dentária , Adolescente , Humanos , Estudos Retrospectivos , Pálpebras/cirurgia , Técnicas de Sutura
11.
Zhonghua Yan Ke Za Zhi ; 58(11): 920-922, 2022 Nov 11.
Artigo em Chinês | MEDLINE | ID: mdl-36348530

RESUMO

A child complained of bilateral congenital non-progressive ptosis for 18 months. According to the clinical characteristics, systemic development and chromosome microarray analysis, the child was diagnosed as 2q37 deletion syndrome related ophthalmo facial malformation. The patient underwent the frontalis aponeurosis flap suspension. After operation, the appearance of eyelids was significantly improved.


Assuntos
Blefaroplastia , Blefaroptose , Criança , Humanos , Blefaroptose/cirurgia , Pálpebras/cirurgia , Deleção Cromossômica , Retalhos Cirúrgicos/cirurgia , Músculos Oculomotores/cirurgia
14.
Ann Plast Surg ; 89(6): 610-614, 2022 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-36302259

RESUMO

BACKGROUND: Laxity of the upper eyelid skin in the elderly usually leads to an aged appearance and visual field defect, which affects their quality of life. However, there are very few reports on the evaluation and treatment strategy for upper eyelid skin redundancy in elderly Asians. Hence, this article describes an upper eyelid skin laxity correction surgery using an innovative parallel palpebral margin incision to improve ptosis and enlarge the visual field. METHODS: From August 2012 to March 2021, 87 patients with severe eyelid laxity and ptosis presented to the Plastic Surgery Department of the Zhongda Hospital Affiliated to Southeast University. Upper eyelid skin laxity correction surgery with eyelid marginal incision was performed to correct the excessive tissue between the eyebrow and the upper eyelid and improve patients' vision field. Thereafter, a postoperative follow-up was conducted to observe the results in terms of skin laxity, eyelid shape changes, visual field improvement, postoperative scars, and patients' satisfaction. RESULTS: During the follow-up, information was collected between 3 months and 1 year after surgery. No visible scars were seen in patients after the operation, and the sagging skin of the upper eyelid was corrected. In addition, the effect of correcting visual field defect is stable, with no recurrence within 1 year. The operation was effective, and patients were satisfied. CONCLUSION: This surgical strategy significantly improved severe upper eyelid skin laxity with inconspicuous postoperative scars. After the operation, patients felt satisfied, and their quality of life was notably improved.


Assuntos
Blefaroplastia , Blefaroptose , Doenças Palpebrais , Idoso , Humanos , Blefaroplastia/métodos , Cicatriz/cirurgia , Estudos Retrospectivos , Pálpebras/cirurgia , Blefaroptose/cirurgia , Doenças Palpebrais/cirurgia
15.
J Plast Reconstr Aesthet Surg ; 75(11): 4297-4303, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36192317

RESUMO

BACKGROUND: The transconjunctival approach is commonly performed in lower lid blepharoplasty so as not to violate the orbicularis oculi muscle integrity and avoid additional scars. This technique does not, however, permit easy access to the lateral fat pad (LFP). As upper and lower blepharoplasty are frequently combined in our clinical practice, the removal of LFP via upper blepharoplasty is a surgical approach that we found most applicable with good outcomes. METHODS: A prospective review of 47 consecutive bilateral combined upper and lower blepharoplasty cases using a single access technique was conducted; patient outcomes and the occurrence of any complications were recorded, in addition to preoperative and postoperative measurements between standardized anatomical landmarks. RESULTS: Forty-seven patients were included in our study. Postoperative measurements showed a decrease of both lateral cantus to inferior orbital border distance and horizontal width of LFP. Good esthetic outcomes and patient satisfaction with surgical results were achieved in the majority of patients. CONCLUSION: The single access upper blepharoplasty and lower lid LFP removal technique can improve esthetic outcomes in lower blepharoplasty. The advantages are many; a low risk of missing the lateral pad, ease of achieving a uniform contour of lower eyelid; short lower transconjunctival incision, minimizing complications associated with an intra-conjunctival scar. This technique, based on cadaveric anatomical studies, has been found to be safe and is of great utility to those patients requiring upper and lower lid blepharoplasties.


Assuntos
Blefaroplastia , Humanos , Blefaroplastia/métodos , Estudos Prospectivos , Pálpebras/cirurgia , Pálpebras/fisiologia , Músculos Faciais/cirurgia , Tecido Adiposo/cirurgia , Cicatriz/cirurgia
16.
Arch. Soc. Esp. Oftalmol ; 97(10): 572-582, Oct. 2022.
Artigo em Espanhol | IBECS | ID: ibc-209652

RESUMO

El tratamiento de la ptosis congénita con mala función del elevador se basa habitualmente en una suspensión del párpado superior al músculo frontal mediante diversos tipos de materiales autógenos o aloplásticos. Sin embargo, el empleo de dichos materiales conlleva una serie de complicaciones, lo cual dio lugar a la búsqueda de una técnica quirúrgica mediante la que, sin necesidad de ningún material adicional, se enlazaran músculo frontal y tarso; el avance de colgajo frontal. No obstante, es una técnica menos conocida y que todavía no está estandarizada, por lo que a lo largo del tiempo se han ido describiendo variaciones para mejorar los resultados estéticos y funcionales. El objetivo de esta revisión bibliográfica es repasar en detalle las distintas variaciones de la técnica quirúrgica y obtener la mejor opción con o sin la combinación de las diferentes versiones empleadas hasta el momento. Según los resultados observados, se podría deducir que la cirugía con mejores resultados estéticos y funcionales sería la siguiente; una única incisión en el surco palpebral para realizar una disección suborbicular hasta alcanzar reborde orbitario. Realización de lipectomía si lo precisa. A continuación, disección roma del músculo frontal y formación de colgajo en «U». Avance de la aponeurosis del elevador si se trata de una ptosis grave. Finalmente, sutura sin polea del colgajo frontal al tarso con tres puntos no reabsorbibles tratando de mantener el contorno simétrico al ojo contralateral y con una altura de 1,5mm por encima del limbo corneal (AU)


The treatment of congenital ptosis with poor levator activity is often based upon the union of the superior eyelid to the frontalis muscle by using different materials as potential grafts. Nevertheless, theses grafts may lead some complications. In order to avoid them, a new technic has been described using an advancement flap of the frontalis muscle, that is tided to the upper tarsus, eliminating the need of a graft. Although, it is not yet a standard procedure, reason why many variants has been recently described with the objective of improving the aesthetical and functional results. The goal of this systematic review is to conscientiously evaluate these variants with the propose of determining which one gives the best results in terms of safety, functional and aesthetical outcomes. From the review of the published procedures, we conclude that the best technique in terms of functional and aesthetical results is: sub-orbicularis dissection via lid crease incision reaching the orbital margin, followed by blunt dissection of the frontalis muscle and creation of a “U” shaped flap (that might be associated to a levator advancement in severe cases), finally, the frontalis flap is stitched to the upper end of the tarsus taking care to maintain a symmetrical contour when compared to the contralateral eye. The final eyelid margin height should be 1.5mm above the sclero-corneal limbus (AU)


Assuntos
Humanos , Blefaroptose/cirurgia , Blefaroplastia/métodos , Retalhos Cirúrgicos , Pálpebras/cirurgia
17.
J Otolaryngol Head Neck Surg ; 51(1): 34, 2022 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-36114564

RESUMO

BACKGROUND: Lateral canthal webbing is a known complication of blepharoplasty, which occurs when the lateral aspect of the upper blepharoplasty incision is taken below the equator of the lateral canthus. Removing excessive eyelid skin laterally can also result in a lateral canthal web. Currently, there is no standard approach for addressing this complication. METHODS: Retrospective review of single surgeon practice between 2011 and 2019. All patients underwent revision surgery using the proposed single Z-plasty technique. RESULTS: Twenty-three patients referred for lateral canthal web were included in the study. All patients had previous upper lid blepharoplasty, with the initial procedure occurring 8-63 months prior to the referral for revision. The majority of the blepharoplasties occurred in Ontario (n = 19), but some patients also underwent surgery in Alberta (n = 1), British Columbia (n = 1), and United States (n = 1). The initial surgeries were performed by a variety of specialities including plastic surgery (n = 16), otolaryngology (n = 4), ophthalmology (n = 2), and family medicine (n = 1). Following revision surgery using the single Z-plasty technique, all patients reported a subjective increase in functional and aesthetic satisfaction. No further revision surgery was required for any of these patients. CONCLUSION: The single Z-plasty technique is simple, robust, and could be easily incorporated into any cosmetic practice to address this complication of blepharoplasty.


Assuntos
Blefaroplastia , Aparelho Lacrimal , Blefaroplastia/métodos , Pálpebras/cirurgia , Humanos , Aparelho Lacrimal/cirurgia , Reoperação
18.
Medicine (Baltimore) ; 101(35): e30409, 2022 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-36107593

RESUMO

Double-eyelid surgery is a very common practice in East Asian patients. The differential distribution of pretarsal tissue layers is considered to be the anatomical mechanism of natural Asiatic single eyelid, it is possible to form double-eyelid crease by re-positioning the pretarsal structure layers. The author presents a new double-eyelid surgery based on re-positioning of the pretarsal structure layers without tissue removal. Over a 6-year period, 1440 patients underwent new double-eyelid surgeries. With the pretarsal orbicularis oculi muscle incised, the pre-pretarsal levator aponeurosis fascia fibroadipose was first dissected to form a fibroadipose flap, and then repositioned with the eyelid lower lip orbicularis oculi muscle flap. The new composite structure was anchored at 3 points on the pretarsal levator aponeurosis fascia; the skin was sutured to form a smooth crease. Post-operative outcome and follow-up data were analyzed. Patients were followed up for an average of 2 years. esthetic outcomes were satisfactory for 97.91% of patients, who enjoyed new double upper eyelids with smooth creases and invisible incision lines. Outcomes were unsatisfactory for 2.08% of patients (double-eyelid regression, 0.76%; asymmetric creases, 1.32%). All patients who were not satisfied with their esthetic outcomes underwent second correction surgery. This new Pan-flap technique focuses on the correct dissection and repositioning of differentially thickened pre-pretarsal levator aponeurosis fascia fibroadipose tissue in East Asian patients. This new technique can generate broader and tighter attachment between pretarsal orbicularis oculi muscle and levator aponeurosis fascia, and form smooth double-eyelid crease without pretarsal soft tissue removal.


Assuntos
Blefaroplastia , Aponeurose , Blefaroplastia/métodos , Estética , Pálpebras/cirurgia , Músculos Faciais , Humanos
19.
Comput Math Methods Med ; 2022: 5315146, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36092793

RESUMO

Objective: This study is aimed at exploring the impact of eye model based on multichannel convolutional neural network (CNN) on eye plastic surgery and aesthetic effect, thus formulating methods to improve the effect of eye plastic surgery. Methods: A total of 64 patients who underwent pouch plastic surgery from January 2020 to March 2021 were selected as the research objects and were divided into observation group and control group by random number table method. The subjects in the observation group were evaluated by multichannel CNN-based eye model and doctors' experience, while those in the control group were evaluated by doctors' experience only, with 32 cases in both groups. Blepharoplasty, lower eyelid skin wrinkles, skin luster, and aesthetic scores were compared between the two groups. Results: The similarity between the multichannel CNN model detected shape and the actual eye shape (98.78%) was considerably higher than that of the CNN model detected shape (78.65%) (P < 0.05). After treatment, the indexes of pouch degree, lower eyelid skin wrinkle, eyelid lacrimal sulcus, skin gloss, and aesthetic score in the observation group were better than those in the control group (P < 0.05). The incidence of complications in the observation group (13%) was considerably lower than that in the control group (28%) (P < 0.05). Conclusion: The eye model based on the multichannel CNN model was helpful to improve the surgical repair and aesthetic effect of patients and can improve the occurrence of postoperative complications.


Assuntos
Blefaroplastia , Cirurgia Plástica , Blefaroplastia/métodos , Estética , Humanos , Redes Neurais de Computação
20.
J Plast Reconstr Aesthet Surg ; 75(10): 3877-3903, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-36114143

RESUMO

BACKGROUND: Needle retention is a rare but dangerous complication in ophthalmologic and oculoplastic surgery, with a limited literature detailing this issue. This study aimed to summarize the characteristics of needle retention after blepharoplasty, introduce intervention experience, and offer preventive suggestions. METHODS: This retrospective case series included six eyes of 6 consecutive Chinese patients that received prior initial blepharoplasties and presented to the emergency unit. Demographics, clinical features, and complications of all patients were collected, and diagnoses were made by three-dimensional computed tomography (3D-CT) scanning with volume rendered technique. All needles were removed by minimally invasive surgery. RESULTS: All patients accepted their initial blepharoplasty either at private cosmetic clinics (5/6) or at a friend's home (1/6). Only on using 3D-CT scanning, could the location of retained needles be confirmed. Needles were located in the lateral part of the left-sided eyelid for all patients, and resided in the orbicularis layer (5/6) or periosteum (1/6). In needle removal surgeries, four patients (2/3) accepted percutaneous small incision method, and the remaining two (1/3) were treated via their existing wounds. No intra- or postoperative complications during operations or follow up were found. CONCLUSIONS: Diagnosis of needle retention is based on histories, and use of 3D-CT scanning is recommended for location. The retained needle should be removed promptly before its potentially devastating migration begins, and small incisional surgery with an aesthetic design is effective. Authentic private and public institutionally qualified surgeons in cosmetic surgery should be validated and supervised by the Government.


Assuntos
Blefaroplastia , Blefaroplastia/efeitos adversos , Blefaroplastia/métodos , Estética , Pálpebras/cirurgia , Humanos , Agulhas , Estudos Retrospectivos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...