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
<strong>Background: </strong>Eyes are one of the most important facial features, their appearance being associated with state of mind, age and beauty. Therefore, upper blepharoplasty is one of the most com...<strong>Background: </strong>Eyes are one of the most important facial features, their appearance being associated with state of mind, age and beauty. Therefore, upper blepharoplasty is one of the most common procedures performed in plastic surgery. Standardized tools allow for measurement of outcomes through patient satisfaction and surgeon experience. <strong>Objectives: </strong>Our objective was to measure the satisfaction index and scar quality of patients who underwent upper blepharoplasty using the Patient-reported Outcome Measure Questionnaire (PROM-Q) and Patient and Observer Scar Assessment Scale (POSAS). <strong>Methods: </strong>A retrospective review of patients that underwent upper blepharoplasty in our institution was performed. We included those with a preoperative anthropometric analysis, standardized incision markings (developed in our center), same operative technique and a 3-month postoperative evaluation with PROM-Q and POSAS. The sample for this study consists of 67 patients, all of them operated between January 1 2019 and June 30 2019 at the Department of Plastic Surgery, South Central High Specialty Hospital, Pemex, Mexico City, Mexico. <strong>Results: </strong>A total of 67 patients were included, 73% female and 27% male. The most frequent indication for surgery was functional visual symptoms. The index of PROM-Q at 3 months demonstrated an increased satisfaction above 90%, and the evaluation with POSAS reported an almost imperceptible scar. <strong>Conclusion:</strong> Evaluating outcomes with objective tools provides data useful to improve the surgical protocols of patients subjecting to aesthetic procedures.展开更多
Background:Upper blepharoplasty is one of the most commonly performed esthetic surgeries,but injection pain during local anesthesia often disturbs patients.The objective of this study was to identify the pain levels a...Background:Upper blepharoplasty is one of the most commonly performed esthetic surgeries,but injection pain during local anesthesia often disturbs patients.The objective of this study was to identify the pain levels associated with anesthetizing the upper eyelids in blepharoplasty and determine whether injection with thin needles is associated with less pain and bleeding than injection with thick needles.Methods:The study included 50 patients who underwent bilateral upper blepharoplasty.The eyelids were anesthetized using 2%lidocaine with 1:100000 epinephrine.One upper eyelid was randomly injected with a thin needle(26G)and the other with a thick needle(22G).The pain level was scored by patients immediately after the injection of each eyelid using a visual analog scale(VAS)ranging from 0 to 10.The incidence of eyelid hematomas caused by the anesthetic injection was also recorded.Results:The VAS scores in eyelids injected with thin needles were not significantly lower than those in eyelids injected with thick needles(4.0 vs.4.0,P=0.393).The formation of eyelid bruises caused by thin-needle injection was less frequent than that caused by thick-needle injection(16%vs.26%),but there was no significant difference between the two groups(P=0.326).Conclusion:Using thin needles for local anesthesia during upper blepharoplasty could not significantly decrease injection pain or hematoma occurrence compared with that associated with using thick needles.展开更多
A blepharoplasty flap has been previously reported as a useful reconstruction approach for anterior lamellar defects lying between the lash line and the eyelid crease.We herein describe a variation of the blepharoplas...A blepharoplasty flap has been previously reported as a useful reconstruction approach for anterior lamellar defects lying between the lash line and the eyelid crease.We herein describe a variation of the blepharoplasty flap and suggest its use as an adjunct in the reconstruction of full-thickness lateral upper eyelid defects.Technique description and retrospective interventional case series.The reconstruction technique was used by an experienced oculoplastics surgeon(ASL)in 3 adults with malignant lesions involving the lateral upper eyelid margin,resulting in a post-excision 50%full-thickness defect between November 2017 and June 2020.The posterior lamella was reconstructed using an ipsilateral free tarsal graft and an inferiorly hinged transposition periosteal flap.The anterior lamella reconstruction was then performed using a local advancement flap utilizing the principles of upper blepharoplasty and Burow’s triangle.Almost full eyelid excursion and full gentle closure were evident at 1–2 weeks follow-up in all three cases.One case later developed 1–2 mm of gentle closure lagophthalmos and was managed successfully with topical lubricants.In all patients,the final eyelid contour and symmetry were adequate,with only minimal scarring,evident already 3 to 4 months postoperative.There were no major complications or need for revisions.The technique described herein highlights the utility of the blepharoplasty flap for lateral,full-thickness upper eyelid defects.This logical variation enables the reconstruction of significant defects using only local tissue,obeying the“like with like”principle,and helps avoid the need for a bridging flap.We provide preliminary evidence of the potential of a good cosmetic outcome of upper lid appearance and contour,together with a fast recovery of appropriate eyelid function.展开更多
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.
文摘<strong>Background: </strong>Eyes are one of the most important facial features, their appearance being associated with state of mind, age and beauty. Therefore, upper blepharoplasty is one of the most common procedures performed in plastic surgery. Standardized tools allow for measurement of outcomes through patient satisfaction and surgeon experience. <strong>Objectives: </strong>Our objective was to measure the satisfaction index and scar quality of patients who underwent upper blepharoplasty using the Patient-reported Outcome Measure Questionnaire (PROM-Q) and Patient and Observer Scar Assessment Scale (POSAS). <strong>Methods: </strong>A retrospective review of patients that underwent upper blepharoplasty in our institution was performed. We included those with a preoperative anthropometric analysis, standardized incision markings (developed in our center), same operative technique and a 3-month postoperative evaluation with PROM-Q and POSAS. The sample for this study consists of 67 patients, all of them operated between January 1 2019 and June 30 2019 at the Department of Plastic Surgery, South Central High Specialty Hospital, Pemex, Mexico City, Mexico. <strong>Results: </strong>A total of 67 patients were included, 73% female and 27% male. The most frequent indication for surgery was functional visual symptoms. The index of PROM-Q at 3 months demonstrated an increased satisfaction above 90%, and the evaluation with POSAS reported an almost imperceptible scar. <strong>Conclusion:</strong> Evaluating outcomes with objective tools provides data useful to improve the surgical protocols of patients subjecting to aesthetic procedures.
基金the National Natural Science Foundation of China(grant no.31870974).
文摘Background:Upper blepharoplasty is one of the most commonly performed esthetic surgeries,but injection pain during local anesthesia often disturbs patients.The objective of this study was to identify the pain levels associated with anesthetizing the upper eyelids in blepharoplasty and determine whether injection with thin needles is associated with less pain and bleeding than injection with thick needles.Methods:The study included 50 patients who underwent bilateral upper blepharoplasty.The eyelids were anesthetized using 2%lidocaine with 1:100000 epinephrine.One upper eyelid was randomly injected with a thin needle(26G)and the other with a thick needle(22G).The pain level was scored by patients immediately after the injection of each eyelid using a visual analog scale(VAS)ranging from 0 to 10.The incidence of eyelid hematomas caused by the anesthetic injection was also recorded.Results:The VAS scores in eyelids injected with thin needles were not significantly lower than those in eyelids injected with thick needles(4.0 vs.4.0,P=0.393).The formation of eyelid bruises caused by thin-needle injection was less frequent than that caused by thick-needle injection(16%vs.26%),but there was no significant difference between the two groups(P=0.326).Conclusion:Using thin needles for local anesthesia during upper blepharoplasty could not significantly decrease injection pain or hematoma occurrence compared with that associated with using thick needles.
文摘A blepharoplasty flap has been previously reported as a useful reconstruction approach for anterior lamellar defects lying between the lash line and the eyelid crease.We herein describe a variation of the blepharoplasty flap and suggest its use as an adjunct in the reconstruction of full-thickness lateral upper eyelid defects.Technique description and retrospective interventional case series.The reconstruction technique was used by an experienced oculoplastics surgeon(ASL)in 3 adults with malignant lesions involving the lateral upper eyelid margin,resulting in a post-excision 50%full-thickness defect between November 2017 and June 2020.The posterior lamella was reconstructed using an ipsilateral free tarsal graft and an inferiorly hinged transposition periosteal flap.The anterior lamella reconstruction was then performed using a local advancement flap utilizing the principles of upper blepharoplasty and Burow’s triangle.Almost full eyelid excursion and full gentle closure were evident at 1–2 weeks follow-up in all three cases.One case later developed 1–2 mm of gentle closure lagophthalmos and was managed successfully with topical lubricants.In all patients,the final eyelid contour and symmetry were adequate,with only minimal scarring,evident already 3 to 4 months postoperative.There were no major complications or need for revisions.The technique described herein highlights the utility of the blepharoplasty flap for lateral,full-thickness upper eyelid defects.This logical variation enables the reconstruction of significant defects using only local tissue,obeying the“like with like”principle,and helps avoid the need for a bridging flap.We provide preliminary evidence of the potential of a good cosmetic outcome of upper lid appearance and contour,together with a fast recovery of appropriate eyelid function.
