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3.
Ophthalmic Plast Reconstr Surg ; 40(3): 346-351, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38738712

RESUMO

PURPOSE: Scar contracture of the eyelid following facial burns often has adverse consequences. Total cicatricial contracture often makes adjustment flap translation challenging to implement. Previously used upper and lower eyelid adhesion methods are ineffective for patients with severe cicatricial contracture, and ectropion can easily recur. This study aimed to retrospectively examine upper and lower eyelid adhesions using an orbicularis oculi muscle flap and verify its stability. METHODS: In patients with ectropion caused by severe scar contracture following head and face burns, we employed a tunnel orbicularis oculi muscle flap technique, which involved creating a tunnel between the skin and the tarsal plate of the eyelid, mobilizing the orbicularis oculi muscle, and rotating it into this tunnel to provide stable adhesion of the upper and lower eyelids. Full-thickness skin grafting was then performed. The eyelids were examined postoperatively to determine whether reoperation was necessary and to monitor for any potential complications. RESULTS: This study included 26 patients and 46 eyes. No accidental disconnection occurred after eyelid adhesion, which lasted for an average of 21.87 ± 10.08 months before the eyelid adhesion was cut open. No complications or adverse reactions occurred, and the adhesions did not break unexpectedly. CONCLUSIONS: Repairing eyelid ectropion with the tunnel orbicularis oculi muscle flap is a simple procedure that immediately creates tension against upper and lower eyelid contractures, providing long-term stable adhesion. This method avoids structural disorders, such as eyelid margin scarring, minimally influences surrounding tissues, and has few postoperative complications. It holds great value for repairing eyelid tissue defects and warrants further study.


Assuntos
Ectrópio , Pálpebras , Músculos Oculomotores , Transplante de Pele , Retalhos Cirúrgicos , Humanos , Ectrópio/cirurgia , Ectrópio/etiologia , Masculino , Feminino , Estudos Retrospectivos , Adulto , Transplante de Pele/métodos , Pessoa de Meia-Idade , Músculos Oculomotores/cirurgia , Músculos Oculomotores/fisiopatologia , Adulto Jovem , Pálpebras/cirurgia , Blefaroplastia/métodos , Adolescente , Criança , Aderências Teciduais/cirurgia , Aderências Teciduais/etiologia , Queimaduras Oculares/cirurgia , Queimaduras Oculares/fisiopatologia , Queimaduras Oculares/diagnóstico
5.
Int Ophthalmol ; 44(1): 217, 2024 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-38705907

RESUMO

PURPOSE: To investigate the efficacy of the retroseptal transconjunctival blepharoplasty together with tear trough ligament (TTL) and Orbicularis retaining ligament (ORL) release with orbital fat graft in the management of groove in the infraorbital region (GIR). METHODS: A prospective study of 80 eyes of 40 patients that underwent retroseptal transconjunctival lower blepharoplasty together with TTL and ORL release and resected orbital fat grafting. An ophthalmic examination includes lower eyelid evaluation and Barton's Tear trough deformity grading was done at baseline, 2 weeks, 3 months, and 6 months after the surgery. Patient satisfaction was evaluated using Global aesthetic improvement scale (GAIS) and Blepharoplasty outcomes evaluation (BOE). RESULTS: Baseline tear trough defects were graded into grade 1, 2, and 3 in 12 (15%), 39 (48.75%) and 29 (36.25%) eyes, respectively. While at 6 months follow-up, grade 0 was recorded in 63 (78.75%) eyes, and grade 1 was recorded in 17 (21.25%) eyes. The amount of fat removed was 0.52 ± 0.04 mL per eye, whereas the amount of injected fat graft was 0.24 ± 0.04. The mean operative time was 33.2 ± 4.1 min per eye. GAIS showed degree 1, 2, and 3 in 8 (20%), 29 (72.5%), and 3 (7.5%) patients at 6 months follow-up, respectively. The mean baseline BOE increased significantly from 36.5 ± 5.9 to 86.9 ± 5.5 at 6 months follow-up. CONCLUSIONS: Our cohort highlights the beneficial effects of TTD/ORL release with resected orbital fat grafting in the management of GIR and infraorbital hollow.


Assuntos
Tecido Adiposo , Blefaroplastia , Túnica Conjuntiva , Órbita , Humanos , Blefaroplastia/métodos , Feminino , Masculino , Estudos Prospectivos , Tecido Adiposo/transplante , Pessoa de Meia-Idade , Adulto , Túnica Conjuntiva/cirurgia , Túnica Conjuntiva/transplante , Órbita/cirurgia , Pálpebras/cirurgia , Seguimentos , Resultado do Tratamento , Idoso , Satisfação do Paciente
6.
Vestn Oftalmol ; 140(2. Vyp. 2): 166-171, 2024.
Artigo em Russo | MEDLINE | ID: mdl-38739147

RESUMO

Loading of the upper eyelid with palpebral implants made of noble metals is the modern standard of surgical treatment for paralytic lagophthalmos, and is aimed at increasing the mobility of the upper eyelid and normalizing involuntary blinking movements. This review presents the results of morphological studies, including immunohistochemical studies, reflecting the features of biointegration of palpebral implants in uncomplicated and complicated course of the postoperative period, and describes the modern understanding of the causes and immunopathological processes underlying the development of nonspecific inflammatory response, which is one of the most serious complications that often becomes an indication for implant removal.


Assuntos
Pálpebras , Humanos , Pálpebras/cirurgia , Doenças Palpebrais/cirurgia , Metais , Próteses e Implantes , Blefaroplastia/métodos , Desenho de Prótese
7.
J Plast Reconstr Aesthet Surg ; 93: 203-209, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38703712

RESUMO

BACKGROUND: Direct browlift is useful but leaves a scar above the brow. We proposed a dual-plane browlift to avoid facial scarring while effectively resolving brow ptosis in young and young adult patients. METHODS: Seven patients with facial palsy underwent dual-plane browlift between July 2018 and June 2022. The mean postoperative follow-up period was 31.9 months. Skin resection at the hairline was combined with subcutaneous dissection down to the inferior margin of the brow to "lift" the brow. Fascia lata strips were fixed to the dermis just inferior to the eyebrow to "hold" the brow, and the strips were suspended upward through the subperiosteal tunnel and fixed to the periosteum. Brow height was compared before and after the procedure and with the contralateral side. RESULTS: The reported complications included slight hematoma at the recipient site, temporary difficulty in closing the eye, and seroma at the fascia donor site. The paralyzed side showed significant differences between the preoperative period and postoperative months (POM) 3, 6, and 12, but differences were not shown in the intervals between POM 3 and 6, 6 and 12, or 3 and 12. The difference in eyebrow height between the paralyzed and nonparalyzed sides was significant preoperatively but not at POM 3, 6, or 12. All scars matured well, and the fascia silhouette was not visible in the forehead region. CONCLUSIONS: Dual-plane browlift enables rigid suspension using the fascia lata and excises flaccid skin without leaving facial scars, yielding excellent cosmetic quality and stable long-term outcomes.


Assuntos
Blefaroptose , Sobrancelhas , Paralisia Facial , Ritidoplastia , Humanos , Feminino , Paralisia Facial/cirurgia , Masculino , Blefaroptose/cirurgia , Ritidoplastia/métodos , Adulto , Adulto Jovem , Fascia Lata/transplante , Testa/cirurgia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Blefaroplastia/métodos
8.
Harefuah ; 163(5): 315-320, 2024 May.
Artigo em Hebraico | MEDLINE | ID: mdl-38734946

RESUMO

INTRODUCTION: Eyelid blepharoplasty, including lower eyelid blepharoplasty, are among the most common aesthetic surgeries recently performed. In contrast to upper eyelid blepharoplasty, lower eyelid blepharoplasty is a surgery with mostly an aesthetic indication, in which patients bear all associated costs, and their expectations rise accordingly. Nevertheless, the complexity of the anatomy, the differences in the aging processes of the face and eyelids between patients, the diversity of surgical methods, and the expectations gap make the surgery more challenging in comparison to upper eyelid blepharoplasty. A comprehensive understanding of the eyelid anatomy and the surrounding tissues, as well as matching expectations alongside with thorough preoperative evaluation, are all essential for providing a more personal adjustment of the surgical method and avoiding complications and mental distress for both patients and surgeons. This article briefly reviews the anatomy and aging processes of the lower eyelids, the main surgical approaches, and their common complications. Moreover, we present a framework for how such complications can be avoided.


Assuntos
Blefaroplastia , Pálpebras , Humanos , Blefaroplastia/métodos , Pálpebras/cirurgia , Envelhecimento/fisiologia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/prevenção & controle , Complicações Pós-Operatórias/etiologia
10.
J Plast Reconstr Aesthet Surg ; 93: 111-113, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38678813

RESUMO

The aging process of lower eyelids results in lower eyelid wrinkles, tear troughs, and eye bags. Many therapies have been described for treatment of lower eyelid aging, and transcutaneous blepharoplasty is often used for treating cases with eyebags and dermatochalasis. However, it may cause depression near the medial orbit resulting in a hollowed look. In the present study, we developed an innovative method transferring the herniated fatty tissue to volume loss area during the surgical procedure of transcutaneous lower eyelid blepharoplasty by means of micro-autologous fat transplantation harvested from resected orbital fat pads. Besides, we also analyze it efficacy and safety compared with traditional methods of transcutaneous lower eyelid blepharoplasty. We reviewed the records of the patients who underwent transcutaneous lower eyelid blepharoplasty with and without micro-autologous fat transplantation, for lower eyelid aging improvement. We used global aesthetic improvement scale, Hirmand's classification system, and Wrinkle Severity Rating Scale to evaluate the cosmetic outcome at 1 week, 1 month, and 3 months after operation by two independent investigators. We found patients received transcutaneous lower eyelid blepharoplasty with autologous fat graft had significantly higher global aesthetic improvement scale and Wrinkle Severity Rating Scale improvement than those underwent transcutaneous lower eyelid blepharoplasty only in each evaluation timepoints. There was no significant difference of adverse effects between both surgical methods. The present study demonstrated the efficacy and safety of the lower eyelid blepharoplasty with micro-autologous fat transplantation harvesting from resected orbital fat pads.


Assuntos
Tecido Adiposo , Blefaroplastia , Pálpebras , Envelhecimento da Pele , Transplante Autólogo , Humanos , Blefaroplastia/métodos , Feminino , Pessoa de Meia-Idade , Tecido Adiposo/transplante , Masculino , Pálpebras/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Idoso , Adulto , Órbita/cirurgia , Estética
11.
Aesthetic Plast Surg ; 48(11): 2050-2056, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38578308

RESUMO

BACKGROUND: Levator aponeurectomy is a common operation for mild to moderate blepharoptosis. The accuracy of ptosis correction relied on intraoperative judgement when patients were under local anesthesia. For patients who must receive the operation under general anesthesia, it would be an issue to determine how much length of levator aponeurosis to shorten. To solve this issue, we collected data from patients who underwent the operation under local anesthesia and concluded an algorithm. METHODS: This single-center, prospective bivariate regression study allocated patients of mild to moderate congenital blepharoptosis who received levator aponeurectomy under local anesthesia. Preoperative MRD1 and levator function, intraoperative amount of levator aponeurotic shortening, and postoperative MRD1 were measured. The follow-up period was right after the operation. RESULTS: Twenty-nine patients were included in this trial. Two subjects exited because of not receiving allocated operation and data of the other 27 subjects (including 34 eyelids) were analyzed. A scatter diagram was drawn where x axis referred to levator function and y axis referred to the ratio of the amount of shortening of levator aponeurosis over the height of MRD1 correction. Linear regression showed y = - 0.2717*x + 5.026, R2 = 0.8553. CONCLUSION: A modified algorithm to predict the amount of shortening of levator aponeurosis based on levator function and height of ptosis correction was concluded with better accuracy and clinical feasibility. 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 .


Assuntos
Algoritmos , Aponeurose , Blefaroplastia , Blefaroptose , Humanos , Blefaroptose/cirurgia , Blefaroptose/congênito , Feminino , Masculino , Estudos Prospectivos , Aponeurose/cirurgia , Blefaroplastia/métodos , Músculos Oculomotores/cirurgia , Criança , Adolescente , Adulto Jovem , Índice de Gravidade de Doença , Pálpebras/cirurgia , Adulto , Pré-Escolar , Resultado do Tratamento
12.
Aesthetic Plast Surg ; 48(11): 2057-2063, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38589561

RESUMO

BACKGROUND: Chat generative pre-trained transformer (ChatGPT) is a publicly available extensive artificial intelligence (AI) language model that leverages deep learning to generate text that mimics human conversations. In this study, the performance of ChatGPT was assessed by offering insightful and precise answers to a series of fictional questions and emulating a preliminary consultation on blepharoplasty. METHODS: ChatGPT was posed with questions derived from a blepharoplasty checklist provided by the American Society of Plastic Surgeons. Board-certified plastic surgeons and non-medical staff members evaluated the responses for accuracy, informativeness, and accessibility. RESULTS: Nine questions were used in this study. Regarding informativeness, the average score given by board-certified plastic surgeons was significantly lower than that given by non-medical staff members (2.89 ± 0.72 vs 4.41 ± 0.71; p = 0.042). No statistically significant differences were observed in accuracy (p = 0.56) or accessibility (p = 0.11). CONCLUSIONS: Our results emphasize the effectiveness of ChatGPT in simulating doctor-patient conversations during blepharoplasty. Non-medical individuals found its responses more informative compared with the surgeons. Although limited in terms of specialized guidance, ChatGPT offers foundational surgical information. Further exploration is warranted to elucidate the broader role of AI in esthetic surgical consultations. LEVEL OF EVIDENCE V: Observational study under respected authorities. 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 .


Assuntos
Inteligência Artificial , Blefaroplastia , Blefaroptose , Humanos , Blefaroplastia/métodos , Blefaroptose/cirurgia , Feminino , Encaminhamento e Consulta , Aconselhamento/métodos , Masculino , Cirurgia Plástica , Relações Médico-Paciente , Adulto
13.
Ophthalmic Plast Reconstr Surg ; 40(3): 331-335, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38624153

RESUMO

PURPOSE: Pilot studies suggest that waiting 15 minutes after a subcutaneous tranexamic acid injection is associated with decreased intraoperative bleeding and postoperative ecchymosis in eyelid surgery. The outcomes of commencing eyelid surgery immediately after injection without a waiting period remain unexplored. METHODS: This prospective, randomized, multicenter, double-masked, controlled study examined bilateral symmetric upper and/or lower lid blepharoplasty or ptosis repair. Patients received tranexamic acid in 1 eyelid and control in the contralateral eyelid. The surgeon recorded the side with more intraoperative bleeding. Two masked graders evaluated periocular ecchymosis at postoperative day 0 and postoperative week 1 (POW 1) with a 5-point scale. At POW 1, patients reported subjective grading of bruising as increased on 1 side or similar on both sides. Results were analyzed with Wilcoxon signed-rank and sign tests. RESULTS: Of 130 patients, there was less eyelid ecchymosis on the tranexamic side at postoperative day 0 ( p = 0.001) and POW 1 ( p < 0.001). By surgery type, the 69 levator advancement surgeries had significantly less ecchymosis at postoperative day 0 ( p < 0.001) and POW 1 ( p = 0.001), while upper eyelid blepharoplasty, combined upper and lower lid blepharoplasty, and conjunctivomullerectomy trended toward significance. Of 68 patients reporting a POW 1 grading, 69% reported less bruising on the tranexamic side ( p < 0.001). Intraoperative bleeding was not significantly different between sides ( p = 0.930). CONCLUSIONS: Without a postinjection waiting period, subcutaneous tranexamic acid for eyelid surgery significantly decreased postoperative ecchymosis on postoperative day 0 and POW 1 but did not affect intraoperative bleeding. Subcutaneous tranexamic acid was not associated with any complications.


Assuntos
Antifibrinolíticos , Blefaroplastia , Blefaroptose , Equimose , Pálpebras , Hemorragia Pós-Operatória , Ácido Tranexâmico , Humanos , Ácido Tranexâmico/administração & dosagem , Antifibrinolíticos/administração & dosagem , Estudos Prospectivos , Método Duplo-Cego , Blefaroplastia/métodos , Blefaroplastia/efeitos adversos , Masculino , Feminino , Pessoa de Meia-Idade , Hemorragia Pós-Operatória/prevenção & controle , Hemorragia Pós-Operatória/diagnóstico , Hemorragia Pós-Operatória/etiologia , Idoso , Pálpebras/cirurgia , Equimose/etiologia , Equimose/prevenção & controle , Equimose/diagnóstico , Blefaroptose/cirurgia , Adulto , Perda Sanguínea Cirúrgica/prevenção & controle
17.
J Fr Ophtalmol ; 47(4): 104135, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38447291

RESUMO

PURPOSE: To evaluate the effect of upper eyelid blepharoplasty surgery on corneal topography, visual field, ocular surface, meibography, corneal biomechanics and dry eye parameters. METHODS: This prospective study included a total 80 eyes of 40 patients. Following a detailed ophthalmological examination, standardized patient satisfaction questions were posed to patients before and after upper eyelid blepharoplasty surgery. Visual field test, non-invasive break up time (NIBUT), meibography, and corneal topography parameters were analyzed and evaluated. RESULTS: The mean (+) visible areas in the visual field were found to be 46.20±24.96 preoperatively, 56.73±21.98 at the 1st postoperative month and 65.96±18.5 at the 3rd month, which were statistically significant. NIBUT values preoperatively, at 1 month and at 3 months were 11.26±4.48, 11.16±4.5 and 10.14±4.0, respectively, which were statistically significant. Meibomian gland loss rates on meibography preoperatively and postoperatively at 1 and 3 months were found to be 30.24±8.3, 29.36±8.2 and 28.22±7.7 respectively and were statistically significant. With the scoring system after blepharoplasty, patients reported improvement in their symptoms. CONCLUSION: Upper eyelid blepharoplasty surgery is predicted to increase the quality of vision. It was observed that there was a functional and cosmetic improvement in the complaints of the patients after blepharoplasty. However, blepharoplasty may cause changes in eyelid dynamics and cause dry eye syndrome.


Assuntos
Blefaroplastia , Síndromes do Olho Seco , Humanos , Blefaroplastia/efeitos adversos , Campos Visuais , Estudos Prospectivos , Glândulas Tarsais , Síndromes do Olho Seco/diagnóstico , Síndromes do Olho Seco/epidemiologia , Síndromes do Olho Seco/etiologia
18.
J Plast Reconstr Aesthet Surg ; 92: 104-110, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38513342

RESUMO

BACKGROUND: High-eyelid fold is a common complication of upper eyelid surgery. This study proposed a novel technique for correcting high-eyelid fold in Asian patients with little eyelid skin and thick orbital fascia to improve cosmetic outcomes and patient satisfaction. METHODS: We retrospectively analysed the clinical data of 38 patients with high-eyelid fold repaired at the Plastic Surgery Hospital, Chinese Academy of Medical Sciences, from July 2017 to April 2022. All patients were treated using this method of preserving the high-eyelid fold and reconstructing the subcutaneous orbital fascia. Postoperative outcomes were reviewed and analysed using objective measures and subjective surgeon and patient evaluations. RESULTS: Thirty-eight patients (71 eyes) were included. Postoperative follow-up was for 6-25 months. At 6 months postoperatively, the mean anatomic crease height decreased from 10.45 mm to 6.22 mm, mean pretarsal show decreased from 3.20 mm to 1.61 mm, and mean margin reflex distance in 1 of the 31 patients with ptosis increased from 2.93 mm to 3.87 mm (P < 0.001). The compliance rate between the surgeon's assessment and patient satisfaction was 89.5%, with 31 cases considered good by both the surgeon and patient and one case considered poor by both (undercorrected ptosis), though a satisfactory result was achieved after reoperation. Neither recurrence of the original crease nor serious complications were reported. CONCLUSION: By preserving high-eyelid folds and reconstructing the subcutaneous orbital fascia, unnaturally high- and deep-eyelid folds were converted to lower, nondepressed folds.


Assuntos
Blefaroplastia , Pálpebras , Fáscia , Satisfação do Paciente , Humanos , Feminino , Masculino , Estudos Retrospectivos , Adulto , Pessoa de Meia-Idade , Blefaroplastia/métodos , Pálpebras/cirurgia , Fáscia/transplante , Órbita/cirurgia , Adulto Jovem , Adolescente , Blefaroptose/cirurgia
19.
Aesthetic Plast Surg ; 48(10): 1920-1925, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38499878

RESUMO

BACKGROUND: To compare outcomes of lower eyelid retraction repair using a subperiosteal midface lifting technique with and without posterior lamellar grafts. METHODS: Charts of patients undergoing a sub-periosteal midface lift for treatment of lower eyelid retraction using 4 techniques for posterior lamellar reconstruction were reviewed. Thirty patients were included in each of the groups: midface with hard palate graft (HPG), midface lift with acellular cadaveric graft (ADG), midface lift with retractor disinsertion (RD) and midface lift alone (NG). Measurements of distance from pupil center to lower lid margin (MRD2) and from lateral limbus to lower lid margin (MRD2limbus) were taken from pre- and postoperative photographs and compared. Secondary outcomes included rates of reoperation, major and minor complications, resolution of symptoms and keratopathy. RESULTS: One hundred twenty operations were assessed (n = 30 for each surgical group). The average follow-up time was 20 weeks. The median MRD2 elevation was 0.95 mm (NG), 0.85 mm (HPG), 1.59 mm (ADG) and 1.02 mm (RD). The median MRD2limbus elevation was 1.06 mm (NG), 0.92 mm (HPG), 1.45 mm (ADG) and 1.12 mm (RD). There were no significant differences in MRD2 or MRD2limbus between the 4 groups (p = 0.06 and 0.29, respectively). Reoperation rates were highest with in the hard palate graft group (33%) compared to other techniques (p = 0.0006). CONCLUSIONS: Similar degrees of lower eyelid elevation were achieved with all the midface lifting techniques, and complication rates did not significantly differ between techniques. However, the higher reoperation rates with the use of spacer grafts suggest that a no-graft technique may be preferable. LEVEL OF EVIDENCE III: 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 .


Assuntos
Blefaroplastia , Humanos , Feminino , Pessoa de Meia-Idade , Masculino , Estudos Retrospectivos , Idoso , Adulto , Resultado do Tratamento , Blefaroplastia/métodos , Bochecha/cirurgia , Ritidoplastia/métodos , Estética , Doenças Palpebrais/cirurgia , Estudos de Coortes , Medição de Risco , Pálpebras/cirurgia , Seguimentos
20.
Aesthetic Plast Surg ; 48(9): 1706-1714, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38519570

RESUMO

BACKGROUND: Traditional facial aging surgeries have risks and extended recovery times, leading to a demand for minimally invasive alternatives. PDO (polydioxanone) threads, which are absorbable sutures that stimulate collagen production and tissue contraction, offer improved aesthetic outcomes. This paper evaluates the combined use of PDO thread mid-cheek lift and lower blepharoplasty for facial rejuvenation. METHODS: This retrospective study compared outcomes in patients undergoing lower blepharoplasty combined with a mid-face lift using PDO threads versus those undergoing only lower blepharoplasty. Focused on individuals with baggy lower eyelids and pronounced nasolabial folds, outcome measures included the Modified Fitzpatrick wrinkle scale, Allergan® midface volume deficit scale, Width of inter zygomatic distance, Patient and Observer Scar Assessment Scale, and patient satisfaction questionnaires, assessed at baseline, 3 months, and 1 year postoperatively. RESULTS: The combined procedure demonstrated superior aesthetic outcomes and higher patient satisfaction compared to lower blepharoplasty alone. Improvements were more significant in wrinkle reduction, midface volume, and inter-zygomatic distance in the combined procedure group. Although the combined procedure had a longer mean operation time, scar assessment scores were similar between both groups, with no complications reported. CONCLUSION: The combination of lower blepharoplasty and mid-face lift using PDO threads is a comprehensive and effective approach for facial rejuvenation. It significantly enhances wrinkle reduction, mid-face lifting, and patient satisfaction. Ultrasound-guided thread lifting, a method of assessing and performing mid-face lifting, proves to be safe and efficient. This approach holds promise as a future option in cosmetic anti-aging surgery, presenting a minimally invasive alternative with natural-looking results and reduced downtime. LEVEL OF EVIDENCE II: 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 https://link.springer.com/journal/00266 .


Assuntos
Blefaroplastia , Satisfação do Paciente , Polidioxanona , Rejuvenescimento , Ritidoplastia , Envelhecimento da Pele , Humanos , Blefaroplastia/métodos , Estudos Retrospectivos , Feminino , Pessoa de Meia-Idade , Ritidoplastia/métodos , Masculino , Resultado do Tratamento , Estética , Idoso , Adulto , Técnicas de Sutura , Suturas , Estudos de Coortes
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