Simple Incisionless Temporary Stabilization: An Adjunct to Lower Blepharoplasty.

Background: Lateral canthal tightening is indicated for patients undergoing lower eyelid blepharoplasty who have preexisting lower eyelid laxity or ectropion. A canthoplasty or canthopexy is indicated at the time of lower blepharoplasty to avoid postoperative complications, such as eyelid retraction or ectropion. Various surgical techniques are described to accomplish this goal, including canthopexy procedures, which usually access the lateral canthal tendon through an upper eyelid blepharoplasty or lateral canthal incision.

The Management of Lumps, Bumps, and Contour Irregularities of the Lower Eyelid and Cheek After Poor Outcome Fat Transfer.

Background: The increasing popularity of fat transfer (FT) to the lower eyelids has led to an increase in unwanted lumps, bumps, and contour irregularities (LBCs). Few studies have addressed the management of LBCs.

Objectives: The aim of this study was to address the management of LBCs.

Quantitative Analysis of Preoperative and Postoperative Photographs Posted on Social Media by Oculoplastic Surgeons.

Purpose: To investigate and quantitatively analyze preoperative and postoperative photographs posted on social media by oculoplastic surgeons.

Methods: Pre- and postoperative blepharoplasty photographs posted by oculoplastic surgeons on the social media platform Instagram were identified over a 4-month period. Photographs demonstrating a frontal pose of the periocular region were selected, and image analysis was performed to compare the preoperative and postoperative photographs.

Complications of Periocular Dermal Fillers.

Dermal fillers, in particular hyaluronic acid gel (HAG) fillers, are used in the treatment of aging changes in the periocular area. Filler treatment requires in-depth knowledge of specific issues relating to product performance and administration, safety protocols, and recognition and treatment of complications. There are different approaches to treatment of the tear trough.

The Spectrum of Aesthetic Canthal Suspension.

Aesthetic canthal suspension can be an effective adjunct to lower eyelid blepharoplasty. Understanding the anatomy and function of the lateral canthal tendon is critical for preoperative evaluation and surgical decision making. In this article, the authors discuss the lateral canthal terminology, anatomy, and aging changes.

Complications Associated with Fat Grafting to the Lower Eyelid.

Fat grafting is effectively used in the lower eyelid and periorbital area for rejuvenation of the aging face. Several complications may occur with fat grafting, including volume undercorrection or overcorrection, contour irregularities, prolonged bruising and swelling, infection, granulomas and inflammation, and vascular embolization with visual loss or stroke. In many cases, complications can be effectively treated, although permanent and serious injury can occur.

Comparison of non-absorbable silk and absorbable polyglactin sutures for external ptosis repair.

: The authors compare the outcomes and revision rates for external levator aponeurotic advancement for the treatment of involutional ptosis using non-absorbable silk and absorbable polyglactin sutures.: An IRB-approved retrospective chart review identified 121 patients who underwent external levator advancement for involutional ptosis between 2015 and 2016 by the senior author (JBH).  All patients underwent ptosis repair using either 5-0 polyglactin 910 on a S-14 spatulated needle or 6-0 silk on a G-1 reverse cutting needle for the aponeurotic advancement.

Phi, Fat, and the Mathematics of a Beautiful Midface.

Purpose: The Golden ratio, or Phi, has been used to explain the substrates of two-dimensional beauty utilizing the faces of models. A "Phi point" has been identified at the apex of the cheek mound that can be targeted in filler injections. The authors report herein how they have applied this algorithm for surgical shaping of the "beautiful" cheek as a routine part of their lower blepharoplasty procedure.

Acute Angle Closure Precipitated by Hemorrhage and Necrosis of a Large Uveal Melanoma in the Setting of Systemic Immunomodulatory Therapy.

Management of nonmetastatic uveal melanoma has been well studied and a large body of work has been published by the Collaborative Ocular Melanoma Study (amongst many others). Management of uveal melanoma that is found to be metastatic upon initial diagnosis, however, is less well defined. We report an interesting case of acute angle closure caused by necrosis and hemorrhage into a large uveal melanoma occurring shortly after initiation of immunomodulatory therapy with ipilimumab and nivolumab for metastatic disease.

Laughter-Induced Transient Vision Loss in a Patient With Silent Sinus Syndrome.

Background: To report a patient with silent sinus syndrome (SSS) who experienced transient ipsilateral monocular vision loss during intense laughter.

Methods: Case report.

Results: Our patient's transient vision loss completely resolved after maxillary sinus decompression and during 7 months of follow-up.

Orbicularis Retaining Ligament Release in Lower Blepharoplasty: Assessing Efficacy and Complications.

Purpose: Release of the orbicularis retaining ligament (ORL) has been advocated as a technique to address tear trough deformities. This study sought to compare the effectiveness and morbidity of lower blepharoplasty with and without ORL release.

Methods: Retrospective chart review of 53 lower blepharoplasty patients.

Lower Eyelid Reconstruction.

Lower eyelid defects are common, and a systematic approach to reconstruction of the lower eyelid is required. Attention to the bilaminar eyelid anatomy and canthal support structures, with efforts to maintain functionally important structures, such as the lacrimal canalicular system, is vital to appropriate lower eyelid reconstruction. Techniques of advancement and rotation flaps and grafting of skin and mucosa are mainstays of lower eyelid reconstruction.

Upper Lid Blepharoplasty.

Upper lid blepharoplasty is a common procedure for restoration and rejuvenation of the upper eyelids that can be performed safely and reliably. Understanding the anatomy and aging process of the brow-upper lid aesthetic unit along with properly assessing the excesses and deficiencies of the periorbital region helps to formulate an appropriate surgical plan. Volume deficiency in the aging upper lid may require corrective augmentation.

Evaluation of Eyelid Function and Aesthetics.

The eyes and periocular area are the central aesthetic unit of the face. Facial aging is a dynamic process that involves skin, subcutaneous soft tissues, and bony structures. An understanding of what is perceived as youthful and beautiful is critical for success.

The Role of Surgeon Technique in Current Practice Patterns for Combined Ptosis and Dermatochalasis.

Purpose: The goal of this study is to identify and describe the role of surgical incision preference, insurance reimbursement, and geographical location on the current ptosis repair practice patterns of American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) members.

Methods: A 9-question survey was designed with surveymonkey.com and a participation link was emailed to all active ASOPRS members' email addresses in February 2015.

Proptosis and Anterior Dislocation as a Late Noninflammatory Complication of Failure of Tissue Integration in the Alphasphere Implant.

A 57-year-old healthy female underwent enucleation for choroidal melanoma with primary implantation of a 2-hydroxyethyl methacrylate sphere (AlphaSphere, Addition Technology, Des Plaines, IL). Her course was uneventful, with successful prosthetic fitting 6 weeks postoperatively. She returned 2 years later, with anterior displacement of the implant, poor implant movement, and poor prosthetic fit.

Automated Ptosis Measurements From Facial Photographs.

Importance: Measurements of the margin reflex distances 1 and 2 are crucial for the surgical planning of ptosis repair and blepharoplasty. Facial photographs annotated with automated measurements of eyelid position could provide objective, accurate, and reproducible documentation of these features.

Objectives: To describe a software algorithm for determining the margin reflex distances 1 and 2 from facial photographs and to evaluate its agreement with manual measurements of the margin reflex distances 1 and 2.