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2.
Clin Plast Surg ; 49(3): 339-348, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35710149

RESUMO

The surgical approach to the brow has changed perhaps more than any other facial esthetic procedure in the past 20 years. Understanding the functional anatomy of the upper face is the best means of maximizing results and minimizing untoward events in this region. The surgical and clinical correlation is addressed in detail in this article. Cadaver and intraoperative photographs are used to illustrate critical points. Armed with the details of this anatomy, the reader will best be able to best individualize surgical treatment.


Assuntos
Ritidoplastia , Estética , Sobrancelhas/anatomia & histologia , Face/anatomia & histologia , Face/cirurgia , Testa/cirurgia , Humanos , Ritidoplastia/métodos
3.
Clin Plast Surg ; 49(3): 349-356, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35710150

RESUMO

Effective rejuvenation of the upper face results when effective brow repositioning is combined with maintenance or improvement of brow shape. Endoscopic brow lift techniques have increased in popularity as surgeons have investigated less invasive surgical procedures. This article provides a comparison of hairline brow lift with other open and endoscopic techniques used for improving brow position. It includes a detailed description of hairline brow lift with videos illustrating the authors' preferred technique. It also provides a description of ideal candidates including indications and contraindications to procedure, and common modifications to technique used in select patient populations.


Assuntos
Testa , Ritidoplastia , Endoscopia/métodos , Sobrancelhas , Testa/cirurgia , Humanos , Rejuvenescimento , Estudos Retrospectivos , Ritidoplastia/métodos
4.
Clin Plast Surg ; 49(3): 357-363, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35710151

RESUMO

This article discusses the physiology of brow ptosis and compares how depressor muscle alteration combined with wide subperiosteal undermining leads to its correction. A detailed description and a series of videos illustrate the endoscopic technique. Long-term before and after photographs demonstrate the efficacy of the procedure. Pitfalls and flaws in technique leading to less-than-ideal outcomes are described.


Assuntos
Ritidoplastia , Endoscopia/métodos , Sobrancelhas , Testa/cirurgia , Humanos , Ritidoplastia/métodos
5.
Clin Plast Surg ; 49(3): 365-375, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35710152

RESUMO

Over the past decades, the understanding of the nuances of forehead anatomy and facial aging has grown immensely. Safe and reliable options for forehead rejuvenation followed. Although noninvasive techniques are an important adjunct in forehead rejuvenation, the mainstay of treatment of the eyebrow is operative intervention. The senior author's technique has developed over many years, first focusing on the open coronal and anterior hairline approach to the forehead lift, then the endoscopic brow lift, and most recently, the lateral subcutaneous temporal lift. This technique allows for reliable and safe elevation of the lateral brow with minimal complications.


Assuntos
Ritidoplastia , Endoscopia/métodos , Sobrancelhas , Testa/anatomia & histologia , Testa/cirurgia , Humanos , Rejuvenescimento , Ritidoplastia/métodos
6.
Clin Plast Surg ; 49(3): 377-387, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35710153

RESUMO

Subcutaneous undermining for brow lifting is not a new technique, but the gliding brow lift is evolutionary in the sense that it can be done through 1 or 2 tiny incisions and the brow shape maintained with transcutaneous running sutures (the hemostatic net). Undermining over the frontalis muscle and galea is performed using blunt dissectors and the lifting is done with superior traction, holding the brow in the desired shape with the hemostatic net.


Assuntos
Hemostáticos , Ritidoplastia , Sobrancelhas , Testa/cirurgia , Humanos , Ritidoplastia/métodos , Suturas
7.
Clin Plast Surg ; 49(3): 389-397, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35710154

RESUMO

Brow lifting, when indicated, can significantly improve upper eyelid aesthetics. Brow lifting is a powerful maneuver to shape and lateralize the curvature of the brow arc and directly influences the upper eyelid fold height and the curvature of the upper eyelid crease. This article reviews the importance of upper periorbital aesthetic assessment because it lays the foundation to tailor the appropriate operative intervention. Highlighted are the authors' preferred approach to aesthetically shape the brow along with other complimentary upper eyelid aesthetic procedures including upper blepharoplasty, blepharoptosis repair, fat grafting, and upper periorbital fat shifting to optimize brow lifting outcomes.


Assuntos
Blefaroplastia , Ritidoplastia , Blefaroplastia/métodos , Estética , Sobrancelhas , Pálpebras/cirurgia , Humanos , Ritidoplastia/métodos
8.
Clin Plast Surg ; 49(3): 409-414, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35710156

RESUMO

Direct browlifting comprises various techniques to lift the brows using incisions on or around the brows. The classic direct browlift involves removing an ellipse of skin and subcutaneous tissue within or just above the brow cilia. However, the technique can be modified to address only lateral brow ptosis, to place the incision in the midforehead or the eyelid crease, and to place the incisions in different areas during bilateral surgery to attempt to improve symmetry. Careful attention to incision location, closure technique, and use of postoperative therapies can allow for nearly invisible scars in some cases.


Assuntos
Blefaroplastia , Ritidoplastia , Blefaroplastia/métodos , Cicatriz/cirurgia , Sobrancelhas , Testa/cirurgia , Humanos , Ritidoplastia/métodos
9.
Clin Plast Surg ; 49(3): 415-420, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35710157

RESUMO

As the approach to the upper face has evolved in recent years, so has the focus of aesthetic brow procedures. Brow position was the primary focus early in the late twentieth century, with the coronal brow lift the primary means of surgical correction. In more recent years, improving or maintaining brow shape has taken on greater importance and has increasingly been addressed by contemporary techniques. These include the endoscopic, temporal, direct, gliding approaches as well as nonsurgical brow lifts. As each patient has individual facial characteristics and expectations, every technique comes with a unique set of indications.


Assuntos
Testa , Ritidoplastia , Envelhecimento , Algoritmos , Endoscopia/métodos , Sobrancelhas , Testa/cirurgia , Humanos , Ritidoplastia/métodos
10.
11.
Work ; 72(2): 539-552, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35527589

RESUMO

BACKGROUND: Unsuitable schoolbags may stress the spine and promote poor body posture, particularly for school students. Global recommendations have suggested that schoolbag weight must not exceed 10% of a healthy student's body mass, which would need continuous monitoring and enforcement. OBJECTIVES: The present study presents a comparison between an ergonomically designed schoolbag, which helps reduce the potential effects of carrying a load, and a commercial one. METHODS: A total of 30 healthy male students were recruited for this experiment. Independent variables determined were schoolbag type (ergonomically designed and commercial schoolbags) and three load levels based on body mass percentage (i.e., 10%, 15%, and 20% of body mass). Heart rate variability (HRV) and body discomfort rating were then measured. RESULTS: Our results showed that the developed schoolbag promoted enhanced subjective measures and HRV response at 15% and 20% of body mass. Participants who wore the developed schoolbags experienced significantly lesser neck, shoulder, upper and lower trunk discomfort than those who wore the traditional ones. Changing the load percentage from 10% to 15% caused an increase in heart rate among participants carrying a commercial schoolbag but a decrease in heart rate among those carrying the developed schoolbag. CONCLUSIONS: The findings presented herein suggest introducing strategies for reducing the potential impact of load carrying through the combined effect of new educational inventions and policy changes.


Assuntos
Remoção , Instituições Acadêmicas , Peso Corporal , Frequência Cardíaca , Humanos , Remoção/efeitos adversos , Masculino , Suporte de Carga/fisiologia
12.
Facial Plast Surg Clin North Am ; 30(2): 205-214, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35501058

RESUMO

Strong command of facial anatomy is paramount for all facelift surgeons. A comprehensive understanding of how aging impacts facial anatomy is equally important for effective preoperative evaluation of the patient undergoing facelift surgery. Key areas for assessment of the patient undergoing facelift surgery are addressed. This article highlights and summarizes the high-yield anatomic pearls in facelift surgery, particularly in sub-SMAS (superficial musculoaponeurotic system) dissection techniques. Emphasis is placed on the depth and transitions of the facial nerve branches and the sub-SMAS potential spaces and their role in deep plane facelift dissection. Key anatomic structures in the deep neck are described.


Assuntos
Ritidoplastia , Sistema Musculoaponeurótico Superficial , Cirurgiões , Face/cirurgia , Humanos , Pescoço/cirurgia , Ritidoplastia/métodos , Sistema Musculoaponeurótico Superficial/cirurgia
13.
Appl Ergon ; 102: 103765, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35405455

RESUMO

Back support exosuits can support workers in physically demanding jobs by reducing muscle load, which could reduce risk of work-related musculoskeletal disorders. This paper presents a two-session evaluation of a commercial exosuit, the Auxivo LiftSuit 1.1. In session 1, 17 participants performed single repetitions of lifting and static leaning tasks with and without the LiftSuit. In session 2, 10 participants performed 50 box lifting repetitions with and without the LiftSuit. In session 1, the exosuit was considered mildly to moderately helpful, and reduced erector spinae and middle trapezius electromyograms. In session 2, the exosuit was not considered helpful, but reduced the middle trapezius electromyogram and trunk and thigh ranges of motion. These effects are likely due to placement of elastic elements and excessive stiffness at the hips. Overall, the LiftSuit appears suboptimal for long-term use, though elastic elements on the upper back may reduce muscle activation in future exosuit designs.


Assuntos
Remoção , Músculos Superficiais do Dorso , Dorso/fisiologia , Fenômenos Biomecânicos , Eletromiografia , Humanos , Músculo Esquelético/fisiologia , Músculos Paraespinais
14.
Appl Ergon ; 102: 103756, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35413576

RESUMO

OBJECTIVE: Investigate the influence of sex, strength capacity, and relative load mass on low-back exposure and lower extremity joint power generation in backboard lifting. BACKGROUND: Sex and strength have been shown to influence lifting strategy, but without load mass being scaled to strength it is unknown which factor influences low-back exposures, and whether there are interactions with load mass. METHODS: Motion capture and force plate data from 28 participants were collected during backboard lifting at load masses scaled to strength capacity. Differences in normalized peak low-back moment, peak knee-to-hip power magnitude ratio and timing were tested as a function of sex, strength, and load mass. RESULTS: Stronger participants had lower normalized peak low-back moments (average 32% change from low-capacity across all load masses), with no significant sex effect (p = 0.582). As load mass increased, normalized peak low-back moment, peak knee-to-hip power magnitude and synchronicity decreased. CONCLUSION: Training to both increase strength capacity and hip-joint power generation may be a strategy to reduce low-back exposure in backboard lifting.


Assuntos
Dorso , Remoção , Fenômenos Biomecânicos , Humanos , Joelho , Articulação do Joelho
15.
Clin Plast Surg ; 49(2): 197-212, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35367030

RESUMO

The upper lid-brow junction is a complex anatomic zone that undergoes many interconnected age-related changes. Although considerable effort has gone into defining the ideal female eye and brow, no such work has been done for the male. Typically, men develop forehead and glabellar lines in conjunction with either upper lid hooding, brow ptosis, or blepharoptosis, whereas some men develop hollowing of the upper lid sulcus. Physical examination defines which features predominate. Treatment can be nonsurgical or surgical. The surgical options include upper lid blepharoplasty, various types of brow lifting or brow shaping, ptosis repair, and fat grafting.


Assuntos
Blefaroplastia , Ritidoplastia , Sobrancelhas , Pálpebras/cirurgia , Feminino , Humanos , Masculino , Rejuvenescimento
16.
Clin Plast Surg ; 49(2): 221-256, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35367032

RESUMO

Increasing numbers of men are seeking surgical rejuvenation of their face and plastic surgeons have come to recognize that male facial aesthetics differ from those in women and that attractive masculinity is not as closely correlated with youth and beauty as is femininity. As a result, men generally seek a somewhat different outcome from facelift surgery. This has led to a rethinking of techniques that have evolved mainly to treat facial aging in women, and techniques have emerged that allow rejuvenation of the male face while preserving a natural, masculine appearance free of signs that surgery has been performed.


Assuntos
Ritidoplastia , Adolescente , Beleza , Face/cirurgia , Feminino , Cabeça , Humanos , Masculino , Rejuvenescimento , Ritidoplastia/métodos
17.
Clin Plast Surg ; 49(2): 257-273, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35367033

RESUMO

Specialists seeking successful outcomes in male facial rejuvenation must be able to achieve adequate results in the neck and submental region to provide their patients with balanced and natural results. A thorough understanding of male jawline and neck surface aesthetics is described and its relevance to perceived age, attractiveness, and body mass index is presented. The neck lift technique described is based on the pursuit of 2 distinct objectives managed independently: (1) Volume contouring or reduction, which is mainly accomplished in the deep structures of the neck beneath the platysma and (2) superficial redraping, which consists of the management of the platysma itself and of the overlying subcutaneous fat and skin under minimal tension. A dual-plane approach to the neck is used, meaning 2 different dissection planes are carried out. In the area cranial to the submandibular-cervical junction line (ie, submandibular segment), a plane is developed both superficial and deep to the platysma, while in the area caudal to this line (ie, cervical segment), dissection is carried out only deep to the platysma, leaving the muscle attached to its overlying skin. A description of the technique is presented as well as its complications and indications for surgical neck enhancement.


Assuntos
Procedimentos Cirúrgicos Reconstrutivos , Ritidoplastia , Sistema Musculoaponeurótico Superficial , Humanos , Masculino , Pescoço/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Rejuvenescimento , Ritidoplastia/métodos , Sistema Musculoaponeurótico Superficial/cirurgia
19.
Plast Reconstr Surg ; 149(6): 1096e-1105e, 2022 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-35383689

RESUMO

BACKGROUND: In 2000, Matarasso et al. performed a survey of American Society of Plastic Surgeons members' face lift practice patterns. Since that publication, the aesthetic marketplace has changed dramatically, as have ancillary face lift techniques. In an attempt to detail these changes, we repeated that original survey, adding questions to address more recent technical issues and advances. The goal of this report was to define current face lift practice patterns, compare current patterns to the previous ones, and define recent advances. METHODS: A 38-question survey assessing face lift techniques, perioperative management, complications, and concomitant procedures was electronically distributed to a random cohort of American Society of Plastic Surgeons members. Data were recorded and statistically analyzed utilizing the Pearson chi-square test. RESULTS: A total of 251 forms were returned and analyzed. Details of demographics, face lift techniques, ancillary procedures, perioperative care, and complications are presented. Current results were compared to the previously published society member practice patterns delineated in the 2000 Plastic and Reconstructive Surgery publication. CONCLUSIONS: The basic approach of American Society of Plastic Surgeons members to the face lift operation has not changed dramatically over the past 20 years. The development of operative adjuncts, however, has been positive, including fat grafting techniques, concomitant use of skin resurfacing, and means of minimizing blood loss with tranexamic acid. In certain instances, respondents do not follow evidence-based guidelines for perioperative care. Finally, common complications of practicing members appear to coincide with published retrospective reviews.


Assuntos
Procedimentos Cirúrgicos Reconstrutivos , Ritidoplastia , Cirurgiões , Cirurgia Plástica , Humanos , Padrões de Prática Médica , Estudos Retrospectivos , Ritidoplastia/métodos , Inquéritos e Questionários , Estados Unidos
20.
Oral Oncol ; 127: 105808, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35263678

RESUMO

Gland-preserving surgery has been introduced to reduce the complications of conventional parotidectomy that requires removal of total superficial or entire parotid gland along with the tumour. Several cosmetic incisions have also been developed along with conservative parotid surgery involving partial dissection of the facial nerve and gland. The incision length in the cosmetic approaches is gradually shortened from facelift to periauricular incision, and endoscopic parotidectomy techniques emerged. A more functional approach via postauricular sulcus incision was also introduced to remove benign parotid tumours with high cosmetic satisfaction and oncological safety. Therefore, this article presents the surgical procedures, potential indications, pros and cons of the postauricular sulcus approach.


Assuntos
Neoplasias Parotídeas , Ritidoplastia , Dissecação/métodos , Humanos , Glândula Parótida/cirurgia , Neoplasias Parotídeas/cirurgia , Complicações Pós-Operatórias
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