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Ophthalmic Plast Reconstr Surg 2021 Jun 4. Epub 2021 Jun 4.

Department of Ophthalmology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel Department of Ophthalmology, Dongguk University Ilsan Hospital, Goyang, Gyeonggido, Korea Division of Oculofacial Plastic and Reconstructive Surgery, Viterbi Family Department of Ophthalmology, UC San Diego Shiley Eye Institute, La Jolla, California, U.S.A. Division of Plastic Surgery, UC San Diego, La Jolla, California, U.S.A.

Purpose: To compare outcomes of Mueller's Muscle Conjunctival Resection (MMCR) between 2 groups of patients with different anatomy due to ethnic heritage.

Methods: The medical records of patients who underwent MMCR between 2013 and 2018 were retrospectively reviewed. Patients who underwent additional procedures, such as upper blepharoplasty and browplasty, were excluded from the study. Read More

Ophthalmic Plast Reconstr Surg 2021 May-Jun 01;37(3S):S113-S114

Graefes Arch Clin Exp Ophthalmol 2021 May 8. Epub 2021 May 8.

Department of Ophthalmology, Yeditepe University Medical School, Istanbul, Turkey.

Purpose: To evaluate the postoperative changes with a computer vision algorithm for anterior full-face photographs of patients who have undergone upper eyelid blepharoplasty surgery with, or without, a Müller's muscle-conjunctival resection (MMCR).

Methods: All patients who underwent upper eyelid blepharoplasty surgery (Group I), or upper eyelid blepharoplasty with MMCR (Group II) were included. Both preoperative and 6-month postoperative anterior full-face photographs of 55 patients were analyzed. Read More

J Med Case Rep 2021 Apr 29;15(1):248. Epub 2021 Apr 29.

Ophthalmology Unit, Humanitas Research Hospital, Rozzano, Milan, Italy.

Background: Dermatochalasis of the upper eyelids (blepharochalasis) is a typical age-related change in the upper third of the face and a major concern for facial aesthetics. Nowadays both surgical and nonsurgical interventions are available for patients complaining of upper eyelid dermatochalasis. Although nonsurgical treatments are often easier to perform, if they are not performed correctly, complications may ensue and worsen the condition. Read More

Facial Plast Surg Clin North Am 2021 May 24;29(2):179-193. Epub 2021 Apr 24.

W Aesthetic Plastic Surgery, 06 - 28/29, Mount Elizabeth Novena Specialist Center, 38 Irrawaddy Road, Singapore 329563, Singapore.

Given the central importance of the "eyes," meaning the periorbital region, to facial appearance, the motivated blepharoplasty patient has the opportunity to improve appearance significantly beyond the minimum of age reversal, to reveal inner beauty or add attractiveness. Bright and beautiful eyes have good three-dimensional contouring. The benefits of a quality eyelid crease enable the surgical focus to be on lid contouring with a reduced requirement for lid skin and fat excision. Read More

Ann Palliat Med 2021 Mar;10(3):3185-3193

Ophthalmology Operating Room, Second Affiliated Hospital Zhejiang University College of Medicine, Hangzhou, China.

Background: Perioperative negative emotion of surgical patients has a greater impact on surgical efficacy and prognosis. The study aimed to analyze the effect of psychological intervention on perioperative anxiety and depression of patients with severe blepharoptosis undergoing autologous fascia lata frontal muscle suspension, and provide a reference for improving and optimizing patient care plans.

Methods: Ninety-two patients with severe blepharoptosis who underwent autologous fascia lata frontal muscle suspension in our hospital from February 2018 to January 2020 were selected as the research subjects. Read More

J Craniofac Surg 2021 Mar 24. Epub 2021 Mar 24.

Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Abstract: Double-eyelid blepharoplasty, the procedure to create supratarsal crease, has been one of the most popular cosmetic operations in Asia for many years. This study aimed to assess the effectiveness and safety of a surgical procedure using a composite tissue flap for double-eyelid blepharoplasty. A surgical technique was introduced and patients having blepharoplasty with this technique from January 2017 to August 2019 were retrospectively studied. Read More

Aesthetic Plast Surg 2021 Mar 15. Epub 2021 Mar 15.

16th department, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, #33 Badachu Road, Shijingshan District, 100144, Beijing, China.

Background: The awareness and treatment of lacrimal gland prolapse (LGP) have been primarily improved with a further understanding of lateral eyelid bulging over the decades. However, for Asian single-eyelid females with LGP, a tailor-made procedure applicable to their comparatively young puffy eyes is needed.

Methods: This is a retrospective study. Read More

Curr Eye Res 2021 Jul 12;46(7):949-953. Epub 2021 Mar 12.

Sheba Medical Center, Goldschleger Eye Institute, Ramat Gan, Israel.

: To examine whether Müller's-muscle-conjunctival-resection (MMCR) changes the position of the lower eyelid.: Retrospective controlled-cohort study. All patients who underwent MMCR (study group) or blepharoplasty (control group) between January 2016 and September 2018 were recruited. Read More

Ophthalmic Plast Reconstr Surg 2021 Mar-Apr 01;37(2):190

Ophthalmic Plast Reconstr Surg 2021 Mar-Apr 01;37(2):190

Facial Plast Surg 2021 Apr 3;37(2):149-159. Epub 2021 Mar 3.

PLLC-Otolaryngology Division, Rochester, New York.

Facial aging in the midface has been described to encompass both soft tissue descent and volumetric change. Currently, there is no established and widely accepted grading system for midfacial ptosis. We propose a simplified grading system for midfacial ptosis ranging from mild to severe in terms of Grades I through III. Read More

Ann Plast Surg 2021 03;86(3S Suppl 2):S253-S258

From the Department of Plastic and Reconstructive Surgery, Beijing University 3rd Hospital, Beijing, China.

Objective: The aim of this study was to explore the effective technique of double eyelid surgery for mild, moderate, and severe sunken upper eyelid in Chinese.

Methods: According to the degree of the sunken upper eyelid, different procedures were performed. For mild sunken upper eyelid, the key technique was named eyelid volume redistribution (EVR)-1 technique, which was advancing or folding the pretarsal orbicularis oculi muscle flap toward up to the upper margin of the incision. Read More

Aesthet Surg J 2021 04;41(5):NP210-NP213

Department of Plastic Surgery, NYU Grossman School of Medicine, New York, NY, USA.

BMC Ophthalmol 2021 Feb 12;21(1):83. Epub 2021 Feb 12.

Department of Ophthalmology, National Taiwan University Hospital, 12F, No.7, Chung Shan S. Rd., Zhongzheng Dist., Taipei, Taiwan.

Background: To investigate the efficacy and predictability of Muller's muscle-conjunctival resection (MMCR) with different lengths of tarsectomy for the treatment of unilateral mild-to-moderate blepharoptosis.

Methods: A retrospective study of patients who underwent MMCR with tarsectomy for unilateral mild-to-moderate blepharoptosis between January 2016 and December 2019 was performed. Individuals with adequate photographic documentation and good levator function were included. Read More

Medicine (Baltimore) 2021 Jan;100(4):e23753

Department of Ophthalmology, San'eikai Tsukazaki Hospital, Himeji.

Abstract: To evaluate the utility of low-concentration nitrous oxide (N2O) anesthesia in ptosis surgeryThis study was a retrospective consecutive case series that included 54 successive patients with blepharoptosis who underwent bilateral levator aponeurosis advancement and on whom skin resection performed by the same surgeon between August 2016 and July 2017. Among these patients, 27 were operated with a local anesthesia injection (air group) and 27 with a local anesthesia injection and low-concentration N2O anesthesia (N2O group). All N2O cases used a total of 6 L of gas comprising 70% oxygen and 30% N2O. Read More

Klin Monbl Augenheilkd 2021 Jan 14;238(1):33-40. Epub 2021 Jan 14.

Augenklinik, Klinikum der Universität München, Deutschland.

Patients with Graves' orbitopathy often develop eyelid changes. These may be the result of a volume effect or a malposition. Both dermatochalasis with fat tissue increase and eyelid retraction may lead to functional or aesthetic impairment. Read More

Aesthetic Plast Surg 2021 06 5;45(3):1047-1055. Epub 2021 Jan 5.

Department of Plastic Surgery, Mylike Medical Cosmetic Hospital, 789 West Yan'an Road, Shanghai, 200050, China.

Background: Upper eyelid aging results from comprehensive changes, and studies have failed to comprehensively address these changes.

Objectives: This study proposes a comprehensive approach to the surgical treatment of aging upper eyelids.

Methods: Data of 116 patients with aging upper eyelids were analyzed. Read More

Aesthet Surg J 2021 05;41(6):NP260-NP266

Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

Background: Severe blepharoptosis with poor levator function (LF) has traditionally been managed with exogenous frontalis suspension but complications such as lagophthalmos, infection, and rejection are often reported.

Objectives: The aim of this study was to design a function-preserving frontalis orbicularis oculi muscle (FOOM) flap to correct severe blepharoptosis with poor LF. The long-term surgical outcome of the technique was assessed. Read More

J Plast Reconstr Aesthet Surg 2021 Jun 14;74(6):1309-1315. Epub 2020 Nov 14.

Department of Plastic and Reconstructive Surgery, Inje University, Ilsan Paik hospital, Korea.

Background: Conventional aponeurotic surgery for blepharoptosis has many advantages, but there is a potential for recurrence and lagophthalmos. The anatomy of the levator palpebrae muscle is relatively well studied, but the relationship of levator aponeurosis with surrounding layers is still controversial. This study aims to prove the presence of an anterior layer of the levator aponeurosis in clinical cases and to describe a technique involving its use for obtaining predictable outcomes in blepharoptosis correction. Read More

J Plast Reconstr Aesthet Surg 2021 06 13;74(6):1355-1401. Epub 2020 Dec 13.

Plastic and Reconstructive Surgery, I.R.C.C.S. Policlinico San Donato, Piazza Edmondo Malan 20097, San Donato Milanese, Italy; Department of Plastic Surgery, Faculty of Medicine, University of Milan, Via Festa del Perdono 20122, Milan, Italy.

Aesthet Surg J 2021 04;41(5):NP198-NP209

Division of Plastic & Reconstructive Surgery, Northwestern Feinberg School of Medicine, Chicago, IL, USA.

Background: Patients presenting for upper blepharoplasty can exhibit different aging patterns and we have anecdotally observed wide variability in upper blepharoplasty approaches among surgeons. However, upper blepharoplasty practice patterns have not been systematically analyzed among members of The Aesthetic Society.

Objectives: The aim of this study was to report upper blepharoplasty practice patterns, the recognition of different patient presenting features, and to assess the incidence and management of ptosis as reported by members of The Aesthetic Society. Read More

Laryngoscope 2021 07 10;131(7):1492-1496. Epub 2020 Dec 10.

Department of Otolaryngology - Head and Neck Surgery, Division of Facial Plastic and Reconstructive Surgery, University of North Carolina, Chapel Hill, North Carolina, U.S.A.

Int Ophthalmol 2021 Apr 4;41(4):1151-1156. Epub 2020 Dec 4.

Department of Oculoplastic, Orbital and Lacrimal Surgery, Aichi Medical University Hospital, Nagakute, Aichi, Japan.

Purpose: This study aims to evaluate the usefulness of creating images of expected appearance after blepharoptosis surgery using mirror image processing software.

Methods: This prospective, observational study included 60 sides from 30 patients with bilateral aponeurotic blepharoptosis who underwent levator resection or aponeurotic repair on both sides. Before surgery, facial photographs were taken after the eyelid on one side was lifted with a curved hook. Read More

Plast Reconstr Surg 2020 12;146(6):1268-1273

From W Aesthetic Plastic Surgery; the Department of Plastic Reconstructive and Aesthetic Surgery, Singapore General Hospital; and The Centre for Facial Plastic Surgery.

Upper eyelid ptosis correction is a complex procedure. The ethnic differences in the Asian upper eyelid anatomy are compounded by the technical challenges of primary and revision ptosis correction. The authors present a technique of upper eyelid ptosis correction that estimates the exact location of suture fixation that uses the musculoaponeurotic junction of the levator as the reference point. Read More

Plast Reconstr Surg 2020 12;146(6):1239-1247

From the Division of Plastic and Reconstructive Surgery, Northwestern Feinberg School of Medicine; and private practice.

Background: Conventional upper blepharoplasty relies on skin, muscle, and fat excision to restore ideal pretarsal space-to-upper lid fold ratios. The purpose of this study was to identify presenting topographic features of upper blepharoplasty patients and their effect on cosmetic outcomes.

Methods: This is a retrospective review of patients who underwent upper blepharoplasty at the authors' institution from 1997 to 2017. Read More

Plast Reconstr Surg 2020 11;146(5):565e-568e

From the Division of Plastic and Reconstructive Surgery, Northwestern University Feinberg School of Medicine.

Background: Achieving excellent results in upper lid rejuvenation requires a balanced approach to address skin, muscle, fat, upper lid margin position, and brow aging changes. In the appropriately selected patient, brow lifting plays an essential complement to upper blepharoplasty to restore more youthful upper lid fold-to-pretarsal ratios. The goal of this study is to describe a safe and reproducible method to perform brow lifting and upper blepharoplasty. Read More

J Craniofac Surg 2020 Nov/Dec;31(8):e802-e805

Department of Ophthalmology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine.

Objective: The surgical treatment of myogenic ptosis accompanying extraocular muscle paralysis is an intractable problem in the field of oculoplastic surgery due to the severe complications such as exposure keratopathy. It is promising to find an appropriate procedure to treat this kind of patients, which is able to ensure the safety and efficacy.

Methods: The authors retrospectively reviewed 12 eyes of 6 patients who underwent the under-corrected "double V-Loop" frontalis suspension sling procedure for myogenic ptosis accompanying extraocular muscle paralysis and access the safety and efficacy of this kind of surgery. Read More

FP Essent 2020 Oct;497:18-22

Washington Hospital Healthcare System, 2000 Mowry Ave, Fremont, CA 94538.

Facial plastic surgery deals with improving the form, function, and appearance of the face. Blepharoplasty (ie, eyelid surgery) is the most commonly performed surgical procedure in men and women 65 years and older. It has been shown to be effective for improving attractiveness and eyelid function (eg, improved visual field). Read More

Indian J Ophthalmol 2020 Oct;68(10):2075-2083

Research Associate, Jules Stein Eye Institute, UCLA, Los Angeles, California, USA.

Of the two common techniques of lower blepharoplasty, the transconjunctival approach is limited to young patients with prominent herniation of lower fat pad without skin excess and the transcutaneous approach to patients requiring skin excision. However, the current trends not only highlight the traditional sculpting of the three orbital fat pads in lower lid blepharoplasty but also additional relocation of the intraorbital fats for correcting the inferior orbital hollowing. The purpose of this review is to analyze the published literature on common types, techniques, indications, and outcomes of the multiple surgical variants of lower lid blepharoplasty often aimed at treating the redundant skin, steatoblepharon, tear trough deformity, lid laxity, and dermatochalasis, thereby to correct the negative vector and inferior orbital hollowing along with effacement of the lid cheek junction. Read More