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 a...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.展开更多
This editorial commentary critically examines the systematic review by Miotti et al,which discusses the evolving trends in upper lid blepharoplasty towards a conservative,volume-preserving approach.The review emphasiz...This editorial commentary critically examines the systematic review by Miotti et al,which discusses the evolving trends in upper lid blepharoplasty towards a conservative,volume-preserving approach.The review emphasizes the shift from traditional tissue resection to techniques that maintain anatomical integrity,paralleling broader trends in panfacial rejuvenation.Miotti et al delve into the nuances of fat pad management,advocating for conservation over reduction to sustain natural contours and improve long-term aesthetic outcomes.This perspective is supported by comparative studies and empirical data,such as those from Massry and Alghoul et al,highlighting the benefits of conservative approaches in terms of patient satisfaction and aesthetic longevity.The review also stresses the importance of surgeon discretion in adapting procedures to diverse patient demographics,particularly in addressing distinct features such as the Asian upper eyelid.However,it identifies a significant gap in long-term comparative research,underscoring the need for future studies to substantiate the safety and efficacy of these minimalist techniques.Overall,Miotti et al.'s work contributes profoundly to the discourse on personalized,conservative cosmetic surgery,urging ongoing research to refine and validate surgical best practices in upper eyelid blepharoplasty.展开更多
AIM： This study aimed to expound the individual idea of micro-invasive surgery from pre-operative preparation, intra-operative processing and post-operative management. METHODS： Pre-operative preparation was improve...AIM： This study aimed to expound the individual idea of micro-invasive surgery from pre-operative preparation, intra-operative processing and post-operative management. METHODS： Pre-operative preparation was improved by analyzing pathological factors and hematoma property, and considering patients＇ age, basic disease, blood pressure control, with persistent haemorrhagia/rehaemorrhagia or not, operative occasion choice, positioning and other procedures. In the surgery, positioner was used. Initial aspiration volume was cautiously controlled. After operation, vital signs of patients were kept stable by cautiously using hematoma liquefacient and combining with free radical scavenger. RESULTS： The core content of individual micro-invasive surgery was mainly to relieve intracranial pressure. Under the condition of sufficient pre-operative preparation known by patients＇ family members, precise positioning was determined and individual therapeutic regimen was made. Meanwhile, caution should be taken in hematoma aspiration. Liquefaction and drainage should be paid more attention, and complications were processed actively. CONCLUSION： During the process of micro-invasive evacuation of intracranial hematoma for treating cerebral hemorrhage, attention should be paid to analyzing cerebral hematoma etiology and pathophysiological mechanism, and individual idea should be considered in surgical treatment aiming at patients＇ concrete disease condition.展开更多
The demand for procedures aiming to rejuvenate the upper third part of the face and the periocular region has increased in the past several years.Blepharoplasty is one of the most frequently performed procedures world...The demand for procedures aiming to rejuvenate the upper third part of the face and the periocular region has increased in the past several years.Blepharoplasty is one of the most frequently performed procedures worldwide to date.Surgery is currently the first choice in order to achieve permanent and effective results;however,it is burdened by potential surgical complications feared by patients.There is an increasing trend in individuals to request less invasive,non-surgical,effective,and safe procedures for eyelid treatment.The aim of this minireview is to present a brief overview of non-surgical blepharoplasty techniques that have been reported in the literature in the past 10 years.Numerous modern techniques that provide a rejuvenation of the entire area have been described.Numerous less invasive methods have been proposed in the current literature and in modern-day routine clinical settings.Dermal fillers are a commonly chosen option for providing enhanced aesthetic results,especially considering that volume loss can be one of the main underlying causes of facial and periorbital aging.Deoxycholic acid use may be considered when the problem is represented by periorbital excess fat deposits.The simultaneous excess and loss of elasticity of the skin can be assessed with techniques such as lasers and plasma exeresis.Furthermore,techniques such as platelet-rich plasma injections and the insertion of twisted polydioxanone threads are emerging as viable methods to rejuvenate the periorbital region.展开更多
Objective The cardiac synchronization therapy (CRT) was proven to have good treatment for the cardiacconduction disorders patients with serious heart failure. But many disadvantages were gradually be noticed,such as d...Objective The cardiac synchronization therapy (CRT) was proven to have good treatment for the cardiacconduction disorders patients with serious heart failure. But many disadvantages were gradually be noticed,such as difficulty of sinus electrode implantation,coronary sinus injury and bleeding,still one third展开更多
Background: Asian Blepharoplasty (AB) is one of the most commonly performed aesthetic procedures today. Despite the increasing demand for AB and advancements in surgical techniques, creating an optimal upper eyelid cr...Background: Asian Blepharoplasty (AB) is one of the most commonly performed aesthetic procedures today. Despite the increasing demand for AB and advancements in surgical techniques, creating an optimal upper eyelid crease remains difficult. This study aimed to determine whether removing the preaponeurotic fat pad (PAF) had any effect on the revision surgery rates following primary Asian blepharoplasty. Methods: A retrospective comparative analysis was conducted on patients who underwent primary AB between January 2016 and December 2020. Patients were divided into PAF removed and PAF not removed groups. The outcomes in the groups were compared by the frequency of revision surgery following primary AB using the chi-square test (p Results: The study included 480 patients, 442 (92%) female and 38 (8%) male, and the final outcome was evaluated after 6 months postoperatively. 412 (86%) patients were observed to have PAF pads intraoperatively, while 68 (14%) had minimal/no PAF pads. In total, 115 (24%) patients underwent revision surgery, of whom 31 (27%) had PAF removed, 66 (57%) had PAF not removed, and 18 (16%) had minimal/no PAF noted. When compared to the PAF not removed group, the PAF removed group showed a significantly lower frequency of revision surgery between the two groups of patients (p = 0.0001). Conclusion: In the final outcome, not removing the PAF in primary AB indicated a strong association with an increase in revision surgery. The removal of PAF in primary AB showed a better overall outcome and patient satisfaction.展开更多
目的:观察眉下缘切口提升术联合重睑成形治疗中重度上睑皮肤松弛的美学效果。方法:回顾性分析2020年10月-2022年10月在笔者医院治疗的62例上睑皮肤松弛患者临床资料,根据治疗方法不同分为联合治疗组(n=32)和眉下切口组(n=30),联合治疗...目的:观察眉下缘切口提升术联合重睑成形治疗中重度上睑皮肤松弛的美学效果。方法:回顾性分析2020年10月-2022年10月在笔者医院治疗的62例上睑皮肤松弛患者临床资料,根据治疗方法不同分为联合治疗组(n=32)和眉下切口组(n=30),联合治疗组行眉下缘切口提升术联合重睑术,眉下切口组行眉下缘切口提升术,术后对患者进行随访,比较两组术后矫治效果,上睑缘至眉距离(The distance between the upper eyelid margin and the eyebrow,DEE)、睑裂宽度(The height of the palpebral fissure,HPF)、瞳孔中点睑缘与重睑距离(Middle pupil margin-fold distance,MPMFD)、角膜内侧睑缘与重睑距离(Medial corneal margin-fold distance,MCMFD)以及外眦处睑缘与重睑距离(Lateral canthus margin-fold distance,LCMFD)、上睑皱纹改善效果(Lemperle评分)、术后外观满意度、术后并发症发生率。结果:治疗后,联合治疗组DEE、HPF、MPMFD、MCMFD、LCMFD均高于对照组(P<0.05);治疗后,两组患者Lemperle评分均有所降低,但联合治疗组低于眉下切口组(P<0.05);治疗后,联合治疗组术后外观满意度96.88%高于眉下切口组76.67%(P<0.05);治疗后,联合治疗组与眉下切口组并发症发生率比较,差异无统计学意义(P>0.05)。结论:眉下缘切口提升术联合重睑成形治疗中重度上睑皮肤松弛,能够有效改善上睑松弛情况,减少上睑皱纹,且患者外观满意度较高。展开更多
文摘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.
文摘This editorial commentary critically examines the systematic review by Miotti et al,which discusses the evolving trends in upper lid blepharoplasty towards a conservative,volume-preserving approach.The review emphasizes the shift from traditional tissue resection to techniques that maintain anatomical integrity,paralleling broader trends in panfacial rejuvenation.Miotti et al delve into the nuances of fat pad management,advocating for conservation over reduction to sustain natural contours and improve long-term aesthetic outcomes.This perspective is supported by comparative studies and empirical data,such as those from Massry and Alghoul et al,highlighting the benefits of conservative approaches in terms of patient satisfaction and aesthetic longevity.The review also stresses the importance of surgeon discretion in adapting procedures to diverse patient demographics,particularly in addressing distinct features such as the Asian upper eyelid.However,it identifies a significant gap in long-term comparative research,underscoring the need for future studies to substantiate the safety and efficacy of these minimalist techniques.Overall,Miotti et al.'s work contributes profoundly to the discourse on personalized,conservative cosmetic surgery,urging ongoing research to refine and validate surgical best practices in upper eyelid blepharoplasty.
基金the National Natural Science Foundation of China, No. 3057062830770751
文摘AIM： This study aimed to expound the individual idea of micro-invasive surgery from pre-operative preparation, intra-operative processing and post-operative management. METHODS： Pre-operative preparation was improved by analyzing pathological factors and hematoma property, and considering patients＇ age, basic disease, blood pressure control, with persistent haemorrhagia/rehaemorrhagia or not, operative occasion choice, positioning and other procedures. In the surgery, positioner was used. Initial aspiration volume was cautiously controlled. After operation, vital signs of patients were kept stable by cautiously using hematoma liquefacient and combining with free radical scavenger. RESULTS： The core content of individual micro-invasive surgery was mainly to relieve intracranial pressure. Under the condition of sufficient pre-operative preparation known by patients＇ family members, precise positioning was determined and individual therapeutic regimen was made. Meanwhile, caution should be taken in hematoma aspiration. Liquefaction and drainage should be paid more attention, and complications were processed actively. CONCLUSION： During the process of micro-invasive evacuation of intracranial hematoma for treating cerebral hemorrhage, attention should be paid to analyzing cerebral hematoma etiology and pathophysiological mechanism, and individual idea should be considered in surgical treatment aiming at patients＇ concrete disease condition.
文摘The demand for procedures aiming to rejuvenate the upper third part of the face and the periocular region has increased in the past several years.Blepharoplasty is one of the most frequently performed procedures worldwide to date.Surgery is currently the first choice in order to achieve permanent and effective results;however,it is burdened by potential surgical complications feared by patients.There is an increasing trend in individuals to request less invasive,non-surgical,effective,and safe procedures for eyelid treatment.The aim of this minireview is to present a brief overview of non-surgical blepharoplasty techniques that have been reported in the literature in the past 10 years.Numerous modern techniques that provide a rejuvenation of the entire area have been described.Numerous less invasive methods have been proposed in the current literature and in modern-day routine clinical settings.Dermal fillers are a commonly chosen option for providing enhanced aesthetic results,especially considering that volume loss can be one of the main underlying causes of facial and periorbital aging.Deoxycholic acid use may be considered when the problem is represented by periorbital excess fat deposits.The simultaneous excess and loss of elasticity of the skin can be assessed with techniques such as lasers and plasma exeresis.Furthermore,techniques such as platelet-rich plasma injections and the insertion of twisted polydioxanone threads are emerging as viable methods to rejuvenate the periorbital region.
文摘Objective The cardiac synchronization therapy (CRT) was proven to have good treatment for the cardiacconduction disorders patients with serious heart failure. But many disadvantages were gradually be noticed,such as difficulty of sinus electrode implantation,coronary sinus injury and bleeding,still one third
文摘Background: Asian Blepharoplasty (AB) is one of the most commonly performed aesthetic procedures today. Despite the increasing demand for AB and advancements in surgical techniques, creating an optimal upper eyelid crease remains difficult. This study aimed to determine whether removing the preaponeurotic fat pad (PAF) had any effect on the revision surgery rates following primary Asian blepharoplasty. Methods: A retrospective comparative analysis was conducted on patients who underwent primary AB between January 2016 and December 2020. Patients were divided into PAF removed and PAF not removed groups. The outcomes in the groups were compared by the frequency of revision surgery following primary AB using the chi-square test (p Results: The study included 480 patients, 442 (92%) female and 38 (8%) male, and the final outcome was evaluated after 6 months postoperatively. 412 (86%) patients were observed to have PAF pads intraoperatively, while 68 (14%) had minimal/no PAF pads. In total, 115 (24%) patients underwent revision surgery, of whom 31 (27%) had PAF removed, 66 (57%) had PAF not removed, and 18 (16%) had minimal/no PAF noted. When compared to the PAF not removed group, the PAF removed group showed a significantly lower frequency of revision surgery between the two groups of patients (p = 0.0001). Conclusion: In the final outcome, not removing the PAF in primary AB indicated a strong association with an increase in revision surgery. The removal of PAF in primary AB showed a better overall outcome and patient satisfaction.
文摘目的:观察眉下缘切口提升术联合重睑成形治疗中重度上睑皮肤松弛的美学效果。方法:回顾性分析2020年10月-2022年10月在笔者医院治疗的62例上睑皮肤松弛患者临床资料,根据治疗方法不同分为联合治疗组(n=32)和眉下切口组(n=30),联合治疗组行眉下缘切口提升术联合重睑术,眉下切口组行眉下缘切口提升术,术后对患者进行随访,比较两组术后矫治效果,上睑缘至眉距离(The distance between the upper eyelid margin and the eyebrow,DEE)、睑裂宽度(The height of the palpebral fissure,HPF)、瞳孔中点睑缘与重睑距离(Middle pupil margin-fold distance,MPMFD)、角膜内侧睑缘与重睑距离(Medial corneal margin-fold distance,MCMFD)以及外眦处睑缘与重睑距离(Lateral canthus margin-fold distance,LCMFD)、上睑皱纹改善效果(Lemperle评分)、术后外观满意度、术后并发症发生率。结果:治疗后,联合治疗组DEE、HPF、MPMFD、MCMFD、LCMFD均高于对照组(P<0.05);治疗后,两组患者Lemperle评分均有所降低,但联合治疗组低于眉下切口组(P<0.05);治疗后,联合治疗组术后外观满意度96.88%高于眉下切口组76.67%(P<0.05);治疗后,联合治疗组与眉下切口组并发症发生率比较,差异无统计学意义(P>0.05)。结论:眉下缘切口提升术联合重睑成形治疗中重度上睑皮肤松弛,能够有效改善上睑松弛情况,减少上睑皱纹,且患者外观满意度较高。
