Sub-brow lift combined with orbicularis oculi folding for periorbital rejuvenation.

The study aimed to evaluate a new method of periorbital rejuvenation in which periorbital muscle manipulation is utilised. Patients (n = 82) who underwent eyebrow lifting surgery in Yichang Central People's Hospital were retrospectively included. All the patients had drooping eyebrows and lateral hooding of the upper eyelids combined with a flat or depressed outer-upper side of the eyebrow arch. Data were collected on the position of the eyebrow relative to the eye before and after surgery and the postoperative satisfaction of patients. The study included 43 patients in the traditional group and 39 patients in the combined group. The postoperative results showed that the combined approach group had more aesthetically pleasing mean (SD) ratio of the position of eyebrows relative to eyes (1.6 ± 0.2 vs 1.7 ± 0.2, p = 0.021). Furthermore, the satisfaction of the patients in the combined group was significantly higher than that of the traditional group (37/39 vs 34/43, p = 0.036). The periorbital rejuvenation through the sub-brow incision, combined with supraorbital orbicularis muscle folding had more aesthetically pleasing ratio of the position of eyebrows relative to eyes and the satisfaction of the patients in the combined group was significantly higher.

Prevalence of Masked versus Unmasked Blepharoptosis in Subjects Seeking for Blepharoplasty and or Eyebrow Lift.

PURPOSE: To report the prevalence of unmasked versus masked in subjects seeking for eyelid and eyebrow rejuvenation. METHODS: This retrospective study included subjects (>18 years) who were seeking for blepharoplasty and/or eyebrow lift procedures in the year 2020. They were either having No ptosis, Unmasked or Exposed ptosis (complaining of simultaneous droopy eyelid, which was confirmed on examination), or Masked or Hidden ptosis (not complaining of simultaneous droopy eyelid, but its presence was revealed on the examination). Margin reflex distance 1 (MRD1) and levator function (LF) were recorded. Associated ptosis was defined as MRD1 of ≤3 mm and regarded as mild (3 and 2.5 mm), moderate (2 and 1.5 mm), and severe (≤1 mm). RESULTS: Included were 1401 subjects with a mean age of 47.2 years. The prevalence of masked and unmasked ptosis was 31% (90% unilateral) and 15.6% (59% bilateral), respectively. A significantly younger mean age (45.6 vs. 59.7 years), higher MRD1 (2.6 vs. 1.9 mm), and better LF (13.3 vs. 11.3 mm) were observed in the masked vs. unmasked ptosis group. More than 80% of the subjects with masked ptosis presented with indirect signs. A majority of both groups (68.8% of masked and 63.5% of unmasked ptosis) were mild to moderate. CONCLUSION: Almost half of the subjects seeking for eyelid and eyebrow rejuvenation had either masked (2/3) or unmasked (1/3) associated ptosis. Masked ptosis was mostly unilateral and presenting with indirect signs of ptosis.

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)

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)

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)

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)

Upper Blepharoplasty and Lateral Wound Dehiscence.

PURPOSE: To report the frequency of lateral wound dehiscence (LWD) after upper blepharoplasty (UB), a technique and its outcome to prevent LWD. MATERIALS AND METHODS: A retrospective review was performed for cases of LWD after UB presenting between 2003 and 2009, and then a prospective comparative study was performed between February 2009 and March 2013. For the comparison, subjects were divided into two groups based on intraoperative assessment of lateral wound tension (same technique and surgeon). Group 1 received 1-3 orbicularis/subcutaneous buried sutures (6-0 polyglactin) before interrupted 6-0 nylon skin closure. Group 2 underwent skin closure only. Subjects, who had re-operation, skin healing disorders, and incomplete follow-up (<6 months), were excluded. P < 0.05 was considered as statistically significant. RESULTS: There were 14 (14/678, 2%) cases with LWD with a mean age of 36.2 years in the audit (2003-2009). The prospective study included 68 subjects (68/293, 23.2%) in Group 1 and 225 in Group 2. Gender and simultaneous forehead and eyebrow procedures were similar between groups (P = 0.3 and P = 0.4 respectively). Group 1 was statistically significantly younger at mean age of 41.4 years, compared to Group 2 at 56.1 years (P = 0.000). The frequency of LWD significantly (P = 0.04) decreased to 0.3% (1/293). CONCLUSION: In the presence of wound tension on skin closure (intraoperative assessment), tension relieving buried orbicularis/subcutaneous 6-0 polyglactin suturing of the lateral UB incision could prevent LWD.

Subcutaneous Forehead Lift

PURPOSE: The purpose is to present an useful and simple surgical method to improve the aging of upper third face in patients with high frontal hairline as well as low frontal hairline. METHODS: Forty eight female patients were treated with subcutaneous forehead lift using an anterior hairline incision over 14 years. This surgical technique is performed under direct vision utilizing a beveled incision made 4 to 5mm into the anterior hairline with subcutaneous dissection, which is continued near to eyebrow, sometimes extended to supraorbital rim to remove corrugator and procerus muscles. In patients with high frontal hairline, excess forehead skin anterior to incision line is removed. On the contrary in the patients with low frontal hairline, scalp posterior to incision line is removed. RESULTS: This technique provided constant and good results with the forty six patients, who were satisfied with eyebrow elevation and removal of wrinkles in forehead and glabellar region. However two patients were undercorrected, and focal alopecia developed in another two patients. One patient complained of pruritus over one year, but subsided spontaneously without any treatment. Temporary paresthesia developed in the forehead and frontal scalp of all cases after operation but permanent sensory loss never occurred in all the patients. CONCLUSION: Subcutaneous forehead lift using an anterior hairline incision is suggested to be one of the effective surgical methods to improve the aging of upper third face in the patients with high frontal hairline as well as low frontal hairline.