Fat management in upper blepharoplasty:Addition or subtraction blepharoplasties,how and when

BACKGROUND As one of the most common aesthetic surgical procedures carried out today,blepharoplasty should be in the repertoire of every plastic surgeon.The term blepharoplasty encompasses a wide range of techniques and options that must be tailored to the specific defect and patient one has to treat.A sound knowledge of the upper and lower eyelids’anatomy is essential for proper surgical execution.Trends have shifted towards more conservative methods(especially of the fat compartment)and sometimes in combination with augmentation techniques,helping to reach a rejuvenated appearance.AIM To present an overview of the surgical techniques considered for upper lid blepharoplasty and fat pad management,in addition to information on how a surgeon may approach the best treatment for his patient based on current publications in literature.METHODS We searched the literature published between 2013,to 2023 using Medline and Reference Citation Analysis.The database was searched using the keywords“upper blepharoplasty”AND“fat”.Papers without full text/abstracts and reviews were excluded.The search strategy followed the PRISMA.The American Society of Plastic Surgeons guidelines for Therapeutic Studies checklist was used to assess all articles.Two authors individually reviewed each article and rated them for importance and relevance to the topic.A consensus was sought and the most relevant studies.RESULTS After the application of the selection criteria used in our review,13 publications were found to address upper lid blepharoplasty specifically.Three of these studies were reviews and three were retrospective studies.Five publications were comparative studies and a further two were clinical trials.CONCLUSION The tendency of modern surgery is to be conservative,by removing adipose tissue only if strictly necessary and restoring the volume of the upper eyelid in a concept of beauty that espouses a"full"sight.There is no gold standard technique to achieve younger and enhanced eyelids.Long-term prospective comparative studies are fundamental in understanding which path is the best to follow.

Gender Differences in Aesthetic Rhinoplasty Patients: A Study on Psychopathological Symptoms

The aim of the current study was to investigate the gender differences in aesthetic rhinoplasty candidates in dimensions of psychopathology. Considering the existing body of literature, it was hypothesized that women would score higher in different dimensions of psychopathology. SCL-90-R was used to evaluate the differences. This instrument consists of 10 subscales which measure depression, anxiety, phobia, hostility, obsessive-compulsive symptoms, interpersonal sensitivity, somatization, paranoid ideation, psychoticism, and added items of psychopathology. Independent t-test between male patients (n = 19) and female patients (n = 32) was performed. Findings indicated that women had higher scores in four subscales. Women had higher scores in anxiety (P < 0.01), obsessive-compulsive symptoms (P < 0.05), depression (P < 0.05), and added items (P < 0.05). Effect size measures were calculated in order for better interpretation of statistical significance tests. Findings supported the notion that women who applied for aesthetic rhinoplasty showed higher scores of anxiety, depression, obsessive-compulsive symptoms, and general psychopathological symptoms. Surgeons can utilize validated psychometric instruments in order to screen psychologically disturbed patients as these patients are more likely to show dissatisfaction after the surgery.

Successful treatment of eyebrow intradermal nevi by shearing combined with electrocautery and curettage:Two case reports

BACKGROUND An intradermal nevus is a common skin tumour,and the classical method of removal has a risk of recurrence and scarring.It is a challenge for dermatologists to treat eyebrow intradermal nevi quickly and efficiently.This study focused on investigating the efficacy and safety of shearing combined with electrocautery and curettage in the treatment of eyebrow intradermal nevi.CASE SUMMARY We describe two adult patients with eyebrow intradermal nevi treated by shearing combined with electrocautery and curettage.Both patients were followed up regularly after surgery.At follow-up,no recurrence of eyebrow intradermal nevus and no obvious scars or hypopigmentation were found in either patient.The results indicated that shearing combined with electrocautery and curettage could remove eyebrow intradermal nevus without side effects and confirmed the efficacy and safety of this modality for treating these skin lesions.CONCLUSION Shearing combined with electrocautery and curettage has superior merits,including simple operation,good cosmetic effects,and high patient satisfaction,presenting great application potential for treating intracutaneous nevus.

The Preauricular Sinus:A Novel Approach for Complete Bilateral Excision via a Modified Face-Lift Incision

Objectives/Hypothesis: To present a novel technique based on the combination of aesthetic and reconstructive techniques for the radical and safe excision of preauricular sinus along with minimal cosmetic impairing. Study Design: Case report, description of surgical method and brief overview of the literature. Methods: In a patient with bilateral preauricular sinus, we used a modified face-lift incision and SMAS-fixation instead of solely excising the sinus with skin ellipse. Results: Total removal of the bilateral fistulous systems could be achieved, along with a very aesthetically pleasing result. Conclusions: The surgical approach shown here allows a radical excision with only minimal aesthetic impairment using a shortened facelift-incision and SMAS-fixation.