The Experts below are selected from a list of 1173 Experts worldwide ranked by ideXlab platform
Farzad R Nahai - One of the best experts on this subject based on the ideXlab platform.
-
transconjunctival Blepharoplasty for upper and lower eyelids
Plastic and Reconstructive Surgery, 2010Co-Authors: Salvatore J Pacella, Farzad R NahaiAbstract:Background:Transconjunctival Blepharoplasty remains a popular and safe technique to treat periorbital aging. In the lower lid, it can be used successfully for orbital fat excision, redistribution, or septal tightening. In the upper lid, transconjunctival Blepharoplasty has a role in removal of the n
-
transconjunctival Blepharoplasty for upper and lower eyelids
Plastic and Reconstructive Surgery, 2010Co-Authors: Salvatore J Pacella, Farzad R NahaiAbstract:BACKGROUND: Transconjunctival Blepharoplasty remains a popular and safe technique to treat periorbital aging. In the lower lid, it can be used successfully for orbital fat excision, redistribution, or septal tightening. In the upper lid, transconjunctival Blepharoplasty has a role in removal of the nasal fat pad via an isolated, direct approach. METHODS: The authors review anatomy, indications, and surgical approaches for upper and lower lid transconjunctival Blepharoplasty. RESULTS: Potential complications, patient results, and the senior author's personal series are discussed. CONCLUSIONS: In the lower lid, this technique can be advocated in an effort to avoid lower lid complications such as sclera show or lid malposition. In the upper lid, it can be effective in treating isolated fat pads with minimal skin excess.
Salvatore J Pacella - One of the best experts on this subject based on the ideXlab platform.
-
Blepharoplasty and brow lift
Plastic and Reconstructive Surgery, 2010Co-Authors: Mark A Codner, Don O Kikkawa, Bobby S Korn, Salvatore J PacellaAbstract:Brow lift and Blepharoplasty are among the most commonly requested procedures in facial aesthetic surgery. The purpose of this article is to provide an overview of current concepts, including goals, surgical options, and outcomes for aesthetic improvement of the forehead and periorbital region. Preoperative patient assessment, anatomical and surgical concepts, advantages and disadvantages, and prevention and management of complications and expected results are discussed. Surgical results of endoscopic and lateral brow lift, upper lid Blepharoplasty with supratarsal fixation, and lower lid Blepharoplasty with correction of the tear trough are presented. Details of the perioperative techniques are presented in accompanying video format. A critical understanding of patient expectation, surgical anatomy, and operative technique is important for avoiding complications and achieving aesthetic results in brow and eyelid rejuvenation.
-
transconjunctival Blepharoplasty for upper and lower eyelids
Plastic and Reconstructive Surgery, 2010Co-Authors: Salvatore J Pacella, Farzad R NahaiAbstract:Background:Transconjunctival Blepharoplasty remains a popular and safe technique to treat periorbital aging. In the lower lid, it can be used successfully for orbital fat excision, redistribution, or septal tightening. In the upper lid, transconjunctival Blepharoplasty has a role in removal of the n
-
transconjunctival Blepharoplasty for upper and lower eyelids
Plastic and Reconstructive Surgery, 2010Co-Authors: Salvatore J Pacella, Farzad R NahaiAbstract:BACKGROUND: Transconjunctival Blepharoplasty remains a popular and safe technique to treat periorbital aging. In the lower lid, it can be used successfully for orbital fat excision, redistribution, or septal tightening. In the upper lid, transconjunctival Blepharoplasty has a role in removal of the nasal fat pad via an isolated, direct approach. METHODS: The authors review anatomy, indications, and surgical approaches for upper and lower lid transconjunctival Blepharoplasty. RESULTS: Potential complications, patient results, and the senior author's personal series are discussed. CONCLUSIONS: In the lower lid, this technique can be advocated in an effort to avoid lower lid complications such as sclera show or lid malposition. In the upper lid, it can be effective in treating isolated fat pads with minimal skin excess.
J Burns - One of the best experts on this subject based on the ideXlab platform.
-
modified visual field test for ptosis surgery leicester peripheral field test
Eye, 2011Co-Authors: S F Ho, A Morawski, Raghavan Sampath, J BurnsAbstract:INTRODUCTION: There is lack of consensus among Primary Health Care Trusts (PCTs) and health insurers on how to reimburse ptosis surgery and upper lid Blepharoplasty, as these procedures can be regarded as cosmetic. Standardised photographs are expensive and difficult to achieve, whilst the routine 24-2 visual field lacks the range to detect visually significant superior field defects.AimTo introduce a modified visual field designed to assess the functional disability associated with ptosis and dermatochalasis and to demonstrate the effectiveness of surgery in improving the visual field. METHODS: Patients who had surgery for ptosis or dermatochalasis between January 2006 and December 2009 were prospectively invited to perform a modified visual field test pre- and post-operatively. RESULTS: In total, 97 patients amounting to 194 eyes were included in the study. Ninety five eyes had aponeurotic repair with or without Blepharoplasty and 77 eyes had Blepharoplasty alone. This modified test has a sensitivity of 98.8% of detecting ptosis. For patients who underwent ptosis surgery with or without Blepharoplasty, 84.2% recorded an improvement in points seen with the test and 81% recorded an improvement in visual field height. For those who had Blepharoplasty alone, 90.9% recorded an improvement in points seen in the modified visual field test and 80.6% had improvement in visual field height. CONCLUSION: Our modified visual field assessment is a quick and easy way to assess patient disability associated with ptosis and dermatochalasis. Surgery improves the demonstrated defect, confirming that ptosis and dermatochalasis can be considered a functional rather than cosmetic issue.
-
Modified visual field test for ptosis surgery (Leicester Peripheral Field Test)
Eye, 2011Co-Authors: A Morawski, Raghavan Sampath, J BurnsAbstract:There is lack of consensus among Primary Health Care Trusts (PCTs) and health insurers on how to reimburse ptosis surgery and upper lid Blepharoplasty, as these procedures can be regarded as cosmetic. Standardised photographs are expensive and difficult to achieve, whilst the routine 24-2 visual field lacks the range to detect visually significant superior field defects. To introduce a modified visual field designed to assess the functional disability associated with ptosis and dermatochalasis and to demonstrate the effectiveness of surgery in improving the visual field. Patients who had surgery for ptosis or dermatochalasis between January 2006 and December 2009 were prospectively invited to perform a modified visual field test pre- and post-operatively. In total, 97 patients amounting to 194 eyes were included in the study. Ninety five eyes had aponeurotic repair with or without Blepharoplasty and 77 eyes had Blepharoplasty alone. This modified test has a sensitivity of 98.8% of detecting ptosis. For patients who underwent ptosis surgery with or without Blepharoplasty, 84.2% recorded an improvement in points seen with the test and 81% recorded an improvement in visual field height. For those who had Blepharoplasty alone, 90.9% recorded an improvement in points seen in the modified visual field test and 80.6% had improvement in visual field height. Our modified visual field assessment is a quick and easy way to assess patient disability associated with ptosis and dermatochalasis. Surgery improves the demonstrated defect, confirming that ptosis and dermatochalasis can be considered a functional rather than cosmetic issue.
Robert A. Goldberg - One of the best experts on this subject based on the ideXlab platform.
-
surgical predictors of reduced marginal reflex distance after upper Blepharoplasty
Ophthalmic Plastic and Reconstructive Surgery, 2019Co-Authors: Bunyada Putthirangsiwong, Robert A. Goldberg, Kenneth D Steinsapir, Blake Katsev, Daniel B RootmanAbstract:Purpose Ptosis may occur in certain cases after upper Blepharoplasty. The authors aim to characterize the incidence of postoperative marginal reflex distance (MRD1) reduction after upper Blepharoplasty and surgical variables that may predict this occurrence. Methods In this cross-sectional study, patients > 18 years old undergoing upper Blepharoplasty were screened. Patients were excluded if they had any history of ptosis and brow surgery. Data regarding the excision of skin, muscle, fat, and brow fat as well as crease formation were documented. The distance in millimeter from the center of the pupil to the upper eyelid margin in the midpupillary line (MRD1) was measured digitally. The primary outcome measure was a postoperative reduction in MRD1 of >1 mm. Secondary outcome was overall mean change in MRD1 and the incidence of ptosis as defined by a final MRD1 ≤ 2.5 mm. Results The final sample consisted of 100 patients (200 eyelids) and the mean age was 55.8 years. There were 65 patients with orbicularis muscle removal, 52 patients with postseptal fat removed, and 9 patients with crease formation. Overall 15 patients developed MRD1 decrease of greater than 1 mm (5 bilaterally and 10 unilaterally) with 7 eyes demonstrating a final MRD1 of ≤ 2.5 mm. In multivariate modeling, muscle removal was found to be the only variable with significant impact on the development of MRD1 reduction > 1 mm after upper Blepharoplasty (p Conclusions Fifteen percent of patients demonstrated a reduction in MRD1 > 1 mm after upper eyelid Blepharoplasty, and those with orbicularis resection were more likely to experience this change.The authors' study demonstrates a 15% incidence of postoperative MRD1 reduction after upper eyelid Blepharoplasty. Orbicularis oculi muscle removal was significantly associated with this occurrence.
-
the effect of upper eyelid Blepharoplasty on eyelid and brow position
Orbit, 2016Co-Authors: Tanuj Nakra, Sara P. Modjtahedi, Ivan Vrcek, Stan Saulny, Ronald Mancini, Robert A. GoldbergAbstract:This article evaluates the effect of upper eyelid Blepharoplasty on eyelid margin position and brow height. This study is a retrospective analysis of patients who underwent upper eyelid Blepharoplasty without concurrent blepharoptosis repair or brow surgery. The medical records of the participants were retrospectively reviewed and an established image analysis software was used to quantify the upper margin reflex distance (MRD1) as well as brow height using high quality standardized clinical photographs. A total of 19 patients (38 eyelids and brows) met the inclusion criteria. The mean preoperative MRD1 was 2.8 mm, and the mean post-operative MRD1 was 3.5 mm, revealing an increase of MRD1 from upper Blepharoplasty alone of 0.7 mm (p = 0.0001). The mean preoperative brow position was 17.5 mm above the pupil, and the mean post-operative position was 17.4 mm, for an average change of position of -0.2 mm (p = 0.39) following upper eyelid Blepharoplasty. Upper eyelid Blepharoplasty without ptosis surgery results in a statistically significant increase in MRD1. Brow position does not demonstrate a statistically significant change in patients who undergo upper eyelid Blepharoplasty for simple dermatochalasis.
-
mueller s muscle conjunctival resection with skin only Blepharoplasty effects on eyelid and eyebrow position
Ophthalmic Plastic and Reconstructive Surgery, 2015Co-Authors: Grant H Moore, Daniel B Rootman, Justin Karlin, Robert A. GoldbergAbstract:PURPOSE To determine the effect of concurrent Blepharoplasty and Mueller's muscle conjunctival resection (MMCR) surgery on eyelid position and eyebrow height. METHODS Clinical data from 274 eyes that met inclusion criteria for this study were reviewed. Mueller's muscle conjunctival resection surgery was performed alone in 198 eyes and was performed with concurrent Blepharoplasty in 76 cases. In this study Blepharoplasty consisted of only skin removal, leaving the muscle, fat, and tarsus intact. Preoperative and postoperative pupil to eyebrow, and eyelid margin to eyebrow distances were calculated and compared. RESULTS Preoperative margin reflex distance 1 (MRD1) was similar for both groups of patients (p > 0.05) as was the postoperative MRD1 (p > 0.05). The change in MRD1 was similar between patients undergoing MMCR alone versus those undergoing MMCR with Blepharoplasty (1.5 mm vs. 1.3 mm, respectively, p = 0.36). For similar amounts of tissue resection, the postoperative change in MRD1 was similar for patients undergoing MMCR-only surgery and MMCR with Blepharoplasty (p > 0.05). Eyebrow height significantly decreased following both MMCR with Blepharoplasty (0.73 mm, p < 0.05) and MMCR-only surgery (0.87 mm, p < 0.05), and this change in eyebrow height was not significantly different between the 2 groups. CONCLUSION Combining MMCR surgery with skin-only Blepharoplasty does not significantly alter eyelid height when compared with MMCR surgery alone for the correction of upper eyelid ptosis. This may assist in preoperative planning for combined MMCR with skin-only Blepharoplasty.
-
cosmetic outcome of posterior approach ptosis surgery an american ophthalmological society thesis
Transactions of the American Ophthalmological Society, 2011Co-Authors: Robert A. GoldbergAbstract:PURPOSE: To test the hypothesis that posterior approach ptosis surgery, with or without Blepharoplasty, can improve the cosmetic appearance of the eyelid. METHODS: In a retrospective, observational, consecutive case cohort study, 261 patients who had posterior approach upper eyelid ptosis surgery with or without concurrent Blepharoplasty performed by one surgeon, between 1997 and 2009, were reviewed. Patients were included if they had symmetric eyelid position within 1.5 mm at 3 months after surgery. Outcome measures were subjective grading of eyelid margin contour, millimeters of tarsal platform show (TPS), and millimeters of eyebrow fat span (BFS). Paired preoperative and postoperative standardized photographs were viewed in masked fashion by three experts. RESULTS: One hundred and forty patients (55 men, 85 women, mean age 70 years, range 20-93) who underwent 233 posterior approach procedures for correction of upper eyelid ptosis had postoperative eyelid symmetry within 1.5 mm. Concurrent Blepharoplasty was performed in 67 cases. Eyelid contour scores were significantly improved following surgery (P=.009). Ptosis surgery, without Blepharoplasty, decreased the TPS, from 6.1±2.5 mm to 4.8±2.0 mm (P<.001). Patients who underwent concurrent Blepharoplasty had a statistically insignificant increase of TPS from 4.0±3.5 mm to 4.3±3.6 mm, had a decrease of BFS from 20.8±6.3 mm to 17.7±6.4 mm (P=.001), and showed similar BFS symmetry postoperatively, compared to patients who had ptosis surgery only. CONCLUSIONS: posterior approach surgery alone was often successful in controlling TPS: it shortened the TPS. Blepharoplasty combined with posterior approach ptosis surgery tended to lengthen the TPS and shorten the BFS.
-
acquired strabismus following cosmetic Blepharoplasty
Plastic and Reconstructive Surgery, 2003Co-Authors: Laura Syniuta, Robert A. Goldberg, Neepa Thacker, Arthur L RosenbaumAbstract:The purpose of this study was to report on 12 patients with acquired strabismus following cosmetic Blepharoplasty and to identify patterns of strabismus related to the surgical procedure. Clinical ophthalmologic examinations were performed to specifically clarify the type of strabismus. Operative reports of the Blepharoplasty procedures were reviewed. Patients were followed for a minimum of 3 months after the Blepharoplasty procedure before surgical intervention was considered. Operative findings at corrective strabismus surgery were noted and an attempt was made to correlate these findings with the clinical ophthalmologic examination and the Blepharoplasty surgical procedure. Twelve cases of persistent vertical strabismus occurred following Blepharoplasty procedures. Five patients had clinical findings consistent with the diagnosis of acquired superior oblique palsy; one of these five patients also showed signs of an acquired Brown syndrome. Seven patients developed an incomitant vertical deviation consistent with an inferior rectus paresis. Strabismus occurred after conventional lower lid, upper lid, and four-lid Blepharoplasty with or without laser Blepharoplasty. Acquired strabismus accompanied by persistent diplopia may occur as a complication of cosmetic Blepharoplasty. Extraocular muscle damage resulting in either superior oblique muscle palsy or inferior rectus paresis was noted in these patients. In some cases, patients with inferior rectus paresis also showed mechanical restriction to upward rotation of the globe.
S F Ho - One of the best experts on this subject based on the ideXlab platform.
-
modified visual field test for ptosis surgery leicester peripheral field test
Eye, 2011Co-Authors: S F Ho, A Morawski, Raghavan Sampath, J BurnsAbstract:INTRODUCTION: There is lack of consensus among Primary Health Care Trusts (PCTs) and health insurers on how to reimburse ptosis surgery and upper lid Blepharoplasty, as these procedures can be regarded as cosmetic. Standardised photographs are expensive and difficult to achieve, whilst the routine 24-2 visual field lacks the range to detect visually significant superior field defects.AimTo introduce a modified visual field designed to assess the functional disability associated with ptosis and dermatochalasis and to demonstrate the effectiveness of surgery in improving the visual field. METHODS: Patients who had surgery for ptosis or dermatochalasis between January 2006 and December 2009 were prospectively invited to perform a modified visual field test pre- and post-operatively. RESULTS: In total, 97 patients amounting to 194 eyes were included in the study. Ninety five eyes had aponeurotic repair with or without Blepharoplasty and 77 eyes had Blepharoplasty alone. This modified test has a sensitivity of 98.8% of detecting ptosis. For patients who underwent ptosis surgery with or without Blepharoplasty, 84.2% recorded an improvement in points seen with the test and 81% recorded an improvement in visual field height. For those who had Blepharoplasty alone, 90.9% recorded an improvement in points seen in the modified visual field test and 80.6% had improvement in visual field height. CONCLUSION: Our modified visual field assessment is a quick and easy way to assess patient disability associated with ptosis and dermatochalasis. Surgery improves the demonstrated defect, confirming that ptosis and dermatochalasis can be considered a functional rather than cosmetic issue.