The Impact of Brow-Lift on Eyelid Closure in Patients with Facial Paralysis.

Brow-lift-induced eyelid closure impairment is commonly discussed in patients with facial paralysis but has not been well quantified. To measure the limitation of eyelid closure in patients with facial paralysis using simulated brow-lift with tape. For 50 facial paralysis patients with brow ptosis who visited our institution from October 2017 to December 2020, brow-lift was simulated by elevating the paralyzed-side brow using surgical tape, and closed palpebral fissure heights in spontaneous blinking were measured using high-speed videography.

Upper eyelid blepharoplasty and associated ancillary procedures to improve cosmesis.

Purpose: To present combined procedures performed for cosmesis in patients with dermatochalasis who underwent upper lid blepharoplasty (ULB).

Method: This retrospective cross-sectional study evaluated patients who underwent ULB with associated surgical procedures from 2012 to 2016. Data were collected on patient demographics and types of procedures.

Periorbital Filling With The MD Codes™ Algorithm: A Narrative Review and a Practical Guide.

Introduction: The hyaluronic acid dermal fillers are employed to bring balance and facial harmony, improving the proportions and asymmetries of the structures, besides acting to reverse the signs of facial aging. The periorbital region is one of the first to show the signs of aging with periocular wrinkles, deepening of the nasojugal and palpebromalar folds, prolapse of the fat bags, excess palpebral skin, ptosis of the eyelashes, disappearance of the upper eyelid crease due to excess skin and hollowing of the upper eyelid.

Aims: To describe the lines and grooves of the periorbital region and present a practical guide to the MD CODES™ algorithm for filling this region based on a narrative review of the literature.

Non-Surgical Eyebrow Rejuvenation Techniques: A Review.

Background: Eyebrow rejuvenation is a common cosmetic concern among patients presenting to dermatologists. Due to increased patient demand for non-invasive procedures, multiple non-surgical, and minimally invasive eyebrow rejuvenation techniques have been developed.

Objective: This review aims to highlight the various non-surgical eyebrow rejuvenation therapeutic techniques described in the medical literature.

Facial expressions can detect Parkinson's disease: preliminary evidence from videos collected online.

A prevalent symptom of Parkinson's disease (PD) is hypomimia - reduced facial expressions. In this paper, we present a method for diagnosing PD that utilizes the study of micro-expressions. We analyzed the facial action units (AU) from 1812 videos of 604 individuals (61 with PD and 543 without PD, with a mean age 63.

Ophthalmic Injuries After the Port of Beirut Blast-One of Largest Nonnuclear Explosions in History.

Importance: A review of the injury patterns, treatment strategies, and responding physicians' experience during the Port of Beirut blast may help guide future ophthalmic disaster response plans.

Objective: To present the ophthalmic injuries and difficulties encountered as a result of the Port of Beirut blast on August 4, 2020.

Design, Setting, And Participants: A retrospective medical record review of all patients who presented to the emergency department and 13 ophthalmology outpatient clinics at the American University of Beirut Medical Center for treatment of ophthalmic injuries sustained from the explosion in Port of Beirut, Beirut, Lebanon, from August 4 to the end of November 2020.

Establishment of Objective Clinical Parameters for Assessment of Trigonocephaly: Are Caliper-Derived Clinical Measures Adequate?

Objective: Objective clinical parameters characterizing the severity of trigonocephaly are essential given the concern for computerized tomography (CT) scans and radiation in infants. The present study seeks to develop a clinical tool by which to characterize trigonocephaly.

Design: Retrospective cohort study.

Target-Specific Sandwich Technique: Facial rejuvenation leveraging CPM technology.

Injectable rejuvenation treatments used in Caucasians might not always suit Asians as the visible signs of aging manifest differently, underscoring a need for Asian-specific strategies that correct underlying structural deficiencies and cumulative age-related changes. The presented Target-Specific Sandwich Technique (TSST) aims to simultaneously restore, rejuvenate, and enhance faces through the distribution of minute amounts of different fillers with different rheologies, using a minimal number of entry points in strategic facial areas and different soft tissue layers in Asians. A total of 14 patients underwent the presented TSST and were subsequently assessed for satisfaction with the treatment and the outcome of the treatment.

Reconstruction of Congenital Alar Rim Defects (Tessier Number 1 Cleft) Using Laterally Based Alar Subunit Rotation Advancement Flap.

Background: Alar rim defects develop in most cases as a result of burns, trauma, or tumor excision. Congenital alar rim defects are rare, with an incidence of 1 in 20,000 to 40,000 live births. Tessier classification is the most commonly used classification system for craniofacial defects.

PeriorbitAI: Artificial Intelligence Automation of Eyelid and Periorbital Measurements.

Purpose: To develop a deep learning semantic segmentation network to automate the assessment of 8 periorbital measurements DESIGN: Development and validation of an artificial intelligence (AI) segmentation algorithm METHODS: A total of 418 photographs of periorbital areas were used to train a deep learning semantic segmentation model to segment iris, aperture, and brow areas. These data were used to develop a post-processing algorithm that measured margin reflex distance (MRD) 1 and 2, medial canthal height (MCH), lateral canthal height (LCH), medial brow height (MBH), lateral brow height (LBH), medial intercanthal distance (MID), and lateral intercanthal distance (LID). The algorithm validity was evaluated on a prospective hold-out test set against 3 graders.

A Comprehensive Approach to Asian Upper Eyelid Ptosis Correction: The Levator Musculo-Aponeurotic Junction Formula.

Background: The unique anatomy of the Asian upper eyelid requires specific adaptation to the levator advancement technique for ptosis correction to achieve predictable and reproducible outcomes.

Objectives: The levator musculo-aponeurotic junction was employed as they key landmark. With a formula developed by the authors, the location of fixation relative to this landmark can be predicted preoperatively.

Double-Incision approach with suspension of the orbicularis oculi muscle and relieving of tension for upper eyelid rejuvenation in Asian women.

Background: In Asian women, upper eyelid skin laxity, lateral hooding, and upper eyelid and brow asymmetry in the aging upper eyelid are prominently and frequently seen. It is difficult to completely resolve these problems with the classical single-incision method. In this study, we investigate the utility of a double-incision approach to address aging-related changes of the upper eyelid.

Sonographic diagnosis of fetal head deflexion and the risk of cesarean delivery.

Background: Malpositions and deflexed cephalic malpresentations are well recognized causes of dysfunctional labor, may result in fetal and maternal complications, and are diagnosed more precisely with an ultrasound examination than with a digital examination.

Objective: This study aimed to assess the incidence of malpositions and deflexed cephalic malpresentations at the beginning of the second stage of labor and to evaluate the role of the sonographic diagnosis of deflexion in the prediction of the mode of delivery.

Study Design: Women in labor with a singleton pregnancy at term with fetuses in a cephalic presentation at 10 cm of cervical dilatation were prospectively examined.

Upper Eyelid Ptosis Correction with Levator Advancement in Asian Patients using the Musculoaponeurotic Junction of the Levator as the Key Reference Point.

Upper eyelid ptosis correction is a complex procedure. The ethnic differences in the Asian upper eyelid anatomy are compounded by the technical challenges of primary and revision ptosis correction. The authors present a technique of upper eyelid ptosis correction that estimates the exact location of suture fixation that uses the musculoaponeurotic junction of the levator as the reference point.

A New Simplified Visual Assessment Tool Describing Facial Morphotypes Observed and Desired in Asian Populations.

A group of established aesthetic physicians sought to develop treatment guidelines for assessing Asian face morphologies that reflect accurate and current beauty standards across Asia. Physicians completed surveys, debated, and voted on their clinical strategies and developed an alternative simplified visual tool of assessment (SVAT) that discerns between country variations in genetic and ideal morphotypes. Electronic and paper surveys were followed by consensus debates and voting.

Many ways to see your feelings: Successful facial expression recognition occurs with diverse patterns of fixation distributions.

Facial expression recognition relies on the processing of diagnostic information from different facial regions. For example, successful recognition of anger versus disgust requires one to process information located in the eye/brow region, or in the mouth/nose region, respectively. Yet, how this information is extracted from the face is less clear.

Electric scooter craniofacial trauma.

Objective: The use of standing electronic scooters associated with micromobility applications (e-scooters) has risen nationally. The aim of this study was to obtain a detailed view of soft tissue and bony craniofacial injury associated with e-scooter-related trauma.

Methods: Single-institution retrospective case series of patients presenting to a level 1 trauma center emergency department or trauma unit with documented e-scooter-related craniofacial injury.

Vectorial facial sculpting: A novel sub-SMAS filler injection technique to reverse the impact of the attenuated retaining ligaments.

Background: Age-related attenuation of the orbital, zygomatic, and masseteric ligaments contribute to temporal brow ptosis, deepening nasolabial fold, and jowl, respectively.

Aims: To present and assess the vectorial facial sculpting (VFS) technique, a novel nonsurgical panfacial rejuvenation method which focuses on reversal of the impact of attenuated ligaments on the aging face.

Methods: This case series included women who underwent vectorial facial sculpting at a private clinic from June 2018 to January 2019.

Late-Onset Upper Eyelid and Brow Edema as a Long-Term Complication of Hyaluronic Acid Filler Injection.

Background: Late-onset upper eyelid edema is an uncommonly recognized complication of hyaluronic acid (HA)-based filler injection to the supraorbital area.

Objectives: The authors sought to report their experience in diagnosing and managing late-onset upper eyelid edema.

Methods: This was a noncomparative, retrospective study of a series of 17 consecutive patients who presented with upper eyelid edema 6 to 24 months after uneventful HA filler injection in the supraorbital area.

Masseteric-zygomatic nerve transfer for the management of eye closure-smile excursion synkinesis.

Objective: The purpose of this study is to illustrate the efficacy of masseteric-to-zygomatic nerve transfer to address eye closure-smile excursion synkinesis after facial nerve paralysis.

Background: Synkinesis after facial nerve paralysis represents a wide range of facial movement disability. One manifestation is involuntary smiling with eye closure and a concomitant reduction of oral commissure movement with attempted smile ("frozen smile") - arising as a result of aberrant fibers populating the zygomatic branch-muscle complex.

Are There Differences Between Intradermal and Intramuscular Injections of Botulinum Toxin on the Forehead?

Background: The intradermal technique to inject botulinum toxin is a popular procedure in upper facial rejuvenation to minimize side effects, such as brow ptosis, and can sometimes result in a lifting effect.

Objective: The present study investigated differences in effects according to injection modality.

Methods And Materials: Fifteen women received intradermal injections of botulinum toxin (total dose, 8U) into the forehead, and 14 women received intramuscular injections.

Transbrow Excision Blepharoplasty for Upper Eyelid Dermatochalasis: A Modified Approach.

Backgrounds: Many aging women with upper lid dermatochalasis pluck their lower lateral eyebrows to combat lateral drooping. The authors present and evaluate outcomes of a modified excision blepharoplasty method performed using a transbrow excision approach instead of infra/suprabrow access to more efficiently correct upper eyelid dermatochalasis.

Methods: The authors conducted a retrospective review of 192 patients who underwent transbrow excision blepharoplasty (TBEB) between 2014 and 2019 at the Plastic Surgery Hospital of Beijing in China.