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At least 487 records · Page 27Linked to original sources
PubMed1993

Rigid contact lens design equivalencies of overall diameter and axial edge lift: individual variations.

We compared the effects on rigid contact lens tear pump efficiency of changes in lens overall and optic zone diameter and of changes in lens axial edge lift by measuring corneal oxygen uptake on the right eyes of six human subjects after 5 min of both static and dynamic contact lens wear. Two sets of five lenses were worn by each subject. In set 1, overall diameter varied from 8.2 to 9.4 mm in 0.3-mm steps, with the optic zone diameter being 1.4 mm smaller and a 0.09 mm axial edge lift. In set 2, axial edge lift varied from 0.05 to 0.13 mm in 0.02-mm steps; overall diameter was 8.8 mm, and optic zone diameter was 7.4 mm. For the pooled data, a 0.3-mm decrease in overall diameter was approximately equivalent to a 0.03-mm increase in axial edge lift as a means of enhancing tear pump efficiency. However, considerable intersubject differences were exhibited, with the following increases in axial edge lift being equivalent to the 0.3-mm reduction in overall diameter: 0.01, 0.01, 0.04, 0.06, 0.09, and > 0.20 mm. This illustrates that subject factors (i.e., palpebral aperture size, lid-to-cornea geometry, corneal toricity, peripheral corneal topography, lid tension) influence lens positioning, movement, and tear pump efficiency.

Adult↗
PubMed1996

Limited-incision forehead lift for eyebrow elevation to enhance upper blepharoplasty.

Treatment of eyebrow ptosis to enhance the cosmetic effect from blepharoplasty is commonly done with a forehead lift using a coronal incision approach. The coronal scalp incision is associated with the annoying sequelae of frontoparietal scalp numbness, itching, and paresthesias, all of which can be permanent. A forehead lift technique with temporal scalp incisions only 4.5 to 5.0 cm in length can produce a result comparable with that of the coronal incision approach when combined with transpalpebral resection of the corrugator supercilii muscles and transection of the procerus muscle. This eyebrow elevation technique, like the endoscopic approach, minimizes the risk of permanently injuring the supraorbital nerve branches that innervate the frontoparietal scalp. Unlike the approach using only endoscopy, however, this technique can effectively treat cases of advanced eyebrow ptosis. The appropriate area of eyelid skin for excision may be difficult to assess when a forehead lift and upper blepharoplasty are done concomitantly. The described forehead lift incorporates a method to determine this area. This forehead lift technique, combined with a technique for protecting against overresecting upper eyelid skin, is described as used effectively on 140 blepharoplasty cases followed for 3 months to 4 years.

Eyebrows↗
PubMed1996

Is there a difference? A prospective study comparing lateral and standard SMAS face lifts with extended SMAS and composite rhytidectomies.

Presented is a prospective study comparing limited SMAS (lateral SMASectomy), conventional SMAS, extended SMAS, and composite rhytidectomies. Randomized patients received either a limited SMAS or conventional SMAS face lift on one side and an extended SMAS or composite rhytidectomy on the other. All procedures were performed at Manhattan Eye, Ear and Throat Hospital in accordance with their well-defined surgical descriptions. Postoperative courses were followed clinically for at least 1 year. Photographs were taken preoperatively and at 6 and 12 months postoperatively. Photographs were reviewed by three independent experienced face lift surgeons. The study comprises 21 patients, 20 women and 1 man, with a mean age of 59 years (range 47 to 70 years). Nineteen patients underwent primary rhytidectomies; two underwent secondary face lifts. For the first 12 patients, each had an extended SMAS procedure performed on one side; on the other, 7 had a conventional SMAS and 5 had a limited SMAS (lateral SMASectomy) face lift. In the last 9 patients, a conventional SMAS was carried out on one side in 8, a limited SMAS in 1, and on the opposite side, a composite rhytidectomy was performed. Complications were few. Temporary weakness of the buccal branch of the facial nerve occurred in 2 patients on the side of the more extensive surgery. On the operating table at completion of the surgery, there was more improvement in reversal of midfacial ptosis and flattening of the nasolabial folds with both extended SMAS and composite rhytidectomies. The composite flap had the most dramatic effect on the nasolabial folds and oral commissure. After 24 hours, once swelling developed and facial motion became reactivated, the noticeable differences in the midface and nasolabial folds were lost. No discernible differences in facial halves were noted again. Differences between facial sides on the 6- and 12-month postoperative photographs were not detectable. We conclude that for routine facial plasty, comparable clinical outcomes are obtained at 6 months and 1 year with limited (lateral SMASectomy) and conventional SMAS face lifts compared with extended SMAS and composite rhytidectomies. All procedures are lacking in their improvement of midface ptosis and the nasolabial folds. The increased surgical risks, morbidity, and convalescence associated with those more extensive procedures do not seem to be warranted in the average patient.

Aged↗
PubMed1997

The contribution of the SMAS to the blood supply in the lateral face lift flap.

The purpose of this study was to compare the arterial blood supply of the lateral face lift flap when the flap is elevated either above or below the SMAS. The transverse facial artery supplies blood to a large portion of the lateral face lift flap. This vessel passes through the superficial musculoaponeurotic system (SMAS) in its course toward the flap. The transverse facial artery is at risk for transection during both elevation of the skin flap and elevation of the SMAS. Nine fresh cadavers underwent a single-plane rhytidectomy either superficial to the SMAS or in a sub-SMAS plane. In half the subjects, the transverse facial artery perforator was identified prior to dissection using surface landmarks and preserved. In the other half of dissected specimens, this perforator was transected by undermining through the transverse facial artery perforation site (near the zygomatic ligament). This transection is typically performed during a face lift. The facial artery and transverse facial artery were selectively injected with ink, and cutaneous staining was recorded. It was found that the pattern and total area of ink staining occurred in an all-or-none fashion depending on whether the transverse facial artery had been preserved or transected. Inclusion or exclusion of the SMAS layer in the dissected lateral face lift flap had no effect on the ink injection pattern, suggesting that the SMAS plays little or no role in lateral face lift flap viability.

Cadaver↗
PubMed1998

In pursuit of optimal rejuvenation of the forehead: endoscopic brow lift with simultaneous carbon dioxide laser resurfacing.

Coronal foreheadplasty has long been the traditional method of improving the aesthetic appearance of the forehead, permitting not only repositioning of ptotic tissues but also direct access for modification of the "frown" muscles. However, it was only moderately successful in eliminating vertical corrugator lines or deeply etched transverse wrinkles. The recent advent of the endoscopic brow lift has permitted us to minimize the dysesthesias associated with the coronal approach by making the incisions shorter and radially oriented and by being more precise in the muscle resection. Nonetheless, endoscopic brow lift gives no further improvement in persistent deep vertical and transverse wrinkles. Carbon dioxide laser resurfacing can improve the existing wrinkles but does not eliminate the muscular cause of forehead wrinkles. It seemed reasonable that combining these techniques might yield better results than either procedure alone. To evaluate this possibility, 30 patients with simultaneous endoscopic brow lift and carbon dioxide resurfacing were compared with 24 patients having laser resurfacing only and with 26 patients who had traditional coronal foreheadplasty. Both foreheadplasty groups had corrugator resection. All patients were evaluated at least 4 to 6 months postoperatively. Ratings were based on the percent of wrinkles removed, both vertical and transverse. The ratings were performed with predetermined criteria by a surgeon not involved with the operative procedures nor after care. A rating of "excellent" (> or = 95 percent reduction in wrinkles) was obtained in 50 percent of coronal foreheadplasties; 41.7 percent of carbon dioxide resurfacing alone and 80 percent of endobrow lifts with carbon dioxide laser resurfacing. There was no vascular compromise from this latter combination of procedures, no hypertrophic scars, and no impairment of healing. We conclude that endoscopic brow lift with carbon dioxide laser resurfacing is a safe and perhaps more effective means of aesthetic rejuvenation of the forehead.

Adult↗
PubMed2002

The use of aerosolized fibrin glue in face-lift surgery.

The purpose of this study was to report the use of aerosolized fibrin glue in face-lift surgery. A prospective study was conducted of 48 patients undergoing face-lift surgery sequentially assigned into two groups. The first 24 patients underwent face lifts without glue and the next 24 patients with the use of aerosolized fibrin glue. One surgeon (J.P.F.) performed all the face lifts using the same technique. Drains were only used in those patients who did not receive fibrin glue. The amount of bruising and edema was compared in the two groups, as was the incidence of complications, such as hematomas. Operating time was also assessed in the two groups. The patients in whom glue was used had significantly less bruising and swelling (p < 0.0001), with a more rapid healing response. The risk of hematoma was also less with the use of glue (0 percent) than without glue (8.3 percent), but this was not statistically significant (p = 0.489). Another benefit was that drains were not needed when glue was used. Operating times were shorter by 13.3 minutes with the use of glue (p < 0.0001). Aerosolized fibrin glue has great promise in improving face-lift results, with excellent outcomes and fewer complications. The added cost of the glue is partially offset by an expedited patient recovery period without the need for drains.

Aerosols↗
PubMed1993

An epidemiologic study of non-occupational lifting as a risk factor for herniated lumbar intervertebral disc. The Northeast Collaborative Group on Low Back Pain.

An epidemiologic case-control study of herniated lumbar intervertebral disc was conducted in Springfield, Massachusetts, New Brunswick, New Jersey, and New York, New York, to evaluate the role of several possible risk factors in the etiology of this disorder. Patients with signs and symptoms of herniated lumbar disc (N = 287) were matched to control subjects without back pain by age, sex, source of care, and geographic area. Of the total case-subject group, 177 were confirmed by surgery, computed tomographic scan, myelogram, or magnetic resonance imaging. This article focuses on non-occupational lifting, an activity not previously reported on. Frequent lifting of objects or children weighing 25 or more pounds with knees straight and back bent was associated with increased risk of herniated lumbar disc. This association was particularly strong among confirmed case subjects (relative risk = 3.95). Positive associations among confirmed case subjects were also seen for frequent lifting with arms extended (relative risk = 1.87) and twisting while lifting (relative risk = 1.90). No associations were found for frequent stretching or carrying. If confirmed in other investigations, these data suggest that instruction in lifting techniques should be extended into the home.

Adult↗
PubMed2006

Comparison between intraperitoneal CO2 insufflation and abdominal wall lift on QT dispersion and rate-corrected QT dispersion during laparoscopic cholecystectomy.

This study compared the effect of intraperitoneal CO2 insufflation with abdominal wall lift on RR interval, QT interval, the rate-corrected QT (QTc) interval, QT dispersion (QTD), and the rate-corrected QTD (QTcD) using computerized measurement during laparoscopic cholecystectomy. Thirty patients scheduled for laparoscopic cholecystectomy were randomly assigned to 2 groups: intraperitoneal CO2 insufflation (CO2 group) or abdominal wall lift (lift group). A 12-lead electrocardiogram was monitored to measure parameters. The RR interval, QT interval, and QTc interval did not change significantly during the study in both groups. The QTD and QTcD in the CO2 group increased significantly during CO2 insufflation, and were significantly higher than those of the lift group. Statistically significant increases of QTD and QTcD, which are associated with an increased risk of arrhythmias and cardiac events, occur during CO2 insufflation, and QTD and QTcD in the CO2 group were significantly higher than those of the lift group.

Abdominal Wall↗
PubMed2005

A posterior-stabilized total knee arthroplasty shows condylar lift-off during deep knee bends.

This prospective randomized study was done to examine whether any difference in presentation of condyler lift-off exists between posterior cruciate-retaining and posterior-stabilized total knee arthroplasties. Fluoroscopic analysis of flexion kinematics under weightbearing condition was done for 18 patients who had bilateral paired total knee arthroplasties. The posterior cruciate-retaining and posterior-stabilized prostheses were from the same total knee arthroplasty series with comparable surface geometries and were implanted by one surgeon. At evaluation, five of 18 patients (28%) with posterior cruciate-retaining total knee arthroplasties had condylar lift-off, compared with 12 of 18 patients (67%) with posterior-stabilized total knee arthroplasties. Consequently, a significant difference in its incidence was seen between the groups. Condylar lift-off in posterior-stabilized knees was observed at various flexion angles, and one knee in this group had lift-off laterally and medially at different flexion angles. These findings raise concern that the higher incidence of condylar lift-off in posterior-stabilized total knee arthroplasty may lead to an increased wear rate of polyethylene associated with long-term prosthetic loosening.

Aged↗
PubMed2002

Endoscopic forehead lift: review of technique, cases, and complications.

Endoscopy has provided a significant improvement in the surgical rejuvenation of the upper face. It offers a minimally invasive alternative that avoids many of the undesirable effects associated with the coronal approach. The standard minimal access forehead endoscopic procedure consists of a subperiosteal undermining through three small triangular prehairline incisions. To successfully elevate the eyebrows, it is essential to release the periosteum at the level of the supraorbital rims and ablate the brow depressor muscles of the glabella. Until the periosteum reattaches itself, elevation is maintained by a temporary suspension suture between staples at the incision sites and 5 cm posterior to the hairline. The transverse closure of the triangular skin incisions achieves some additional elevation. The biplanar approach adds a partial subcutaneous undermining of the forehead to the endoscopic technique and allows plication of the frontalis muscle and excision of excess forehead skin. It is offered to patients with very ptotic eyebrows, deep transverse wrinkles, or a high forehead. The prehairline incision is a disadvantage but is tolerated quite well in older patients. The medical records of 393 consecutive patients who underwent endoscopic forehead lift from 1994 to 2000 were reviewed. Because seven patients had the endoscopic forehead lift repeated, the number of forehead endoscopies totaled 400. The complication rate was quite acceptable and did not markedly increase when a forehead lift was performed in combination with other facial procedures. The endoscopic forehead lift consistently attenuated the transverse forehead wrinkles, reduced the glabellar frown lines, and raised the eyebrows. It provided an appearance that was less tired and angry in addition to opening the area around the eyes. Long-term follow-up has shown that the endoscopic forehead lift produces lasting and predictable results.

Adolescent↗
PubMed2006

Body lift: an account of 200 consecutive cases in the massive weight loss patient.

BACKGROUND: The epidemic of obesity in the United States has led to a rapid increase in the number of bariatric procedures performed over the past several years. The dramatic changes to the torso following massive weight loss are only partially addressed by routine procedures such as abdominoplasty and liposuction. Circumferential body lifts or simultaneous abdominoplasty, thigh, and buttock lifts are becoming the method of choice for treating the postbariatric condition. In this article, the authors review the senior author's experience of 200 body lifts with massive weight loss individuals. METHODS: The charts of 200 consecutive body lift patients were reviewed for complications and other variables. The preoperative markings, current surgical technique, and postoperative care are described. The patients were classified into three types according to their body mass index at the time of surgery. Type I individuals had a body mass index less than 28, type II individuals had a body mass index between 28 and 32, and type III individuals had a body mass index greater than 32. RESULTS: Type I and II patients in many instances achieved a nearly ideal body contour. Type II and III individuals also had a significant functional and aesthetic improvement but were more likely to have complications. The overall complication rate was 50.0 percent. The most frequent complications were skin dehiscence and seroma formation at 32.5 percent and 16.5 percent, respectively. CONCLUSIONS: The body lift very effectively addresses the functional and aesthetic concerns of the massive weight loss patient. Careful patient selection and education are essential to a good outcome.

Abdomen↗
PubMed2004

Endoscopic-assisted face lift: review of 200 cases.

The use of endoscopic techniques in facial esthetic surgery has gained increasing popularity in the last decade. Endoscopic forehead rejuvenation became a reliable technique and an attractive option for both the surgeon and the patient. The use of the endoscope in face and neck lift surgery did not gain the same popularity, as explained by the relative few indications for this technique. In this study, we retrospectively review a series of 200 patients who underwent endoscopic-assisted face-lifts alone or in combination with other esthetic procedures. We divided the patients into 4 groups according to the type of incisions and the surgical approach used in each of them. We also reviewed the current status of using the endoscope in face and neck lift surgery. The technique described in this study uses limited access incisions (limited postauricular, submental, and temporal scalp) to reposition the ptotic facial elements, while avoiding the preauricular and postauricular scarring when indicated. Under endoscopic visualization, the composite face-lift flap elevates the malar fat pad above the zygomaticus muscle to the nasolabial fold. The lower-lid orbicularis oculi muscle is incorporated and lifted with composite flap through the lower blepharoplasty incision. The jowl area is contoured by tangential excision and tightening of the lateral platysma. Pretunneling and hydrodissection defines the plane of dissection and helps to reduce the bleeding during facial and cervical flap elevation. In this study, endoscopic techniques were applicable in selected patients undergoing facial rejuvenation with goals of decreased scarring. Indications for using the technique include young patients (eg, less than 50 years) with a relatively small amount of skin excess or older patients with thick skin and minimal skin redundancy. The technique is particularly attractive to the male patient, by avoiding the preauricular incision and the disruption of the beard line. Patients with excess skin underwent the standard cervicofacial incision. In this group the endoscope was used as a tool for better magnification and illumination.

Adult↗
PubMed1992

Enumeration of subgingival species on primary isolation plates using colony lifts.

This study evaluated the feasibility of using a colony lift method and DNA probes to enumerate bacterial species cultured on primary isolation plates. Fourteen digoxigenin-labeled whole chromosomal DNA probes representing 12 subgingival species were validated by hybridization with colony lifts prepared from 249 reference strains of 51 species grown on Trypticase soy agar plates supplemented with 5% sheep blood. Colonies of reference strains were lifted onto Nytran filters from plates and treated to lyse cells, remove cellular proteins, denature and fix microbial DNA to the filters. Positive reactions were detected with an anti-digoxigenin antibody conjugated to alkaline phosphatase and revealed by bromo-chloro-indolyl phosphate and nitroblue tetrazolium. Cross-reactions were not observed for 13/14 probes, but 2 strains of Streptococcus mitis reacted with the probe to Streptococcus sanguis II. Subgingival plaque samples were taken by means of a sterile curette from mesiobuccal surfaces of teeth present in each of 26 subjects with differing periodontal disease states. Samples were dispersed, diluted, plated and incubated anaerobically for 7 d at 35 degrees C. Colonies were lifted as described above. Filters were cut into sections and hybridized with the 14 digoxigenin-labeled DNA probes. The probes were used to enumerate the test species and the total number of isolates was determined in 711 plaque samples. The colony lift method and DNA probes provided a sensitive, economical and quantitative method for enumerating cultivable microbial species in subgingival plaque samples. In addition, the amplification provided by growing the organisms on agar plates facilitated determination of numbers of organisms in small plaque samples, such as those from healthy sites.

Actinomyces↗
PubMed2004

Skin lifting in aesthetic cervicofacial rhytidectomy: personal experience in more than 1500 patients.

BACKGROUND: Skin lifting alone in face-lifting surgery is limited to minor lifts in younger patients. The extent of skin undermining depends on the operative plan. AIMS: An optimal aim is to minimize the amount of undermining to achieve a pleasing, natural rejuvenated result. RESULTS: By respecting the extensive network of the dermal vascular plexus and by good surgical technique, ischaemia of the elevated skin may be minimized. CONCLUSION: Moderate to maximal lifting, however, has proven to be anatomically sound in over 1500 cases operated on over the last 20 years using classical face-lift techniques to correct the pathoanatomy of the ageing face.

Journal Article↗
PubMed1993

Scalp lifting. An 8-year experience with over 1,230 cases.

BACKGROUND: This article reviews the author's 8-year experience with extensive scalp-lifting, which includes 1,230 cases. OBJECTIVE: To overview extensive scalp-lifting paying particular attention to the areas of complications and the ways to reduce them. METHOD: Retrospective analysis of 1,230 cases was done. Necrosis, infection, hematoma, numbness, and scarring were evaluated. RESULTS: 1) Vertical incision occipital artery ligatory should be performed 4 to 8 weeks prior to a scalp lift. 2) Use a delay procedure prior to a frontoparietal advancement flap. 3) Use only lateral lifts on patients with prior punch-grafting. 4) Locate the temporal arteries preoperatively with Doppler ultrasonography. 5) Do not perform frontoparietal advancement flaps on patients with prior punch-grafts. CONCLUSION: Scalp lifting is an extremely effective and expedient method to treat alopecia; however, certain precautionary measures must be taken to obtain excellent, consistent results.

Alopecia↗
PubMed1994

Scalp lifting. Anatomic and technical considerations.

BACKGROUND: Extensive scalp lifting, though offering the potential for tremendous benefit to the patient with extensive male-pattern alopecia, has not been widely accepted or understood. OBJECTIVE: The anatomic and technical features of extensive scalp lifting are discussed. METHODS: The performance of extensive scalp lift surgery must be preceded by a thorough understanding of the specific goals, anatomic considerations, surgical techniques, and specific methods for successful completion of this operation. A knowledge of preoperative preparation, anesthesia, intraoperative methods, undermining, hemostasis, means of scalp advancement, and proper closure are essential for minimizing side effects and complications of this beneficial procedure. One must understand the dynamics of scalp stretching and lifting in order to achieve optimum removal of baldness and to successfully predict the outcome of the operation. CONCLUSION: Present and future advantages of scalp lifting over traditional scalp reduction have been enumerated and discussed.

Alopecia↗
PubMed1997

A comparison of the scalp kinetics in scalp-lifting with and without an intact occipital neurovascular bundle.

BACKGROUND: This paper compares the scalp kinetics of the scalp-lifting procedures with and without an intact occipital neurovascular bundle. OBJECTIVE: The objective of this paper is to perform lateral scalp-lifts and observe if an intact occipital neurovascular bundle hampers the amount of scalp advancement. METHODS: Ten consecutive patients had lateral scalp-lifts performed without severing the occipital neurovascular bundle. Advancements were then measured at three points (mid-posterior, above the pinna, and at the temporal recession). The occipital neurovascular bundle was then divided, and the same measurements were made. RESULTS: An intact occipital neurovascular bundle impeded the amount of advancement that could be accomplished with scalp-lifting. The anterior vector was primarily affected. CONCLUSION: In light of the finding that an intact occipital neurovascular hampers the amount of advancement with scalp-lifting, the surgeon must weigh the advantages and disadvantages of both approaches (prior division of occipital neurovascular bundles versus leaving the bundles intact) when deciding upon the appropriate approach for the given patient.

Adult↗
PubMed2005

The sinus lift with phycogenic bone substitute. A histomorphometric study.

OBJECTIVES: The aim of this histomorphometric prospective study was to ascertain the efficacy of phycogenic bone substitute in an augmented sinus. The process of graft healing, bone remodeling, and biomaterial replacement was examined. MATERIAL AND METHODS: The phycogenic material (fluorohydroxyapatite) made from calcium-encrusted sea algae was used for the sinus lifts. Twenty-four procedures were carried out (one-stage and two-stage equally) and 45 titanium stepped-screw implants were placed. The patients were followed for 12-23 months. In intervals of 6, 9, 12, or 15 months after the sinus lift, 24 graft specimens were taken with a trephine bur. These specimens were examined histomorphometrically. RESULTS: The grafting material was gradually resorbed and replaced by newly formed bone. Between the sixth and 15th month after the sinus lift, the percentage of newly formed bone grew linearly (from 15.5+/-9.6% to 40.8+/-15.3%) and the percentage of bone substitute decreased linearly (from 34.5+/-8.6% to 13+/-9.6%). After 15 months, the density of trabeculae in grafted bone corresponded to cancellous bone of good quality; however, the bone substitute was not completely resorbed during this period. No significant difference between the quality of the newly formed bone in the cases of the one- and two-stage sinus lifts was found. CONCLUSION: Sinus lift carried out with phycogenic bone substitute was shown to be an effective method with limited invasiveness and a high survival rate of implants (97.8%).

Adolescent↗