Minimally invasive options for the brow and upper lid

Factors that affect eyelid show and their importance in upper eyelid blepharoplasty: a systematic review

An understanding of the complexity of the surgical anatomy of the upper eyelid and the surrounding structures is mandatory when trying to minimize complications and achieve excellent cosmetic results during eyelid surgery. Postoperative upper eyelid asymmetry is one of the most common causes of patients' dissatisfaction, and several parameters should be taken into consideration when performing cosmetic blepharoplasties and ptosis surgery. Tarsal platform show and brow fat span are two of the most important variables pertaining to the perception of beauty and youthfulness that every oculoplastic and facial plastic surgeon should address when performing such surgery. The aim of this review paper is to provide a detailed anatomy of the upper eyelid and the surrounding structures, to highlight all the relevant factors that contribute to the perception of beauty and the changes that occur to the aging face and to address the preoperative factors that need to be carefully examined before performing upper eyelid surgery.

Evaluation of the efficacy and safety of plasma exeresis in periorbital rejuvenation using the Reviscometer®

BACKGROUND

Periorbital rejuvenation is performed through various methods. Recently, plasma exeresis has been suggested for the treatment of dermatochalasis and periorbital wrinkles.

AIMS

To evaluate the clinical efficacy and safety of plasma exeresis in periorbital rejuvenation and palpebral laxity and assess its effectiveness using the Reviscometer^® .

PATIENTS/METHODS

Fifty-six women with mild-to-severe dermatochalasis and periorbital wrinkles volunteered to participate in this clinical trial. They received plasma exeresis thrice at one-month intervals. The efficacy of the intervention was evaluated according to the Cutaneous Resonance Running Time (CRRT) value changes, photographic changes, patients' satisfaction, and clinical side effects.

RESULTS

This study showed significant clinical improvements in dermatochalasis and palpebral laxity after treatment compared with the baseline (p < 0.001). Most of the participants had relative satisfaction, and no significant or permanent side effects were observed.

CONCLUSION

The findings of this study suggest that plasma exeresis is a safe and effective nonsurgical method for periorbital rejuvenation. Furthermore, the procedure has no serious adverse effects if performed correctly and for the right patient.

Periorbital facial rejuvenation; applied anatomy and pre-operative assessment

PURPOSE

Since different subspecialties are currently performing a variety of upper facial rejuvenation procedures, and the level of knowledge on the ocular and periocular anatomy and physiology is different, this review aims to highlight the most important preoperative examinations and tests with special attention to the eye and periocular adnexal structures for general ophthalmologist and specialties other than oculo-facial surgeons in order to inform them about the fine and important points that should be considered before surgery to have both cosmetic and functional improvement.

METHODS

English literature review was performed using PubMed with the different keywords of "periorbital rejuvenation", "blepharoptosis", "eyebrow ptosis", "blepharoplasty", "eyelid examination", "facial assessment", and "lifting". Initial screening was performed by the senior author to include the most pertinent articles. The full text of the selected articles was reviewed, and some articles were added based upon the references of the initial articles. Included articles were then reviewed with special attention to the preoperative assessment of the periorbital facial rejuvenation procedures.

RESULTS

There were 254 articles in the initial screening from which 84 articles were found to be mostly related to the topic of this review. The number finally increased to 112 articles after adding the pertinent references of the initial articles.

CONCLUSION

Static and dynamic aging changes of the periorbital area should be assessed as an eyelid-eyebrow unit paying more attention to the anthropometric landmarks. Assessing the facial asymmetry, performing comprehensive and detailed ocular examination, and asking about patients' expectation are three key elements in this regard. Furthermore, taking standard facial pictures, obtaining special consent form, and finally getting feedback are also indispensable tools toward a better outcome.

Periorbital Surgery: Forehead, Brow, and Midface

Periorbital rejuvenation requires a careful understanding of the interplay between the eyelids, brow, forehead, and midface. Reversing periorbital signs of aging requires a correction of volume loss, soft tissue ptosis, and skin changes. Many surgical and nonsurgical techniques exist to treat the aging periorbital region; however, careful consideration of the patient's complaints and existing anatomy is critical to achieving a safe and esthetically pleasing outcome.