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Wang JY, Kabakova M, Patel P, Bitterman D, Zafar K, Philip R, Gollogly JM, Rivas S, Kurtti A, Yousefi N, Onikoyi O, Masub N, Jagdeo J. Outstanding user reported satisfaction for light emitting diodes under-eye rejuvenation. Arch Dermatol Res 2024; 316:511. [PMID: 39133416 DOI: 10.1007/s00403-024-03254-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/23/2024] [Accepted: 07/30/2024] [Indexed: 08/13/2024]
Abstract
The under-eye region is an area of significant cosmetic concern. Photobiomodulation (PBM) has emerged as an effective, safe, inexpensive, and convenient treatment for skin rejuvenation. Herein, we aim to evaluate the safety and efficacy of a LED under-eye device for under-eye rejuvenation, as measured by objective and patient reported outcomes. Eleven participants self-administered treatment using a commercially available LED device emitting red (633 nm) and near infrared (830 nm) light for six weeks. Standardized photographs and questionnaires were administered at baseline and six weeks. Photographic digital analysis indicated an improvement in under-eye wrinkles at six weeks compared to baseline, with a reduction in wrinkle score from 20.05 to 19.72. However, this finding was not statistically significant. Participants self-reported consistent improvements in under-eye wrinkles, texture, dark circles, bags, pigmentation, and erythema. All participants reported a high degree of comfortability, ease of use, and satisfaction with the eye device. The participants noted no moderate or severe adverse events and few reports of transient expected outcomes such as mild erythema. The participants' self-reported improvements and high user satisfaction, and the device's favorable safety profile, highlights the benefits of at-home LED devices for under-eye rejuvenation. Future randomized controlled trials with larger sample sizes could further establish the safety and efficacy of at-home LED under-eye treatments.
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Affiliation(s)
- Jennifer Y Wang
- Department of Dermatology, SUNY Downstate Medical Center, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, USA
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System - Brooklyn Campus, Brooklyn, NY, USA
| | - Margaret Kabakova
- Department of Dermatology, SUNY Downstate Medical Center, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, USA
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System - Brooklyn Campus, Brooklyn, NY, USA
| | - Paras Patel
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System - Brooklyn Campus, Brooklyn, NY, USA
- Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | - David Bitterman
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System - Brooklyn Campus, Brooklyn, NY, USA
- New York Medical College, Valhalla, NY, USA
| | - Kayla Zafar
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System - Brooklyn Campus, Brooklyn, NY, USA
- St. George's University School of Medicine, West Indies, Grenada
| | - Raichel Philip
- Department of Dermatology, SUNY Downstate Medical Center, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, USA
| | - Jessica Mineroff Gollogly
- Department of Dermatology, SUNY Downstate Medical Center, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, USA
| | - Sharen Rivas
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alana Kurtti
- Department of Dermatology, SUNY Downstate Medical Center, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, USA
| | - Nyousha Yousefi
- Department of Dermatology, SUNY Downstate Medical Center, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, USA
| | - Omobola Onikoyi
- Department of Dermatology, SUNY Downstate Medical Center, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, USA
| | - Natasha Masub
- Department of Dermatology, SUNY Downstate Medical Center, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, USA
| | - Jared Jagdeo
- Department of Dermatology, SUNY Downstate Medical Center, State University of New York, Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, USA.
- Dermatology Service, Veterans Affairs New York Harbor Healthcare System - Brooklyn Campus, Brooklyn, NY, USA.
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Reducing Surgical Risks in a Blepharoplasty. Facial Plast Surg Clin North Am 2023; 31:227-238. [PMID: 37001926 DOI: 10.1016/j.fsc.2023.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Blepharoplasty is one of the commonest procedures performed for facial rejuvenation. The eyelids play a vital role in maintaining ocular surface integrity and visual functioning. Care must be taken to avoid complications that pose a risk to vision and ocular comfort. In addition, cosmetic complications can adversely affect patient satisfaction. Here the authors review the common complications encountered with blepharoplasty surgery and discuss how to minimize the risk of these and how to treat them if they do arise. With careful preoperative patient counseling, sound intraoperative technique, and appropriate postsurgical care, blepharoplasty remains a safe and well-tolerated procedure.
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Smith AG, Miles VN, Holmes DT, Chen X, Lei W. Clinical Trials, Potential Mechanisms, and Adverse Effects of Arnica as an Adjunct Medication for Pain Management. MEDICINES (BASEL, SWITZERLAND) 2021; 8:medicines8100058. [PMID: 34677487 PMCID: PMC8537440 DOI: 10.3390/medicines8100058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/10/2021] [Accepted: 10/02/2021] [Indexed: 04/17/2023]
Abstract
Arnica has traditionally been used in treating numerous medical conditions, including inflammation and pain. This review aims to summarize the results of studies testing Arnica products for pain management under different conditions, including post-operation, arthritis, low back pain, and other types of musculoskeletal pain. Based on data from clinical trials, Arnica extract or gel/cream containing Arnica extract shows promising effects for pain relief. These medical benefits of Arnica may be attributed to its chemical components, with demonstrated anti-inflammatory, antioxidant, anti-microbial, and other biological activities. In conclusion, Arnica could be an adjunct therapeutical approach for acute and chronic pain management.
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Affiliation(s)
- Amanda G. Smith
- Department of Pharmaceutical and Administrative Sciences, Presbyterian College School of Pharmacy, Clinton, SC 29325, USA; (A.G.S.); (V.N.M.)
| | - Victoria N. Miles
- Department of Pharmaceutical and Administrative Sciences, Presbyterian College School of Pharmacy, Clinton, SC 29325, USA; (A.G.S.); (V.N.M.)
| | - Deltrice T. Holmes
- Department of Biology, College of Art and Sciences, Presbyterian College, Clinton, SC 29325, USA;
| | - Xin Chen
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Campbell University, Buies Creek, NC 27506, USA;
| | - Wei Lei
- Department of Pharmaceutical and Administrative Sciences, Presbyterian College School of Pharmacy, Clinton, SC 29325, USA; (A.G.S.); (V.N.M.)
- Correspondence: ; Tel.: +1-(864)-938-3836
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Tao JP, Aakalu VK, Freitag SK, Sobel RK, Foster JA, Wladis EJ, McCulley TJ, Yen MT. Homeopathic Agents or Vitamins in Reducing Ecchymosis after Oculofacial Surgery: A Report by the American Academy of Ophthalmology. Ophthalmology 2021; 129:220-226. [PMID: 34176651 DOI: 10.1016/j.ophtha.2021.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 05/14/2021] [Indexed: 10/21/2022] Open
Abstract
PURPOSE To review the published literature to determine the efficacy and safety of homeopathic agents or vitamins in reducing ecchymosis after oculofacial surgery or laser surgery. METHODS A literature search was conducted in the PubMed database initially in December 2019 and updated in March 2020 to identify all studies in the English language literature on the use of homeopathic agents or vitamins in oculofacial procedures, including laser surgery. The search yielded 124 citations, and 11 articles met all inclusion criteria for this assessment. A panel methodologist then assigned a level of evidence rating for each study. Eleven studies met inclusion criteria; 9 were rated level I, and 2 were rated level III. RESULTS The agents studied in the articles identified included oral or topical Arnica montana (AM), oral Melilotus extract, topical vitamin K oxide, and topical AM combined with Rhododendron tomentosum. Metrics to describe ecchymosis varied. In 7 controlled studies, perioperative AM provided no or negligible benefit versus placebo. In 2 studies, vitamin K cream was equivalent to placebo. One study of oral Melilotus extract had less ecchymosis compared with controls in paranasal and eyelid ecchymosis at postoperative day (POD) 7, but not at PODs 1 and 4. A lone cohort study of combined topical AM and R. tomentosum lacked objective metrics and adequate controls. No serious side effects from administration of homeopathic agents or vitamins were identified. CONCLUSIONS The current literature does not support the use of AM, vitamin K oxide, R. tomentosum, or Melilotus extract for reducing ecchymosis after oculofacial surgery or pulsed dye laser surgery.
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Affiliation(s)
- Jeremiah P Tao
- Gavin Herbert Eye Institute, University of California, Irvine School of Medicine, Irvine, California
| | - Vinay K Aakalu
- Illinois Eye and Ear Infirmary, University of Illinois College of Medicine at Chicago, Chicago, Illinois
| | - Suzanne K Freitag
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts
| | - Rachel K Sobel
- Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jill A Foster
- Ophthalmic Surgeons and Consultants of Ohio, Columbus, Ohio
| | - Edward J Wladis
- Ophthalmic Plastic Surgery, Lions Eye Institute, Department of Ophthalmology, Albany Medical Center, Albany (Slingerlands), New York
| | - Timothy J McCulley
- Department of Ophthalmology, McGovern Medical School at University of Texas Health Science Center, Houston, Texas
| | - Michael T Yen
- Cullen Eye Institute, Baylor College of Medicine, Houston, Texas
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Sherban A, Wang JV, Geronemus RG. Growing role for arnica in cosmetic dermatology: Lose the bruise. J Cosmet Dermatol 2021; 20:2062-2068. [PMID: 33930256 DOI: 10.1111/jocd.14191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 04/16/2021] [Accepted: 04/23/2021] [Indexed: 12/01/2022]
Abstract
This commentary examines the utility of arnica in cosmetic dermatology. For many years, arnica has been used to reduce the morbidity associated with various procedures, including surgeries and treatments with lasers and other energy-based devices. Arnica is a traditional homeopathic remedy that can reduce post-procedural edema and bruising. Although it has been used clinically by many physicians and is widely and readily available to patients, the available data is limited and often conflicting. We reviewed the relevant information on arnica and offer our own insights into its use in order to shed more light on its periprocedural utility.
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Affiliation(s)
- Alexander Sherban
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Jordan V Wang
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA, USA.,Laser & Skin Surgery Center of New York, New York, NY, USA
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Malik M, Shamil E, D'Souza AR. Routine Postoperative Management of Blepharoplasty: A Review of Current Evidence-Based Practice. Facial Plast Surg 2021; 37:333-339. [PMID: 33626588 DOI: 10.1055/s-0041-1722908] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Advances in blepharoplasty have resulted in an improved understanding of preoperative risk factors, intraoperative hemostasis, and wound closure. This has reduced the risk of severe adverse events. The aim of this review is to determine the current evidence base for routine postblepharoplasty management. A literature review was performed using MEDLINE, PUBMED, and EMBASE databases. Expanded search criterion "bleph*" was combined with individual terms assessing postoperative management. Articles were assessed and qualified as per Oxford Centre of Evidence-Based Medicine levels 1 to 5 (1 = highest level of evidence). A total of 47 unique articles matched our search strategy. Most articles were a description of individual expert opinion, surveys of practice, or case series (level 4-5 evidence). Few randomized controlled trials were performed (level 2). Many articles describe the clinical experience of senior facial plastic surgeons. Our review found some evidence for postoperative cooling and preincision antisepsis to be effective. This review highlights the need for higher-quality studies to improve the evidence base for routine postoperative management.
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Affiliation(s)
- Mohsan Malik
- Department of Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom of Great Britain and Northern Ireland
| | - Eamon Shamil
- Department of Otolaryngology and Facial Plastic Surgery, University Hospital Lewisham, London, United Kingdom of Great Britain and Northern Ireland
| | - Alwyn Ray D'Souza
- Department of Otolaryngology, Lewisham and Greenwich NHS Trust, London, United Kingdom of Great Britain and Northern Ireland
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Healing Adjuncts in Craniofacial Surgery: A Practical Review of Dietary Vitamins and Supplements. J Craniofac Surg 2020; 32:1099-1003. [PMID: 33177422 DOI: 10.1097/scs.0000000000007138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND In the United States, the use of herbal supplements on a regular basis ranges from 32% to 97%. Prevalence of supplement use is particularly elevated after facial surgery. It has been reported as high as 50%. Unfortunately, there is a paucity of literature on the dietary use of supplements. They are not regulated by the FDA. Often, they are not reported by patients. This study examines the role of dietary supplements as adjuncts to healing in craniofacial and facial aesthetic surgeries. METHODS A comprehensive literature review was conducted using MEDLINE, PubMed, and EMBASE. Databases were screened for papers describing the use of supplements in craniofacial procedures in adult patients using relevant search terms. Data on criteria, outcomes, and patient satisfaction were collected. RESULTS A total of 19 articles were selected from the 806 identified. Fifteen different supplements or combinations of supplements have been studied for use in facial surgeries. Of these 15 supplements, the following demonstrated potential healing benefits: dry ivy leaf extract, Nazalzem ointment (vitamin A and dexpanthenol), combination nasal sprays (phospholipids, fatty acids, vitamin A, and vitamin E), Saireito pills, topical olive oil, yunnan baiyao, melilotus extract, arnica, and combination arnica and ledum. Arnica is the most commonly studied supplement in a variety of facial operations. CONCLUSIONS There is ample evidence to support a role for the use of certain dietary supplements to optimize wound healing in craniofacial and facial aesthetic surgery. Controlled diet and use of appropriate supplements may have a synergistic beneficial effect on wound healing following craniofacial surgery. However, there is a need for additional reporting to allow for the creation of stronger guidelines and increased patient screening, reporting, and compliance.
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Knackstedt R, Oliver J, Gatherwright J. Evidence-Based Perioperative Nutrition Recommendations: Optimizing Results and Minimizing Risks. Plast Reconstr Surg 2020; 146:423-435. [PMID: 32740600 DOI: 10.1097/prs.0000000000007004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Plastic surgery patients span the nutritional spectrum from generally healthy, nutritionally competent patients to inherently catabolic, nutritionally deficient, and chronic wound patients. Therefore, plastic and reconstructive surgery affords the opportunity to investigate the impact of nutrition across a heterogeneous patient population following a wide variety of procedures. Although patients may be nutritionally deficient in certain vitamins warranting perioperative repletion, other supplements have the potential to benefit all patients, regardless of nutritional status. Despite these putative benefits, there is a dearth of information regarding nutritional optimization, with the limited, available literature focusing mostly on herbal supplements and their potential side effects. A significant barrier to supplement use is the lack of education and available supporting information regarding the indications, contraindications, and physiology of these adjuncts. The goal of this article is to provide a comprehensive, evidence-based review of available nutritional supplements that can be considered for the plastic surgery patient in the perioperative period to optimize surgical outcomes while minimizing risk. Prospective, well-designed studies using validated, high-quality supplements will be critical in determining the significance that perioperative supplementation can have for surgical outcomes. Until well-done prospective studies are performed, the supplement, dose, and duration should be determined on an individual, patient-per-patient basis at the discretion of the operating surgeon.
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Affiliation(s)
- Rebecca Knackstedt
- From the Department of Plastic Surgery, Cleveland Clinic; the Mayo Medical School; and the Division of Plastic Surgery, MetroHealth
| | - Jeremie Oliver
- From the Department of Plastic Surgery, Cleveland Clinic; the Mayo Medical School; and the Division of Plastic Surgery, MetroHealth
| | - James Gatherwright
- From the Department of Plastic Surgery, Cleveland Clinic; the Mayo Medical School; and the Division of Plastic Surgery, MetroHealth
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Abstract
BACKGROUND Surveys have reported that as high as 80% of plastic surgery patients utilize integrative medicine approaches including natural products (NPs) and mind-body practices (MBPs). Little is known regarding the evidence of benefit of these integrative therapies specifically in a plastic surgery patient population. METHODS We conducted a systematic review of studies in MEDLINE, PubMed, and EMBASE (inception through December 2016) evaluating integrative medicine among plastic surgery patients. Search terms included 76 separate NP and MBP interventions as listed in the 2013 American Board of Integrative Health Medicine Curriculum. Two independent reviewers extracted data from each study, including study type, population, intervention, outcomes, conclusions (beneficial, harmful, or neutral), year of publication, and journal type. Level of evidence was assessed according to the American Society of Plastic Surgeons Rating Levels of Evidence and Grading Recommendations. RESULTS Of 29 studies analyzed, 13 studies (45%) evaluated NPs and 16 (55%) studied MBPs. Level II reproducible evidence supports use of arnica to decrease postoperative edema after rhinoplasty, onion extract to improve scar pigmentation, hypnosis to alleviate perioperative anxiety, and acupuncture to improve perioperative nausea. Level V evidence reports on the risk of bleeding in gingko and kelp use and the risk of infection in acupuncture use. After year 2000, 92% of NP studies versus 44% of MBP studies were published (P = 0.008). CONCLUSIONS High-level evidence studies demonstrate promising results for the use of both NPs and MBPs in the care of plastic surgery patients. Further study in this field is warranted.
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Hollander MHJ, Schortinghuis J, Vissink A, Jansma J, Schepers RH. Aesthetic outcomes of upper eyelid blepharoplasty: a systematic review. Int J Oral Maxillofac Surg 2019; 49:750-764. [PMID: 31722817 DOI: 10.1016/j.ijom.2019.10.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 09/01/2019] [Accepted: 10/18/2019] [Indexed: 12/20/2022]
Abstract
Although upper blepharoplasty is a common cosmetic surgical intervention, a better scientific understanding of the aesthetic results and the preferred surgical technique to achieve the best aesthetic results is still needed. A systematic search using four search engines (PubMed, Embase, CINAHL, and Cochrane) was performed to identify any study on the aesthetic outcome of a solitary upper blepharoplasty; these were subjected to quality assessment for possible inclusion. Eligible studies were randomized controlled trials, controlled trials, cohort studies, and case series (n ≥ 10). A total of 4043 studies were assessed, of which 26 were included. Aesthetic outcomes included patient-reported outcome measures, scarring, eyebrow height, tarsal platform show, and panel or expert evaluation. Meta-analysis was not possible. Patients were generally satisfied with the aesthetic result and scar formation after an upper blepharoplasty. The amount of tarsal platform show increases, which positively affects the aesthetics. The eyebrow seems to move down slightly. The surgical technique used (skin only or skin/muscle removal) did not influence patient satisfaction or the physician-assessed aesthetic outcomes. Patients are generally satisfied after an upper blepharoplasty. The optimal design of the skin excision is still a matter of debate, especially when addressing lateral hooding. Further objective research is advised.
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Affiliation(s)
- M H J Hollander
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Centre Groningen (UMCG), Groningen, The Netherlands.
| | - J Schortinghuis
- Department of Oral and Maxillofacial Surgery, Treant Scheper Hospital, Emmen, The Netherlands
| | - A Vissink
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Centre Groningen (UMCG), Groningen, The Netherlands
| | - J Jansma
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Centre Groningen (UMCG), Groningen, The Netherlands
| | - R H Schepers
- Department of Oral and Maxillofacial Surgery, University of Groningen and University Medical Centre Groningen (UMCG), Groningen, The Netherlands
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Keserü M, Dulz S, Wolf A, Green S, Press U, Schaudig U. [Postoperative care and options for scar treatment in eyelid surgery]. Ophthalmologe 2019; 115:283-292. [PMID: 29188383 DOI: 10.1007/s00347-017-0617-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Oculoplastic surgery places special demands on postoperative care because of the functional importance of the eyelids for the ocular surface. We present an overview of postoperative care after surgical eyelid interventions. All options, limits and the scientific evidence are discussed with a special focus on the treatment of postoperative edema, analgesia, infection prophylaxis and scar treatment.
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Affiliation(s)
- M Keserü
- Augenklinik, Asklepios Klinik Barmbek, Rübenkamp 220, 22291, Hamburg, Deutschland.
| | - S Dulz
- Klinik und Poliklinik für Augenheilkunde, Unversitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - A Wolf
- Augenklinik, Krankenhaus der Barmherzigen Brüder, Trier, Deutschland
| | - S Green
- Klinik und Poliklinik für Augenheilkunde, Unversitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - U Press
- Augenklinik, Krankenhaus der Barmherzigen Brüder, Trier, Deutschland
| | - U Schaudig
- Augenklinik, Asklepios Klinik Barmbek, Rübenkamp 220, 22291, Hamburg, Deutschland
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