Raising the suborbicularis oculi fat (SOOF): its role in chronic facial palsy.
AIMS: To determine the adjuvant role of unilateral suborbicularis oculi fat (SOOF) lift in the periorbital rehabilitation of patients with chronic facial palsy. METHODS: In a non-comparative prospective case series nine adult patients (seven male, two female) aged 34-90 years (mean 60.5) with chronic unrecovered facial palsy (over 1 year), who had not had any previous rehabilitative periorbital surgery, were studied. Lateral tarsal strip and adjuvant transconjunctival approach subperiosteal SOOF lift under local or general anaesthesia were performed; medial canthoplasty was performed where indicated. There was clinical observation of the long term (over 1 year) effect on the ptotic palpebral-malar sulcus and lower eyelid retraction. RESULTS: The patients were followed up for 12-24 months (mean 16). Seven patients (77%) had sustained clinical reduction of palpebral-malar sulcus ptosis. All patients had sustained reduction of lagophthalmos. Early postoperative complications included conjunctival cheimosis in 77%. Three patients with persistent keratitis required further surgical procedures on their upper eyelid to reduce the palpebral aperture. There were no cases of infraorbital nerve anaesthesia or recurrent lower eyelid retraction. CONCLUSIONS: The SOOF lift has an adjuvant role in chronic facial palsy with lower eyelid retraction and ptotic-palpebral malar sulcus. It supports the lower eyelid elevation and tightening achieved with the lateral tarsal strip. The best results were obtained in congenital facial palsy. (+info)
Psychosocial implications of blepharoptosis and dermatochalasis.
PURPOSE: To investigate, for the first time, the psychosocial implications of blepharoptosis and dermatochalasis. METHODS: Two hundred ten individuals rated whole-face photographs of a series of patients on the basis of 11 different personal characteristics: intelligence, throat, friendliness, health, trustworthiness, hard work, mental illness, financial success, attractiveness, alcoholism, and happiness. Preoperative and postoperative photographs of both male and female patients with bilateral blepharoptosis and/or dermatochalasis were used. The paired t test was used to compare preoperative and postoperative ratings on the 11 characteristics. RESULTS: The preoperative photographs were rated more negatively than the postoperative photographs (P < .01-P < .001) on all 11 characteristics for both male and female patients by the 210 study subjects. CONCLUSIONS: Members of society seem to view individuals with blepharoptosis and dermatochalasis negatively. These psychosocial attitudes may lead to unjust bias toward affected patients, and surgical correction likely provides benefits beyond improved visual function. (+info)
Endoscopic aesthetic facial surgery: technique and results.
The endoscopic approach to forehead and midface lifting has become popular method of face rejuvenation with minimal incisions. We have performed 67 endoscopic facelift procedures in the last four years. Forehead lifting technique included five small scalp incisions, wide subperiosteal elevation, endoscopic myotomy and forehead tissue fixation with srews, superficial temporal fascia (STF) suture to deep temporal fascia (DTF). Midface lifting technique included temporal 2.5 cm and 1.5 cm vertical intraoral incision, midface subperiosteal undermining and midface elevation with cable sutures Bichat's fat to DTF. Age mediana of patients who underwent endoscopic front lift was 46, patients who had endoscopic front lift and midface lift procedure age mediana was 40. Postoperative complication rate was 7.5% and included frontal branch weakness (n=2), hematoma (n=1), infraorbital nerve paresthesia (n=1) and asymmetrical smile (n=1). The main question is the quality of the results. We have reviewed 49 patients who were followed 6 months or more. Preoperative and postoperative life-size photographs were analyzed. The mean elevation mediana at medial canthus was 2.2 mm, at medial limbus 2.3 mm, at lateral limbus 2.5 mm, at lateral canthus 2.9 mm. Midface - lift effect resulted cheek elevation from 1.07 till 4.71 mm lip corner elevation 1.03 mm to 3.27 mm. We observed cheek elevation, improving nasolabial line, increasing volume of malar region, elevating lip angles in patients after endoscopic midface lift. We have found that important advantage of subperiosteal midface lift, when performed in conjunction with endoscopic brow lift, is its ability to move the cosmetic eye unit, proportionally, leading to a harmonious facial appearance. Endoscopic facelift is effective procedure for face rejuvenation especially for eyebrows and cheek elevation. (+info)
Mycobacterium chelonae infections associated with face lifts--New Jersey, 2002-2003.
In March 2003, the New Jersey Department of Health and Senior Services (NJDHSS) was notified about three patients who acquired surgical-site infections caused by Mycobacterium chelonae after having face lifts (i.e., rhytidectomies) performed at an outpatient surgical center. NJDHSS learned subsequently of another patient with M. chelonae infection who had a rhytidectomy performed at a second surgical center. The four patients received diagnoses of M. chelonae infection during March 2002-February 2003. NJDHSS conducted an epidemiologic, environmental, and microbiologic investigation. This report summarizes the results of that investigation, which identified contaminated methylene blue used as a tissue-marking agent as the source of infection. Surgeons should use only sterile, single-use, tissue-marking agents during procedures that require aseptic technique, and clinicians should consider M. chelonae when evaluating surgical-site infections. (+info)
Wound care after laser skin resurfacing (LSR) is critical for achieving a successful result. The superficial thermal injury created by LSR heals more quickly and with a reduced risk of scarring under occlusion. While open and closed wound care regimens can be employed to expedite reepithelialization, closed methods with semi-occlusive dressings may decrease morbidity. Effective medications and management techniques can help to minimize expected effects of the procedure such as crusting, discomfort, pruritus, erythema, and swelling. (+info)
Face-lifting: an overview.
Numerous adaptations of face-lift techniques have been devised, and each surgical approach has its own risks and benefits, as well as proponents and detractors. All of the conventionally accepted techniques achieve removal of redundant skin. However, its the variations in approach to the deeper soft tissue structures that separate the many face-lifting procedures. A skin only face-lift was the earliest form of surgical rhytidectomy, but failed to achieve significant long-term benefit. Cosmetic surgeons of various backgrounds thus sought to achieve a more durable benefit from the surgery. While certain techniques have been classically ascribed to a particular surgeon, innovation does not occur in a vacuum and many surgeons are responsible for our current state of knowledge with regards to facial rhytidectomy surgery. (+info)
Combining chin-jowl implants with local anesthesia facial rejuvenation.
Mandibular implantation is an outpatient procedure that can be used in combination with other minimally invasive cosmetic interventions. Specifically, silastic chin implants can help create a strong chin and smooth the jaw-line in carefully selected patients. A standard surgical excision tray plus a few additional simple instruments are required, and a variety of commercially available implants are available for placement via an intraoral or submental approach. Meticulous technique minimizes the small risk of nerve injury and numbness. Chin-jowl implants may be preceded by neck liposuction and immediately followed by a face-lift to achieve overall facial enhancement. (+info)
Reduction of face and neck laxity with anchored, barbed polypropylene sutures (Contour Threads).
The use of nonabsorbable sutures for lifting lax, aging skin is an increasingly popular option for cosmetic surgeons. Contour Thread (Surgical Specialties Corp.) are novel modified polypropylene sutures recently approved for this purpose by the US FDA. Design and technical modifications incorporated into this implant may reduce complications and limitations seen with previous, similar products. Early experience has been positive, although the durability of cosmetic effect and the potential for long-term complications remain to be seen. (+info)