The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Sam T Hamra - One of the best experts on this subject based on the ideXlab platform.
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the role of the septal reset in creating a youthful eyelid cheek complex in facial rejuvenation
Plastic and Reconstructive Surgery, 2004Co-Authors: Sam T HamraAbstract:Resetting of the septum orbitale over the orbital rim, or "septal reset," is the latest step in achieving Periorbital rejuvenation in composite rhytidectomy. The first significant step was the addition of orbicularis repositioning to conventional lateral vector deep plane rhytidectomy, followed by orbital fat preservation using the arcus marginalis release and fat transposition over the orbital rim. Those early procedures have been further refined to include the zygomaticus muscles with the orbicularis oculi in the composite flap, or zygorbicular cheek flap, and a septal reset. The septum orbitale reset has distinct advantages over transposition of orbital fat alone, as it creates a firmer undersurface for the lower eyelid. This maneuver will create a truly youthful lower eyelid-cheek complex, as the normal concave aging skeletonization of the periorbit is transformed to a convex contour of youth. The effectiveness of this operation can be demonstrated in most variations of human anatomy, whether congenital or iatrogenic, allowing the plastic surgeon to utilize the septal reset in virtually every patient undergoing and desiring a harmonious facial rejuvenation.
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a study of the long term effect of malar fat repositioning in face lift surgery short term success but long term failure
Plastic and Reconstructive Surgery, 2002Co-Authors: Sam T HamraAbstract:In 1990, the author reported on a series of 403 cases of deep plane face lifts, the first published technique describing the repositioning of the cheek fat, known as malar fat, in face lift surgery. This study examines the long-term results of 20 of the original series in an attempt to determine what areas of the rejuvenated face (specifically, the malar fat) showed long-term improvement. The results were judged by comparing the preoperative and long-term postoperative views in a half-and-half same-side hemiface photograph. The anatomy of the jawline (superficial musculoaponeurotic system [SMAS]), the nasolabial fold (malar fat), and the Periorbital diameter were evaluated. The results confirmed that repositioning of the SMAS remained for longer than improvement in the nasolabial fold and that the vertical diameter of the periorbit did not change at all. The early results of malar fat repositioning shown at 1 to 2 years were successful, but the long-term results showed failure of the early improvement, manifested by recurrence of the nasolabial folds. There was, however, continuation of the improved results of the forehead lift and SMAS maneuvers of the original procedure. The conclusion is that only a direct excision will produce a permanent correction of the aging nasolabial fold.
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Periorbital rejuvenation in composite rhytidectomy
Operative Techniques in Plastic and Reconstructive Surgery, 1998Co-Authors: Sam T HamraAbstract:Conventional blepharoplasty and rhytidectomy techniques do not adequately address the Periorbital area in facial rejuvenation. Conventional blepharoplasty, whether transcutaneous or transconjunctival, normally removes lower-eyelid fat when present and only redrapes the skin from the incision line to the orbital rim. The eyelid frequently appears more hollow after surgery. The diameter of the periorbit does not become youthful, and narrow because the complete orbicularis muscle has not been repositioned. Traditional rhytidectomy techniques redrape facial tissues in a lateral direction toward the ear without repositioning of the orbicularis muscle. Composite rhytidectomy and arcus marginalis release create Periorbital rejuvenation by preservation and repositioning of the lower-eyelid fat and repositioning of the orbicularis oculi muscle. This procedure satisfies the goal of harmonious facial rejuvenation by making the lower-eyelid-cheek complex appear as young as the remaining parts of the face that have been surgically rejuvenated. Recent modifications of the arcus marginalis release and the orbicularis repositioning allow more predictable results. These modifications are a zygorbicular (zygorbicular-orbicularis) cheek dissection with an arcus marginalis release and septal reset. A transcanthal canthopexy stabilizes the lateral canthal position. Creation of a firm suborbicularis convex surface with this Periorbital rejuvenative technique prevents a hollow lower eyelid and improves the appearance of redraped eyelid skin.
Eduardo D. Rodriguez - One of the best experts on this subject based on the ideXlab platform.
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eyelid transplantation lessons from a total face transplant and the importance of blink
Plastic and Reconstructive Surgery, 2015Co-Authors: Michael Sosin, Mark Fisher, Amir H Dorafshar, Branko Bojovic, Nicholas T Iliff, Gerhard S Mundinger, Michael R Christy, Eduardo D. RodriguezAbstract:BACKGROUND Despite inclusion of Periorbital structures in facial transplants, critical assessment of posttransplantation short- and long-term Periorbital function has not been reported. The purpose of this article is to report recovery of ocular and Periorbital function, with critical appraisal of posttransplant blink in the setting of revision surgery. METHODS Prospective ocular and Periorbital functional assessments were completed at multiple time points in a patient undergoing facial transplantation and subsequent revision operations. Function was evaluated using clinical ocular examinations, visual acuity assessments, photography, and video at various intervals from preoperative baseline to 13.5 months after transplantation. During this period, revision operations involving Periorbital structures were performed at 6 and 9 months after transplantation. RESULTS Before transplantation, volitional blink was 100 percent in both eyes. Involuntary blink was 40 percent in the right eye and 90 percent in the left eye, with occasional full closure. Following face transplantation, voluntary blink was preserved, partial skin sensation was present, and involuntary blink improved to 70 percent in the right eye and 100 percent in the left eye. Following revision surgery, visual acuity and voluntary and involuntary blink were impaired. By 7.5 months after revision, improvement comparable to the pretransplantation assessment was observed. CONCLUSIONS Adherence to principles of blink preservation is critical in Periorbital transplantation. Involuntary blink is essential for preserving vision, and can be improved after transplantation. Revision surgery may temporarily impair advances made with initial allotransplantation. A comprehensive understanding of ocular biomechanics and function is invaluable to the reconstructive surgeon performing facial transplantation involving Periorbital structures and posttransplant revision operations. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, V.
Johannes Geier - One of the best experts on this subject based on the ideXlab platform.
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Periorbital dermatitis in 4779 patients patch test results during a 10 year period
Contact Dermatitis, 2014Co-Authors: Lilla Landeck, Swen Malte John, Johannes GeierAbstract:Summary Background The thinness of the Periorbital skin may facilitate allergen penetration, making this area particularly susceptible to sensitization. Material and methods For the cross-sectional study, data were collected by the 57 participating centres of the Information Network of Departments of Dermatology. A total of 101 403 patients patch tested between January 2001 and December 2010 were included. Of these, 4779 patients suffered from Periorbital dermatitis. Results Two major subgroups with different general epidemiological data and sensitization to specific allergens have to be considered: (i) young females with increased rates of skin atopy and allergies, particularly from cosmetic and skin care products; and (ii) older subjects with allergy to topical medications. The prevalence of sensitization to ophthalmic allergens is generally less than that to environmental allergens. Conclusions Allergic contact dermatitis is a leading cause of Periorbital dermatitis. Patch testing should be considered in all patients with Periorbital dermatitis when contact allergy is suspected, in order to identify and avoid offending allergens.
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allergic and non allergic Periorbital dermatitis patch test results of the information network of the departments of dermatology during a 5 year period
Contact Dermatitis, 2004Co-Authors: Rudolf A Herbst, Claudia Pirker, Wolfgang Uter, Johannes Geier, Peter J. FroschAbstract:Periorbital dermatitis is common and can be due to the external use of ophthalmic drugs. We evaluated patch test results of the Information Network of the Departments of Dermatology. During a 5-year period (1995–99), of a total 49 256 patch-tested patients, 1053 (2.1%) were eventually diagnosed as allergic Periorbital contact dermatitis (APD) and 588 (1.2%) as non-allergic Periorbital dermatitis (NAPD). Patient characteristics between APD, NAPD and other cases (OCs) differed with respect to sex (19.7% male in both Periorbital groups versus 36.3% in OCs), atopic dermatitis (10.4% in APD versus 60.2% in NAPD versus 16.9% in OCs) and age, APD being substantially more often (68.2%) aged 40 and above than NAPD (52.6%). Several of the top allergens in OCs [such as fragrance mix, Myroxylon pereirae resin (balsam of Peru), lanolin alcohol and potassium dichromate] caused significantly fewer positive test reactions in both Periorbital groups. In contrast, thimerosal, phenylmercuric acetate, sodium disulfite, gentamicin sulfate, phenylephrine hydrochloride and benzalkonium chloride tested positively significantly more often in APD but not in NAPD, verifying them as true ophthalmic allergens. Finally, in 42 cases (4%) of APD patients, additional allergens were identified by testing of the patients' own substances (mostly β-blockers, oxybuprocaine and dexpanthenol), supporting the necessity of testing with ophthalmic drugs as is where individual substances are not readily available.
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allergic and non allergic Periorbital dermatitis patch test results of the information network of the departments of dermatology during a 5 year period
Contact Dermatitis, 2004Co-Authors: Rudolf A Herbst, Claudia Pirker, Wolfgang Uter, Johannes Geier, Peter J. FroschAbstract:Periorbital dermatitis is common and can be due to the external use of ophthalmic drugs. We evaluated patch test results of the Information Network of the Departments of Dermatology. During a 5-year period (1995-99), of a total 49,256 patch-tested patients, 1053 (2.1%) were eventually diagnosed as allergic Periorbital contact dermatitis (APD) and 588 (1.2%) as non-allergic Periorbital dermatitis (NAPD). Patient characteristics between APD, NAPD and other cases (OCs) differed with respect to sex (19.7% male in both Periorbital groups versus 36.3% in OCs), atopic dermatitis (10.4% in APD versus 60.2% in NAPD versus 16.9% in OCs) and age, APD being substantially more often (68.2%) aged 40 and above than NAPD (52.6%). Several of the top allergens in OCs [such as fragrance mix, Myroxylon pereirae resin (balsam of Peru), lanolin alcohol and potassium dichromate] caused significantly fewer positive test reactions in both Periorbital groups. In contrast, thimerosal, phenylmercuric acetate, sodium disulfite, gentamicin sulfate, phenylephrine hydrochloride and benzalkonium chloride tested positively significantly more often in APD but not in NAPD, verifying them as true ophthalmic allergens. Finally, in 42 cases (4%) of APD patients, additional allergens were identified by testing of the patients' own substances (mostly beta-blockers, oxybuprocaine and dexpanthenol), supporting the necessity of testing with ophthalmic drugs as is where individual substances are not readily available.
Sheri L Demartelaere - One of the best experts on this subject based on the ideXlab platform.
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use of the boston ocular surface prosthesis in the management of severe Periorbital thermal injuries a case series of 10 patients
Ophthalmology, 2012Co-Authors: Kevin Kalwerisky, Brett W Davies, L Mihora, Craig N Czyz, Jill A Foster, Sheri L DemartelaereAbstract:Purpose To report the use of the Boston Ocular Surface Prosthesis (BOSP) in patients with severe Periorbital thermal injuries. Design Retrospective, interventional case series. Participants Patients with severe Periorbital thermal injuries treated with the BOSP. Methods Chart review of 10 consecutive patients (16 eyes) who sustained severe Periorbital thermal injuries during combat missions in Iraq and Afghanistan and were treated for exposure keratopathy with the BOSP, a Food and Drug Administration-approved gas-permeable, scleral contact lens. Main Outcome Measures Corneal epithelial defect healing, uncorrected and best-corrected visual acuity, and BOSP wear time. Results Exposure keratopathy occurred after severe Periorbital thermal injuries and followed a predictable course of scar contracture. In all patients, vision-threatening ocular surface disease developed as a result of chronic ocular exposure. Rehabilitation of the ocular surface was accomplished using the BOSP, with 10 of the 16 treated eyes achieving a corrected visual acuity of 20/70 or better. Five eyes achieved a best-corrected visual acuity of 20/40 or better. The BOSP also was used as a drug-delivery vehicle to treat corneal ulcers successfully in 6 eyes. The only eye that required penetrating keratoplasty was an early intervention believed to be a direct sequelae of the original thermal burn, rather than a failure of the BOSP regimen. The mean BOSP wear time was 16 hours per day. Conclusions The BOSP can play an important role in rehabilitation of the ocular surface for patients with severe Periorbital thermal injuries and resultant exposure keratopathy. Use of the BOSP should be considered as a treatment option for these difficult cases of severe Periorbital thermal injuries. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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neoadjuvant chemotherapy specific and overall treatment outcomes in patients with cutaneous angiosarcoma of the face with Periorbital involvement
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2008Co-Authors: Sheri L Demartelaere, Dianna B Roberts, M A Burgess, William H Morrison, Peter W T Pisters, Erich M Sturgis, Bita EsmaeliAbstract:Background. Recent isolated case reports have suggested a potential role for neoadjuvant chemotherapy in patients with angiosarcoma. The goal of this report was to inves- tigate the overall treatment outcomes and the neoadjuvant chemotherapy-specific outcomes in patients with cutaneous angiosarcoma of the face with Periorbital involvement. Methods. Our tumor database was searched for patients with angiosarcoma and Periorbital involvement seen at our insti-
Steven Fagien - One of the best experts on this subject based on the ideXlab platform.
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advanced rejuvenative upper blepharoplasty enhancing aesthetics of the upper Periorbita
Plastic and Reconstructive Surgery, 2002Co-Authors: Steven FagienAbstract:The surgical approach to rejuvenation of the Periorbita continues to evolve with the application of procedures that are safe and effective with a greater sensitivity of aesthetics. Most of the topics in the recent literature discuss improvements with techniques relating to the lower eyelid and midface. Improved surgical techniques of the upper Periorbita have been mostly limited to advances in brow lifting. The most common and traditional approach to upper blepharoplasty has remained essentially unchanged and has not considered, to the same degree as in the lower Periorbita, the actual changes that occur with age or more accurate surgical approaches toward rejuvenation. The author presents an overview of his personal view of the concepts relating to the aging upper Periorbita and discusses his experiences with this procedure.
