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Ivan Vrcek, Eva Chou, Marie Somogyi, John W Shore
PURPOSE: Loss of volume in the sub-brow fat pad with associated descent of the eyebrow is a common anatomical finding resulting in both functional and aesthetic consequences. A variety of techniques have been described to address brow position at the time of blepharoplasty. To our knowledge, none of these techniques treat the sub-brow fat pad as an isolated unit. Doing so enables the surgeon to stabilize and volumize the brow without resultant tension on the blepharoplasty wound. The authors describe a technique for addressing volume loss in the eyebrow with associated brow descent that treats the sub-brow fat pad as an isolated unit...
March 31, 2017: Ophthalmic Plastic and Reconstructive Surgery
Molly L Fuller, César A Briceño, Christine C Nelson, Elizabeth A Bradley
PURPOSE: To determine if tangent visual fields gathered during assessment of superior visual field deficits caused by blepharoptosis and dermatochalasis offer good correlation to clinical exam in a time and cost efficient manner. METHODS: Prospective, observational case series. Subjects included all patients referred to a single surgeon (CCN) who underwent surgical correction of blepharoptosis and/or dermatochalasis. Preoperatively and postoperatively, upper margin-to-reflex distances were assessed...
2017: PloS One
Arpine Barsegian, Adam Botwinick, Harsha S Reddy
PURPOSE: To characterize the phenylephrine test in ptotic patients to help clinicians perform the test more efficiently. METHODS: Adults with involutional ptosis (n = 24, 30 eyes) were assessed with digital photographs for response to topical 2.5% phenylephrine drop instillation. Patient characteristics (age, gender, iris color, dermatochalasis, brow ptosis, and baseline marginal reflex distance-1 [MRD-1] height) were recorded. From the photographs, change in (MRD-1), presence of conjunctival blanching, pupillary dilation, and Hering effect were recorded at specified time intervals, 1 minute to 1 hour after drop placement...
March 28, 2017: Ophthalmic Plastic and Reconstructive Surgery
Michael Murri, Eric B Hamill, Matthew J Hauck, Douglas P Marx
Aging changes to the lower eyelids and midface include pseudoherniated orbital fat, tear trough deformity, lid laxity, and dermatochalasis. Surgical repair often aims at treating redundant skin or orbital fat malposition with a lower eyelid blepharoplasty. Either a transcutaneous or transconjunctival approach may be used, though recent trends have favored the transconjunctival technique if procedures require more than simple skin excision. In manipulating the inferior orbital fat pads, a surgeon has many options including excision, repositioning, or augmentation with synthetic dermal filler, autologous fat grafts, or acellular dermal allografts...
February 2017: Seminars in Plastic Surgery
Ali Karnaz, Yasemin Aslan Katircioglu, Evin Singar Ozdemir, Pınar Celebli, Sema Hucumenoglu, Firdevs Ornek
PURPOSE: To assess changes in lymphatic vessels, collagen, and elastic fiber structure in excised tissues with dermatochalasis (DC). METHODS: In this prospective histopathological study, 70 upper eyelid skins of 35 patients operated on for dermatochalasis were compared with 10 eyelid skins of 10 patients operated on for other diagnoses. In histopathological examination, the two groups of patients were compared with respect to number of lymphatic vessels, largest lymphatic vessel diameter, number of elastic fibers, number of macrophages, edema between collagen fibers, and depth of stromal collagen bed...
February 6, 2017: Seminars in Ophthalmology
Shani Golan, Gilad Rabina, Shimon Kurtz, Igal Leibovitch
PURPOSE AND DESIGN: The aim of this study was to establish the prevalence of known glaucoma in patients undergoing ectropion or entropion surgical repair. In this study, retrospective review of case series was performed. PARTICIPANTS: All patients who underwent ectropion or entropion surgery in a tertiary medical center between 2007 and 2014 were included. The etiology of eyelid malpositioning was involutional or cicatricial. METHODS: The medical files of the study participants were reviewed for the presence and type of glaucoma, medical treatment, duration of treatment, and the amount of drops per day...
2016: Clinical Interventions in Aging
Seoung Hyun An, Sang Wook Jin, Yoon Hyung Kwon, Won Yeol Ryu, Woo Jin Jeong, Hee Bae Ahn
AIM: To assess the effects of upper lid blepharoplasty on visual quality. METHODS: Seventy-three eyelids of 39 patients were subjected to upper lid blepharoplasty. Pre- and post-operative contrast sensitivity, visual acuity, vertical palpebral aperture and the degree of lash ptosis were measured. RESULTS: The mean log contrast sensitivities under photopic (P=0.017) and scotopic conditions (P=0.009) were improved after surgery, and these differences were significant...
2016: International Journal of Ophthalmology
César A Briceño, Molly L Fuller, Elizabeth A Bradley, Christine C Nelson
PURPOSE: To evaluate the Abbreviated National Eye Institute Visual Function Questionnaire (NEI VFQ 9), which is shorter than those previously published, as a tool for assessing vision-related quality of life in patients with ptosis and dermatochalasis. METHODS: This is a cohort study of 46 patients who underwent blepharoptosis and/or upper eyelid blepharoplasty surgery by a single surgeon (CN) in 2013 in a public, academic, ambulatory care referral center. Patients included 29 who underwent blepharoplasty, 11 who underwent ptosis surgery, and 6 who underwent combined surgery...
July 2016: Arquivos Brasileiros de Oftalmologia
Tanuj Nakra, Sara Modjtahedi, Ivan Vrcek, Ronald Mancini, Stan Saulny, Robert A Goldberg
This article evaluates the effect of upper eyelid blepharoplasty on eyelid margin position and brow height. This study is a retrospective analysis of patients who underwent upper eyelid blepharoplasty without concurrent blepharoptosis repair or brow surgery. The medical records of the participants were retrospectively reviewed and an established image analysis software was used to quantify the upper margin reflex distance (MRD1) as well as brow height using high quality standardized clinical photographs. A total of 19 patients (38 eyelids and brows) met the inclusion criteria...
December 2016: Orbit
Matthew Martin, Christopher T Shah, Payal Attawala, Keith Neaman, Melissa Meldrum, Adam S Hassan
BACKGROUND: As the ptotic brow drops below the supraorbital rim, it can exacerbate dermatochalasis by pushing the adjacent skin of the upper lid further down. AIM: The purpose of this study was to evaluate the outcomes associated with a combined pretrichial brow lift and upper lid blepharoplasty in patients with dermatochalasis and mild to moderate brow ptosis. MATERIALS AND METHODS: A retrospective case series of 46 patients with dermatochalasis and mild to moderate brow ptosis treated with a combined, bilateral pretrichial brow lift and upper lid blepharoplasty from January 2008 to December 2011...
April 2016: Journal of Cutaneous and Aesthetic Surgery
Kurşat Atalay, Ceren Gurez, Ahmet Kirgiz, Kubra Serefoglu Cabuk
PURPOSE: The aim of this study was to investigate the possibility of a relationship between corneal biomechanical properties and different grades of dermatochalasis. PATIENTS AND METHODS: Patients were assigned to four groups according to the severity of their dermatochalasis: normal (Group 1), mild (Group 2), moderate (Group 3), and severe (Group 4). An Ocular Response Analyzer device was used to measure corneal hysteresis (CH), corneal resistance factor (CRF), and corneal-compensated intraocular pressure (IOPcc)...
2016: Clinical Interventions in Aging
Gregory H Branham
The goal of lower eyelid blepharoplasty is to rejuvenate the lower lid while maintaining a natural, unoperated appearance. Successful lower eyelid blepharoplasty depends on knowledge of the anatomy and surgical techniques, accurate preoperative analysis, and attention to detail. Common issues of the lower eyelid such as malar descent, tear trough deformity, pseudoherniated fat, lid laxity, and skin texture changes as well as dermatochalasis and festoons must be recognized. Specific techniques to address these include transcutaneous and transconjunctival approaches, fat excision, fat transposition, orbicularis suspension, lateral canthal tightening, malar suspension, and skin excision/resurfacing...
May 2016: Facial Plastic Surgery Clinics of North America
Michael G Neimkin, Steven M Couch, John B Holds, Zachary M Bodnar, Sara N Reggie
PURPOSE: The goal of this study is to identify and describe the role of surgical incision preference, insurance reimbursement, and geographical location on the current ptosis repair practice patterns of American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) members. METHODS: A 9-question survey was designed with and a participation link was emailed to all active ASOPRS members' email addresses in February 2015. After a reminder email, the survey was closed and the results were analyzed...
March 2017: Ophthalmic Plastic and Reconstructive Surgery
Yoon Kyung Kim, Jung Hee In, Sun Young Jang
PURPOSE: To analyze corneal curvature changes (eg, central corneal power and corneal astigmatism) after upper eyelid surgery, and to compare the effects of different upper eyelid procedures on corneal curvature. METHODS: Fifty eyes of 34 patients with various degrees of dermatochalasis or ptosis underwent corneal topography before surgery, and at 6 weeks after blepharoplasty or levator resection. Patients were divided into groups according to the method of surgery...
May 2016: Journal of Craniofacial Surgery
Francesco Romeo
BACKGROUND: The upper eyelid of young people is characterized by a proper fullness and projection. Aging eyes show upper eyelid volume loss, symmetric or asymmetric hollowing with too much upper lid showing, dermatochalasis with skin excess. While in the past blepharoplasty surgery was the only approach used to improve eye appearance in the last years, hyaluronic acid (HA) filling of the upper eyelid area has been found very effective in reaching good eye rejuvenation and use of traditional surgical techniques can be limited...
April 2016: Aesthetic Plastic Surgery
Midori Hentona Osaki, Tammy Hentona Osaki, Teissy Osaki
PURPOSE: In Asian patients, lateral hooding in the aging upper eyelid is prominent and frequently seen. Removal of the redundant skin of this region during classic blepharoplasty tends to produce a resultant prolonged scar. Furthermore, as the height of the eyelid skin excision increases, suturing of the thick upper skin to the thin pretarsal skin can result in upper lid fullness. This study documents the combination of infrabrow skin excision and upper blepharoplasty to address lateral hooding in select patients of Asian ancestry...
January 2017: Ophthalmic Plastic and Reconstructive Surgery
Stéphane Bruneau, Jean-Marc Foletti, Samuel Muller, Camille Vercasson, Frederic Lauwers, Laurent Guyot
BACKGROUND: It is commonly assumed that a progressive sagging of the eyebrow occurs with the facial aging process. Only a few studies have analyzed this modification, and the findings are disparate and inconclusive. This study, based on reproducible and validated data, aimed to quantify the modifications of eyebrow position that may occur with aging. Also analyzed were the effects of these eyebrow position changes on the upper eyelid and on frontal muscle activity. METHODS: The study included 95 Caucasian adults divided in three groups: 20 to 39, 40 to 59, and 60 to 79 years of age...
February 2016: Plastic and Reconstructive Surgery
Antonio Augusto Velasco E Cruz, Patricia M S Akaishi, Mohammed Al-Dufaileej, Alicia Galindo-Ferreiro
PURPOSE: To describe the use of a lid crease incision for upper eyelid margin rotation in cicatricial entropion combining internal traction on the anterior lamella, tarsotomy, and tarsal overlap without external sutures. METHODS: Surgical description: The main steps of the procedure consisted of exposure of the entire tarsal plate up to the eyelashes followed by tarsotomy through the conjunctiva. A double-armed 6.0 polyglactin suture was then passed through the distal tarsal fragment to the marginal section of the orbicularis oculi muscle...
November 2015: Arquivos Brasileiros de Oftalmologia
Charalambos K Rammos, Samir Mardini
UNLABELLED: The upper third of the face, composed of the forehead and the brow, is a critical aesthetic subunit. Brow ptosis is a common presenting complaint for patients seeking elective improvement of their facial appearance. Browlift surgery has a long history of technique evolution, with various reported methods and refinements. Since the introduction of the endoscopic brow lifting in the 1990s, it has become widely accepted as an approach to forehead rejuvenation. Endoscopy provides minimal incisions in well hidden areas, avoiding long, visible scars...
January 2016: Journal of Craniofacial Surgery
Suhail A Dar, Tal J Rubinstein, Julian D Perry
PURPOSE: To evaluate the effect of upper blepharoplasty on eyebrow height, accounting for ocular dominance, fat excision, change in MRD1, and degree of dermatochalasis. METHODS: Retrospective review of patients undergoing upper blepharoplasty between January 2013 and July 2014. Patients with a prior history of ocular trauma, disease, and surgery were excluded. Digital photographs were analyzed using NIH ImageJ software to measure pre and postoperative eyebrow height at the medial, central, and lateral positions, MRD1, and dermatochalasis...
2015: Orbit
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