Clinical effect of integrated prosthesis on eyebrow arch augmentation / 中华医学美学美容杂志

Objective:To explore the feasibility and advantages of integrated prosthesis of expanded polytetra-fluoroethylene (e-PTFE) in eyebrow arch augmentation.Methods:The clinical data of 45 patients with low or flat brow arch and glabellar zone from June 2019 to October 2020 in Chengdu High-tech Zone Xinyuerong Medical Aesthetic Clinic were analyzed retrospectively, in which it included 45 women, whose ages ranged from 20 to 39 years with average 29.8 years. Forty-three cases underwent primary surgery, and 2 cases underwent repair. The e-PTFE was sculpted to be personalized integrated prosthesis according to the shape of the patient's eyebrow arch and glabellar zone. The incision was designed on the medial and lateral sides of the lower margin of the bilateral eyebrow to avoid the supraorbital foramen, and the lacunae were striped under the frontal periosteum, and the two sides were connected to cover the glabellar zone and inverted triangle area between the eyebrows. The carved e-PTFE was implanted into one side and pulled out from the other side. The prosthesis was smoothed by Venn pliers of the ventral and dorsal sides.Results:The 45 patients in this group were followed up for 6-18 months. The incisions of all the patients were healed Ⅰ/A, and the scar of the incisions was concealed. Slight scalp numbness occurred in 4 patients and returned to normal 3 months later. The prosthesis in the glabellar zone appeared in 1 case 3 months after operation and returned to normal after reoperation. The symmetry, radian, fullness, convexity and tactility of bilateral eyebrow arch were all satisfactory in 45 cases. 39 cases were very satisfied, accounting for 86.7%; 6 cases (13.3%) were satisfactory. The sagittal distance of the anterior surface of the cornea to the soft tissues overlying the supraorbital rims was (2.02±1.72) mm preoperatively and (6.5±1.19) mm in the last follow-up. The difference was statistically significant ( t=14.49, P<0.01). Conclusions:This design of integral e-PTFE in eyebrow arch augmentation is safe, effective and easy to operate. It can significantly increase the bony beauty and stereoscopic sense of the eyebrow arch and glabellar zone, effectively deepen the eye socket, improve the eye protrusion, and reduce the risk of asymmetry and prosthesis displacement, and therefore it is one of the ideal methods for eyebrow arch augmentation.

Relationship between eyebrow and eye aesthetics after correction of aponeurotic ptosis / 中华医学美学美容杂志

Objective:To evaluate the specific changes and importance of the proportions of the eyebrows and eyes after surgery by analyzing and measuring the changes of the values of the eyebrows and eyes in elderly patients with aponeurotic ptosis before.Methods:A total of 54 cases (108 eyes) of elderly patients with aponeurotic ptosis who were treated in our department from 2019.01 to 2020.12 were collected preoperatively and 6 months postoperatively, and they were set as the study group. At the same time, the data of 48 cases (96 eyes) of healthy people with good face were collected and set as the young control group, and the data of 50 cases (100 eyes) of elderly healthy people without ptosis were collected and set as the elderly control group. The corresponding objective data were analyzed, and the specific changes and proportional relationship of eyebrows and eyes after surgery were evaluated.Results:Compared with the preoperative data, the marginal reflex distance 1 (MRD1), the height of the palpebral fissure (HPF) in the study group increased at 6 months after the operation, and the distance between the eyebrow and eye at each site increased or shortened ( P<0.05). Six months after the operation, the brow height from medial canthus (MBH), the central brow and eye distance (brow height from upper eyelid margin on midpupillary level, CBH), and the lateral brow and eye distance (brow height from lateral, LBH) had been changed. The change rates of canthus compared with preoperatively were that (88.29±11.69)%, (85.04±14.96)%, and (93.61±13.56)%, respectively, among which CBH shortened most significantly, and the shortened distance was (3.76±2.43) mm. The MRD1 and HPF in the group increased significantly at 6 months after operation, which were significantly greater than those in the elderly control group ( P<0.05). CBH was significantly shortened ( P<0.05); compared with preoperative, the ratio of HPF/CBH, HPF/length of the palpebral fissure (LPF) in the study group increased at 6 months after operation, and the lateral canthus brow tail line [ratio of lateral canthus to lateral end of eyebrow (LLE)]/LPF decreased ( P<0.05); HPF/CBH in the study group was lower than that in the young control group at 6 months after operation, but greater than that in the elderly control group ( P<0.05). Monthly HPF/LPF was significantly higher than that of the elderly control group ( P<0.05), and the LLE/LPF of the study group was significantly higher than that of the young control group at 6 months after operation ( P<0.05); intraoperative levator muscle shortening (LMS) was negatively correlated with postoperative MBH, CBH and LBH ( P<0.05), among which LMS had the greatest correlation with CBH ( r=-0.587). Conclusions:After ptosis correction, the palpebral fissures are larger, the distance between the eyebrows and the eyes is shortened, and there is a certain proportional relationship. After surgery, the patient's eyebrow-eye ratio is better than that of the elderly in the same age group, and it is closer to the young people, and the intraoperative LMS has a correlation with the eyebrow-eye distance, which can be used as a factor to predict the shortened distance of the eyebrow-eye distance.

Effects of eyebrow arch augmentation with personalized PEEK implant assisted by endoscope / 中华医学美学美容杂志

Objective:To investigate the effect of eyebrow arch augmentation with personalized polyether ether ketone (PEEK) implant assisted by endoscope.Methods:From January 2019 to August 2021, 9 patients with low and flat eyebrow arch requiring eyebrow arch augmentation were treated in the plastic surgery department of the Friendship Plastic Surgery Hospital Affiliated to Nanjing Medical University. The cranial and maxillofacial CT scanning data were obtained before operation, the eyebrow arch elevation range and height were designed according to the patient's requirements, and personalized peek implants were manufactured. During the operation, a small temporal hairline incision was used to accurately separate the implantation cavity of individualized peek implants under the periosteum of the eyebrow arch implantation area with the aid of endoscope. Personalized PEEK implants were implanted under endoscope to make them fully fit with the eyebrow arch bone and fixed with titanium nails. Photos were taken and analyzed before and after operation.Results:All patients were followed up for 3 months to 2 years. Their facial expressions were normal, and there were no motor nerve injury, rejection and iatrogenic infection. The patients were satisfied with the postoperative effect. Compared with before operation, the low level of orbital bone in eyebrow area was improved, and the facial contour was three-dimensional and harmonious.Conclusions:The eyebrow arch augmentation with individualized peek implant assisted by endoscope is safe and effective. It can greatly reshape the upper contour of the face, deepen the upper eyelid fossa and improve the convex eye phenomenon, so as to achieve the cosmetic effect of enhancing the three-dimensional sense of the eyebrow orbital area, which is worthy of clinical application.

Resultados funcionales de la blefaroplastia superior / Functional results of upper blepharoplasty

Objetivo: Describir los resultados funcionales de la blefaroplastia superior. Métodos: Se realizó un estudio descriptivo longitudinal prospectivo de 99 pacientes (198 párpados) con diagnóstico de dermatochalasis de párpado superior, algunos asociados a ptosis palpebral y de la ceja, en el Instituto Cubano de Oftalmología "Ramón Pando Ferrer", en el período comprendido de febrero del año 2019 a enero de 2020. Resultados: El 85,8 por ciento fueron del sexo femenino y el 43,5 por ciento eran mayores de 62 años. Predominó la dermatochalasis del párpado superior y la ptosis palpebral en el 68,4 por ciento, así como la dermatochalasis y la ptosis palpebral severa, las cuales representaron el 47,5 y el 50 por ciento respectivamente. En el grupo de 56 a 61 años sobresalió la dermatochalasis del párpado superior y la ptosis de la ceja, con el 61 por ciento. En el 98 por ciento de los casos intervenidos se obtuvo la corrección total de la dermatochalasis del párpado superior, la corrección de la ptosis en el 86 por ciento y de la ceja en el 88 por ciento. No se presentaron complicaciones en el 94 por ciento de los párpados intervenidos. La complicación más frecuente fue el sangramiento, con el 2,5 por ciento. Conclusiones: El abordaje de la ptosis palpebral y de las cejas transblefaroplastia superior logra en la mayoría de los pacientes la corrección total de estas afecciones y de la dermatochalasis. Este procedimiento constituye una herramienta importante para el rejuvenecimiento facial(AU)

Objective: Describe the functional results of upper blepharoplasty. Methods: A prospective longitudinal descriptive study was conducted of 99 patients (198 eyelids) diagnosed with upper eyelid dermatochalasis, in some cases associated to eyelid and eyebrow ptosis. The study was carried out at Ramón Pando Ferrer Cuban Institute of Ophthalmology from February 2019 to January 2020. Results: Of the total patients studied, 85.8 percent were female and 43.5 percent were aged over 62 years. Upper eyelid dermatochalasis and palpebral ptosis prevailed with 68.4 percent, whereas severe dermatochalasis and palpebral ptosis represented 47.5 percent and 50 percent, respectively. A predominance was found of upper eyelid dermatochalasis and eyebrow ptosis in the 56-61 age group (61 percent). Total correction of upper eyelid dermatochalasis was achieved in 98 percent of the cases intervened, eyelid ptosis correction in 86 percent and eyebrow ptosis correction in 88 percent. No complications appeared in 94 percent of the eyelids intervened. The most common complication was bleeding with 2.5 percent. Conclusions: In most cases, management of palpebral ptosis and upper eyebrow transblepharoplasty achieves total correction of these disorders and dermatochalasis. The procedure is an important tool for facial rejuvenation(AU)

Long-term comparison of the efficacies of internal and external browpexy combined with blepharoplasty / Comparação a longo prazo da eficácia de browpexy interna ou externa associada à blefaroplastia

ABSTRACT Purpose: To perform a long-term comparison of the quantitative efficacy of internal and external browpexy in combination with upper-lid blepharoplasty based on lateral and central eyebrow positions. Methods: This retrospective study evaluated internal and external browpexy with upper-lid blepharoplasty surgeries that were performed during the period between January 2012 and December 2017 in the oculoplastic surgery department of our hospital. Patients who had undergone periorbital and forehead surgery, who had ophthalmologic or neurological diseases, and who were Botox users were not included in the study. Preoperative and postoperative measurements were made on photographs taken in the same position. The distances from the pupil center and from the point of intersection between the horizontal line passing through the pupil and the vertical line passing through the lateral canthus to the upper eyebrow borders were measured. Photogrammetric analysis of eyebrow position was analyzed using Corel Draw software. Results: Preoperative and postoperative photographs of 70 eyelids were analyzed. Measurements were taken 24 months after surgery. Mean elevations of 2.10 and 3.19 mm were observed in the central region and lateral regions, respectively, in the internal browpexy group. These elevations were 2.66 and 3.03 mm in the external browpexy group and 0.48 and 0.55 mm in the control group. Eyebrow elevations in the central and lateral regions were not significantly different from baseline in the control group (p=0.126 and p=0.25). Internal and external browpexy showed statistically similar elevation values in the central and lateral regions (p=0.636 and p=0.342). Conclusions: External and internal browpexy surgery afforded adequate and similar elevations of the central and lateral brow, which were significantly different from those in the standard blepharoplasty group during long-term follow-up.

RESUMO Objetivo: Avaliar a comparação, a longo prazo, da eficácia quantitativa da sobrancelha interna e externa em combinação com a blefaroplastia da pálpebra superior com base nas posições lateral e central da sobrancelha. Métodos: Este estudo retrospectivo avaliou as cirurgias interna e externa da braquiterapia com blefaroplastia de pálpebra superior realizadas entre janeiro de 2012 e dezembro de 2017 no setor de cirurgia Oculoplástica de nosso hospital. Pacientes submetidos à cirurgia periorbitária e frontal, com doenças oftalmológicas ou neurológicas e usuários de Botox não foram incluídos no estudo. Medidas pré e pós-operatórias foram feitas em fotografias tiradas na mesma posição. Foram medidas as distâncias do centro da pupila e do ponto de intersecção entre a linha horizontal que passa pela pupila e a linha vertical que passa pelo canto lateral do olho até as bordas superiores da sobrancelha. A análise fotogramétrica da posição da sobrancelha foi analisada usando o software Corel Draw. Resultados: Foram analisadas fotografias pré e pós-operatórias de 70 pálpebras. As medidas foram feitas 24 meses após a cirurgia. Elevações médias de 2,10 e 3,19 mm foram observadas na região central e laterais, respectivamente, no grupo de sobrancelha interna. Essas elevações foram de 2,66 e 3,03 mm no grupo da sobrancelha externa e 0,48 e 0,55 mm no grupo controle (p=0,126, p=0,25). A sobrancelha interna e externa apresentou valores de elevação estatisticamente semelhantes nas regiões central e lateral (p=0,636, p=0,342). Conclusões: Cirurgia de sobrancelha externa e interna proporcionam elevações adequadas e semelhantes nas sobrancelhas central e lateral que foram significativamente diferentes daqueles no grupo de blefaroplastia padrão no acompanhamento a longo prazo.

Upper eyelid and eyebrow dimensions in adult Filipinos

Objectives@# To determine the normative values for upper eyelid and eyebrow dimensions among adult Filipinos and the effects of age and sex on these parameters.@*Methods@#This was a prospective, descriptive study involving 75 Filipino adults who were recruited from a single tertiary government hospital in the Philippines. Profile data collected included age and sex, while clinical data included measurements of the pretarsal skin height (PSH), eyelid crease height (ECH) and eyebrow height (EBH) by a single observer, with the average of an individual’s eyes used as the representative measurement. An intereye correlation coefficient was calculated. The subjects were categorized into 4 age groups (i.e. early, early middle, late middle, and late adulthood) and according to gender for statistical analyses. All measurements were compared across age groups using Analysis of Variance (ANOVA) and between sexes using t-test.@*Results@#This study included 43 males and 32 females. Overall, mean PSH measured was 4.5 ± 1.5 mm; mean ECH was 5.9 ± 1.7 mm, while mean EBH was 10.4 ± 2.7 mm. Means of PSH and EBH showed similar measurements between sexes. The mean ECH of females in early adulthood was significantly higher than the mean ECH of males belonging to the same age group (p=0.01). Among the female group, mean EBH was also observed to increase with age (p=0.02). A high degree of inter-eye correlation was observed (r = 0.94 to 1.00).@*Conclusion@#Filipinos have unique upper eyelid and brow features compared to other races. Sex-related differences were not identified in PSH and EBH. While EBH increased with age among female subjects.

Resultados quirúrgicos de la técnica de elevación de la ceja transblefaroplastia / Clinical outcomes of the eyebrow lift technique of transblepharoplasty

RESUMEN Objetivo: Evaluar los resultados quirúrgicos de la técnica de elevación de la ceja transblefaroplastia y las complicaciones presentadas. Métodos: Se realizó un estudio descriptivo, retrospectivo, de corte longitudinal, de 12 pacientes (24 párpados) con ptosis de la ceja asociada a dermatochalasis del párpado superior desde mayo a septiembre del año 2018, en la consulta de Cirugía Plástica Ocular del Instituto Cubano de Oftalmología "Ramón Pando Ferrer". Fueron excluidos los que ya tenían una cirugía anterior del tercio facial superior. Resultados: El 83,3 por ciento de los pacientes fueron del sexo femenino. En cuanto a los grupos de edades resultó más frecuente el grupo de mayores de 62 años de edad. Hubo un predominio de la raza blanca, para un 58,3 por ciento. En el 60 por ciento de los casos del sexo femenino (6 pacientes), la dermatochalasis del párpado superior, asociada a la ptosis de la ceja, fue moderada. La ptosis de la ceja resultó corregida en 18 párpados, para el 75 por ciento. Se presentó el 25 por ciento de complicaciones (3 pacientes). Conclusiones: La técnica de elevación de la ceja transblefaroplastia logra la corrección de la ceja en el mayor número de pacientes con un bajo porcentaje de complicaciones, y constituye una buena opción quirúrgica para este tipo de afección palpebral(AU)

ABSTRACT Objective: To assess the surgical outcomes of the eyebrow lift technique of transblepharoplasty and the complications presented. Methods: A descriptive, retrospective, longitudinal study was carried out with 12 patients (24 eyelids) with eyebrow ptosis associated with upper eyelid dermatochalasis, from May to September 2018, in the Ocular Plastic Surgery office of Ramón Pando Ferrer Cuban Institute of Ophthalmology. Those who already had a previous surgery of the upper facial third were excluded. Results: 83.3 percent of the patients were female. Regarding the age groups, the group of people over 62 years of age was more frequent. There was a predominance of the white race, accounting for 58.3 percent. In 60 percent of female cases (6 patients), dermatochalasis of the upper eyelid, associated with eyebrow ptosis, was moderate. Eyebrow ptosis was corrected in 18 eyelids, for 75 percent. 25 percent of complications were presented (3 patients). Conclusions: The eyebrow lift technique of transblepharoplasty achieves eyebrow correction in the greatest number of patients with a low percentage of complications, and constitutes a good surgical option for this type of eyelid condition(AU)

Peripheral osteoma on the medial eyebrow successfully extracted while preserving supratrochlear nerve

Osteomas are benign, slow-growing osteogenic lesions frequently found in the craniomaxillofacial region. They can be classified as peripheral, central, or extraskeletal. Reactive mechanisms to trauma or infection, as well as muscle traction, are thought to play a major role in the development of peripheral osteomas. In the present report, a 41-year-old woman presented with a slow-growing, painless mass on her left eyebrow. She had suffered trauma 15 years prior. In the computed tomography scan, a 2.5 × 2 × 0.7-cm radio-opaque tumor was detected just medial to the left supraorbital foramen, and a peripheral osteoma was clinically diagnosed. An elective operation under general anesthesia was planned. Following a suprabrow incision, subcutaneous and intramuscular dissection was performed. In the surgical plane deep to the corrugator muscles and superficial to periosteum, a branch of the supratrochlear nerve was encountered and preserved using a vessel loop. The osteoma beneath the periosteum was extracted in multiple fragments using a chisel and mallet to minimize trauma to the nerve. Contour and facial symmetry were corrected. To use a suprabrow incision, the surgeon must understand neighboring anatomical structures, including the course of the supratrochlear and supraorbital neurovascular bundles. When these structures are located adjacent to tumor lesions, careful surgical maneuvers should be performed to preserve them.

Analysis of subbrow upper blepharoplasty by measuring the lid-to-brow distance

BACKGROUND: Conventional upper blepharoplasty through a supratarsal incision is commonly performed for periorbital rejuvenation. However, the drawbacks of this technique include insufficient removal of lateral hooding and an unnatural postoperative appearance. Subbrow upper blepharoplasty with submuscular fascia fixation was developed to avoid these shortcomings. Herein, we report our experiences with this technique and present an objective analysis of the results. METHODS: Subbrow upper blepharoplasty was performed in 30 patients between June 2016 and October 2017. All patients had preoperative frontal view photographs, and the distance from the upper lid margin to the lower edge of the eyebrow was measured at the lateral limbus (LBD-L). RESULTS: Between preoperative and postoperative measurements, the LBD-L was shortened by an average of 0.800 and 0.833 mm on the right and left, respectively (P=0.047 and P=0.070). Most patients were satisfied with their aesthetic appearance and the improvement of their visual field. CONCLUSIONS: The lid-to-brow distance was minimally changed by the procedure, but the results were aesthetically favorable. This seemingly paradoxical finding is explained by the characteristics of the surgical procedure and the related anatomy. Among the various possible blepharoplasty techniques, subbrow upper blepharoplasty with submuscular fascia fixation has definite value for Asians.

Elevación de la ceja y abordaje mínimamente invasivo mediante la blefaroplastia / Eyebrow lift by blepharoplasty with a minimally invasive approach

Las cejas y el párpado superior están íntimamente relacionados, por lo que se recomienda realizar un plan quirúrgico basado en la evaluación de las cejas y del área periorbitaria para lograr los resultados deseados de una apariencia descansada y natural. Para el levantamiento de las cejas se han realizado diferentes técnicas. Cada técnica tiene sus ventajas, desventajas e indicaciones. Se realizó una búsqueda bibliográfica en bases de datos que ofrece Infomed, como Ebsco, Hinari, Pubmed, Google académico y textos básicos de Oftalmología y Cirugía Estética. La elevación de la ceja mediante la blefaroplastia produce beneficios, tales como un abordaje menos invasivo, cicatrices posteriores menos evidentes, un plano de disección más fácil que disminuye el sangrado transquirúrgico, la disminución del tiempo de cirugía y por consiguiente menores complicaciones posoperatorias. Además, permite que los resultados sean duraderos, al igual que los obtenidos en la cirugía de elevación de las cejas mediante técnicas endoscópicas, con una marcada disminución en los costos al no utilizar el endoscopio. La presente revisión se realizó con el objetivo de ampliar los conocimientos sobre el envejecimiento del tercio superior facial, así como el empleo de la blefaroplastia ampliada como una alternativa quirúrgica de rejuvenecimiento periocular(AU)

The eyebrows and upper eyelids are closely related structures. It is therefore recommended to develop a surgical plan based on evaluation of the eyebrows and the periorbital area in order to achieve the desired result of a rested, natural appearance. Different techniques have been used for eyebrow lifting. Each technique has advantages, disadvantages and indications. A bibliographic search was conducted in the databases offered by Infomed, such as Ebsco, Hinari, Pubmed, Google Scholar, as well as ophthalmology and aesthetic surgery basic textbooks. Eyebrow lift by transblepharoplasty has benefits such as a less invasive approach, less visible scars after surgery, an easier dissection plane reducing intraoperative bleeding, reduced surgery time and therefore fewer postoperative complications. On the other hand, results are as lasting as those obtained by eyebrow lift surgery by endoscopic techniques, but costs are markedly lower due to the non-use of an endoscope. The present review was conducted with the purpose of broadening our knowledge about aging of the facial upper third, as well as about the use of extended blepharoplasty as a surgical alternative for periocular rejuvenation(AU)

Depressor orbicularis lateralis: concept, anatomy and clinical relevance / 中华整形外科杂志

The concept of depressor orbicularis lateralis arises through anatomy of brow ptosis and innovations of its correction. This vertical muscle band is usually found running inferiorly from the lateral brow down along the lateral orbital rim, adjacent to the orbicularis oculi. The muscle segment is a powerful depressor of the brow and may lead to recurrent lateral eyebrow ptosis, if it is not addressed at the time of the facelift. In this review, the anatomical evidence, basic functions of depressor orbicularis lateralis, as well as its clinical relevance and the proper measures in handling this structure as part of brow ptosis and crow′s feet surgery will be discussed.

Clinical study of therapeutic effect in eyebrow lifting with different incisions / 中华整形外科杂志

Objective@#To evaluate the therapeutic effect of choosing different surgical incisions in eyebrow lifting.@*Methods@#This research recruited 87 female who underwent eyebrow lifting in our hospital from January 2015 to December 2017, with the mean age of 52.4 years ranging from 25 to 71 years. According to the degree of the upper eyelid soft tissue laxity the level of eyebrow drooping and cosmetic patients personal requirements, we performed different surgical incisions respectively. Therefore, there were 39 cases upper-eyebrow incision, 31 cases under-eyebrow incision and 17 cases combined with upper and lower eyebrow incision.@*Results@#87 women who had undergone the 3 months to 4 years follow-up (average period, 6.3-month), are pleased with their eyebrow and rejuvenation after eyebrow lifting, with 90.8% (79 of 87) satisfaction, 6.9% (6 of 87) satisfaction basically and 2.3% (2 of 87) dissatisfaction. And only 2 patients had secondary surgery for unacceptable brow shape.@*Conclusions@#By choosing different eyebrow incisions and removing skin around the eyebrow, there were efficient ways to rectify the upper eyelid skin relaxation and eyebrow drooping, widen the double eyelid line as well as to improve crow′s-feet. We firmly believe that it is essential for surgeons to sufficiently get to know patients′ requirements and design a personalized treatment scheme according to the relaxation degree of the upper eyelid soft tissue and the shape of eye-brow.

Application of controllable hair density of eyebrow reconstruction with the treatment of scar baldness during the same operation stage / 中华医学美学美容杂志

Objective To explore a method of eyebrow reconstruction which can control eyebrows,and to repair scar baldness in the same operation stage.Methods Operations were performed in two stages.In the first stage,an expander was placed under the scalp at the same side of the defect eyebrow through the direction of the superficial temporal artery.Other expanders were placed around the scar baldness.After the incision healed,water was injected into the expander.During the expansion,the scalp hair density was approaching the uninjured eyebrow side.Then the second stage operation was prepared:an island flap with superficial temporal artery as axial artery was harvested and the expander was extracted.The subcutaneous tunnel was made in the temporal region of the eyebrow defect side.The expanded superficial temporal artery island scalp flap was passed through the tunnel and transferred to the defect eyebrow area to repair the eyebrow.After incising the scar baldness,the left expanded scalp flaps were transferred to cover the wound.Results 12 patients underwent this method of eyebrow reconstruction with scar baldness,all island scalp flaps survived,with no case of flap necrosis.After 6-24 months of follow-up,the hair density of the reconstructed eyebrows was very close to that of the uninjured side,without excessive thickening or excessive rarefaction.The scalp scars were small and can be shaded by the hair.All patients were satisfied with the operation.Conclusions The method of controllable hair density of eyebrow reconstruction with the treatment of scar baldness has good effects on reconstructing eyebrow defect and scar baldness.It is simple,economic and suitable for further application.

Changes in Eyebrow Position and Movement with Aging

BACKGROUND: This study evaluated dynamic changes in eyebrow position related to aging. METHODS: Female participants were recruited and separated into two groups aged 20–30 years (the younger group, n=20; mean age, 24.8 years) and 50–70 years (the older group, n=20; mean age, 55.8 years). Photogrammetry was used to determine the eyebrow position at the medial canthus (MC), lateral limbus, lateral canthus, and lateral end point (EP) for 6 actions: smooth opening (the reference action) and closing of the eye, forward gaze, maximum opening and closing of the eye, and maximum frown. Videos were also recorded. RESULTS: No differences in eyebrow position were detected at the MC when opening or closing the eyes smoothly, gazing straight ahead, or closing the eyes maximally. For all 6 actions, the position of the lateral EP in the older group was significantly lower than in the younger group (P=0.003), and the smallest degree of vertical movement at this point was found in both age groups (P<0.001). Vertical movement at the 4 landmarks of the eyebrows decreased with aging. CONCLUSIONS: Eyebrow position was unchanged at the MC with aging, except at maximal eye opening and maximal frown. No differences in eyebrow position were observed between the younger and older groups when eyes were maximally closed, except at the EP. It is important to focus on correction of the lateral EP for periorbital rejuvenation.

Clinical application and effect of pick-stab skill in eyebrow embroidery / 中华医学美学美容杂志

Objective To investigate the clinical application and effect of pick-stab skill in eyebrow embroidery.Methods From July 2015 to January 2016,36 cases were selected to receive eyebrow embroidery with pick-stab skill in our department,including 1 male and 35 females.The cosmetic outcomes,complications and satisfaction rate were observed in these cases.Results In these 36 cases,14 cases were colored in one time,19 cases were colored twice,and 3 cases were more than 3 times.All patients were followed up for 6 months.The color of the eyebrow was natural,and the blue color was not existed.Conclusions The pick-stab skill in eyebrow embroidery is worthy in clinic with better cosmetic effect,higher success rate and safety.

Surgical effect of eyebrow plasty combined with hair grafting technique / 中华医学美学美容杂志

Objective To observe the effect of eyebrow plasty combined with hair grafting technique.Methods From January 2011 to April 2015,19 patients with eyebrow defect by eyebrow tattooing,operation or trauma received eyebrow plasty.The removed eyebrow tissue was separated into hair follicle units,and the eyebrow shape was redesigned.The hair grafting method was used for repairing eyebrow defect.Scalp was used as a supplement to get enough hair follicle units.Results All but one patients with eyebrow defect obtained good results,and the grafted hairs were growing well with satisfied direction and shape.One patient sustained folliculitis and was cured after inunctions with 75 ％ alcohol.Conclusions Eyebrow plasty combined with hair grafting technique is a safe and effective method for repairing eyebrow defect,with reducing the number of operations and shortening the treatment time.

Eyebrow approach procedures for upper eyelid rejuvenation / 中华医学美学美容杂志

Objective To explore the clinical indication and operative methods for different upper eyelid aging through perieyebrow incision.Methods We collected totally one hundred fifty-two cases in this study,including six males and 146 females,and aged from 26 to 80 years (average 47).There were 29 cases with only ptosis of upper eyelid,and the rest 123 cases were ptosis of upper eyelid with ptosis of eyebrow,sunken upper eyelid,bloated upper eyelid,or over-wide between eyebrow and eye region (compensatory eyebrow elevation).Through the incision of upper or lower margin of eyebrow,we treated these five types of upper eyelid aging by excision of redundant skin,orbicularis oculi muscle,frontal muscle,ROOF,or orbital fat,or ROOF elevation for upper eyelid rejuvenation.Results Patients were followed up for 3 to 120 months,with average 14.4 months.All ptosis of upper eyelid and over-wide between eyebrow and eye region patients were improved obviously.In 36 ptosis of upper eyelid with ptosis of eyebrow,seven of them treated with upper eyebrow margin incision got the best results;and the rest 29 patients treated with lower eyebrow margin incision,fifteen patients were lifted slightly,and the rest fourteen patients got no improvement.All scars of inferior eyebrow margin incision were invisible.Faded and applanate one millimeter wide scars were seen on two patients with superior eyebrow margin incision.In all patients with ptosis of upper eyelid,80％ patients with sunken upper eyelid were improved obviously,and 85 ％ with bloated upper eyelid were improved significantly.Conclusions Upper eyelid aging is divided into five categories.Upper eyelid aging could be corrected by perieyebrow approach.Our methods are simple,safe,fewer complications,and with short convalescence,which is the minimally invasive procedure recommended for Chinese patients with upper eyelid aging.

Efficacy of follicular unit extraction in the repair of scarring eyebrow loss: a clinical observation / 中华皮肤科杂志

Objective To evaluate the efficacy of follicular unit extraction (FUE) in the repair of scarring eyebrow loss.Methods A total of 30 patients with scarring eyebrow loss were treated with FUE technique in the Department of Plastic Surgery of Zhengzhou First People's Hospital,including 18 females and 12 males with 41 eyebrow defects.Fine soft hairs with a length of 5-10 mm were extracted from the back of the ear and temporal region of the patients,and then were split into individual follicular units under a microscope at 6 × magnification.The transplant density ranged from 20 to 30 FU/cm2.Results During the 3-18 months of follow-up after the surgery,eyebrows in the recipient areas grew in a natural direction and showed good appearance.The survival rate of hair grafts was up to 90％,and the patients were satisfied with the results.Conclusion FUE may be an ideal method for the treatment of scarring eyebrow loss with less injury and high survival rate of hair grafts.

Tinea faciei on the right eyebrow caused by Trichophyton interdigitale

Abstract Tinea faciei is a relatively uncommon dermatophyte infection entailing atypical clinical symptoms, usually misdiagnosed and treated with corticosteroids. The authors describe a case of tinea faciei on the right eyebrow caused by Trichophyton interdigitale. The patient was an 18-year-old girl, who had an inflammatory plaque with a scaly, pustular surface on the right eyebrow and upper eyelid, which had persisted for over 1 month. She was once misdiagnosed as having eczema and was treated using corticosteroid cream. A diagnosis of tinea faciei was made based on direct microscopy and culture. The sequencing of the nuclear ribosomal ITS region and β-tubulin gene of the isolate established its T. interdigitale lineage. The patient was cured by treatment with systemic terbinafine in combination with topical application of 1% naftifine-0.25% ketaconazole cream for 2 weeks.

Lateral Brow Lift: A Multi-Point Suture Fixation Technique

BACKGROUND: Descent of the lateral aspect of the brow is one of the earliest signs of aging. The purpose of this study was to describe an open surgical technique for lateral brow lifts, with the goal of achieving reliable, predictable, and long-lasting results. METHODS: An incision was made behind and parallel to the temporal hairline, and then extended deeper through the temporoparietal fascia to the level of the deep temporal fascia. Dissection was continued anteriorly on the surface of the deep temporal fascia and subperiosteally beyond the temporal crest, to the level of the superolateral orbital rim. Fixation of the lateral brow and tightening of the orbicularis oculi muscle was achieved with the placement of sutures that secured the tissue directly to the galea aponeurotica on the lateral aspect of the incision. An additional fixation was made between the temporoparietal fascia and the deep temporal fascia, as well as between the temporoparietal fascia and the galea aponeurotica. The excess skin in the temporal area was excised and the incision was closed. RESULTS: A total of 519 patients were included in the study. Satisfactory lateral brow elevation was obtained in most of the patients (94.41%). The following complications were observed: total relapse (n=8), partial relapse (n=21), neurapraxia of the frontal branch of the facial nerve (n=5), and limited alopecia in the temporal incision (n=9). CONCLUSIONS: We consider this approach to be a safe and effective procedure, with long-lasting results.