فهرست مطالب hamed sianati

None of brow lift techniques are completely satisfactory because of their limited effectiveness, lack of longevity, and potential complications. The aim of this study was to provide a comprehensive review of the literature on the pros and cons of the most popular techniques in brow and forehead lift. Relevant original articles in the PubMed database (English language) were sought using the search terms “eyebrow lift”, “forehead lift”, ”periorbital rejuvenation”, ”eyebrow ptosis”, ”blepharoplasty and eyebrow change”, ”surgical eyebrow lift”, and ”non-surgical eyebrow lift”, No date limitation was considered. Titles and abstracts were scanned to include the most pertinent articles. Subsequently, full texts of included articles (111 articles) were skimmed and finally 56 references were selected for the review. A narrative synthesis of data was finally undertaken with particular attention to the indications, techniques, and common complications of the eyebrow lift procedures. Ten popular techniques including two nonsurgical methods (Botulinum toxin A and soft tissue fillers) were reviewed in this article. In general, non-surgical methods of forehead/brow lift are temporary, need less experience and correction would be easier should any complication occur. Surgical methods are divided into three categories: trans-blepharoplasty eyebrow lift, direct eyebrow lift, and trans-forehead eyebrow/forehead lift. Currently, the most popular method is the endoscopic forehead lift approach even though its longevity is limited. Direct brow-lift is particularly useful in patients with facial palsy and those who are more likely to be accepting of the scar (male gender, high forehead hair line).

PurposeSince 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.
MethodsEnglish 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.
ResultsThere 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.
ConclusionStatic 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 patient's 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.

To evaluate the efficiency and safety of using autologous fibrin glue for attachment of a conjunctival autograft in primary pterygium surgery In this prospective interventional case series, 15 eyes from 13 patients with primary nasal pterygium were included for conjunctival autograft surgery. On the operation day, thrombin and fibrinogen were prepared from the patient’s own blood in two separate sealed tubes in the blood transfusion center. Autologous fibrin glue was applied over the bare sclera for attachment of the free conjunctival autograft to the surrounding conjunctiva and sclera. The anatomic outcomes of flap, surgical time, recurrence rate, and other complications were evaluated on days 1, 3, and 7 and at months 1, 6, and 9 and 3 year after operation. A patient’s pain was evaluated using a 5-point scale from Lim-Bon-Siong et al grading at all visits. Of the 13 patients, 76.9% were male. The mean age of the patients was 37.26±12.61 (SD) years (range 23-60). The mean follow-up period was 34.67±2.96 months (range 25-36). Three eyes (20%) developed autograft retraction that resolved completely with continued eye patching. Two eyes (13.33%) developed total graft dehiscence, and sutures were used for reattachment of the graft in its correct position. Two eyes (13.33%) developed recurrence of pterygium, one of them had already a total graft dehiscence. In 13 eyes (86.66%), the conjunctival grafts were appropriately adhered to the bed and surrounding conjunctiva without suturing in the final visit. In the first postoperative day, ocular pain was recorded as grade 1 in 11 eyes (73.3%), grade 2 in 3 eyes (20%), and grade 3 in 1 eye (6.6%). In all patients, ocular pain disappeared during the 5 days after operation, except for two patients who needed suturing for graft reattachment, in whom ocular pain continued for 2 weeks. No other complications were found during follow-up. This case series suggests that autologous fibrin glue is a safe and useful alternative method for graft fixation in pterygium surgery.