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At least 631 records · Page 35Linked to original sources
PubMed2003

A new paradigm for the aging Asian face.

Traditionally, Asians have been thought to age more gracefully than Caucasians. The resistance to aging in the Asian patient was credited to the thicker dermis of Asian skin that contains greater collagen and the darker pigment that protects against photoaging. Although these statements are true, the authors propose a new paradigm that explains how the illusion of Asian youthfulness may be understood. The "baby model" purports that the Asian face has many attributes similar to an infant, including a wider and rounder face, higher eyebrow, fuller upper lid, lower nasal bridge, flatter midface, apparently more protuberant lips, and more receded chin. These commonalities between the infant and the Asian compel the viewer to perceive the Asian face as more youthful. However, the Asian face is subjected to a greater amount of gravitational force due to weaker skeletal support, heavier soft tissue, larger amount of malar fat, thicker skin, and a weaker chin. Facial rejuvenative surgery should always be cognizant of the propensity of the Asian skin to unfavorable healing, need for greater tissue suspension, and more conspicuous temporal alopecia. Asian aesthetics that differ and converge with Western ideals are reviewed so that the Western surgeon in particular can comprehend the Asian conception of youthful beauty.

Adipose Tissue↗
PubMed2004

The minimal approach: an innovation in facial cosmetic procedures.

Plastic surgery is a rapidly growing field, particularly the use of less invasive procedures such as biodegradable dermal fillers and botulinum toxin. Aging is a complex process involving two important factors: volume loss throughout the face, and repetitive muscle movements that cause wrinkles and folds. Dermal fillers work by providing support for facial structures, whereas botulinum toxin reduces the mimetic effects. In combination, these products can be used effectively to reshape and rejuvenate the face and neck. Dermal fillers can be used throughout the face to raise the eyebrows, fill the tear trough, reshape the nose, lift the nose tip, fill nasolabial folds and oral comissures, fill the cheeks, raise the cheekbones, reshape the jaw line, and rejuvenate the neck area. This "minimal approach" offers a faster, less painful, and less costly alternative or complement to surgical facelifts. A variety of biodegradable injectable products are currently available, the most common of which are collagen- or hyaluronic acid-based. Using these products in combination takes advantage of their hydrophobic and hydrophilic properties and can provide better and longer-lasting results. The addition of botulinum toxin can further extend the duration of results by reducing the mimetic stress that can break down the polymers. With regular maintenance treatments, the minimal approach using dermal fillers and botulinum toxin can give patients a "whole new look" with a fast and relatively painless lunchtime procedure.

Absorbable Implants↗
PubMedDate not supplied

Open frontal lift: a conservative approach.

This study aimed to demonstrate that during an open frontal lift, transection of the galea is not necessary. The forehead is elevated, and the ptotic brow is raised after a strip of skin or scalp is removed by folding of the galea. The marcation is penciled on the skin according to the amount of skin--scalp the surgeon estimates it is necessary to remove. Local anesthesia is profusely injected, separating all layers and facilitating surgery. The skin is stripped off the galea, and then through a small incision in the middle, a large dissector separates the galea from the periosteum of the forehead and temporal regions. This dissection can be completed from the temporal area or from the blepharoplasty incisions. With a long pair of scissors, the orbital borders are reached and opened perpendicularly to the bone, releasing the fascia and muscle attachments from the orbital rim without anything being cut. During the coronal approach, once the scalp and forehead are completely mobile, the galea is folded with a continuous running 3/0 Vicryl suture, which after five or six big bites is strongly pulled to fold the galea. The wound then is sutured without tension using staples. When the incision is precapillary, the folding is fixed with Vicryl 3/0 uncolored thread, and the skin is sutured with mononylon 6/0. Complementary corrugator transections are performed from the blepharoplasty incision or by use of the endoscope. With the coronal approach, the surgery requires about 20 min, whereas the precapillary approach requires about 40 min. When only the skin is removed, bleeding is scarce and frontal postoperative edema is minimal. The author has used these techniques in 22 precapillary cases and the intracapillary procedure in 28 cases, some of which had a 4-year follow-up period. With the precapillary approach, temporary paresthesia occurred in some cases, but in all cases, sensibility was recovered within the first 2 to 6 months. With this simple and brief technique, the galea is not transected, no branches of the sensitive nerves are sectioned, and temporal and frontal arteries and veins that supply the scalp are not interrupted. Thereafter, wound healing is fast, allowing a quick recovery without areas of permanent numbness. As a result of this technique, the position of the eyebrows is the same as when frontal lifts are performed with transection of the galea and eversion of the flap, but without the side effects.

Contraindications↗
PubMedDate not supplied

A new technique applying botulinum toxin in narrow and wide foreheads.

The use of botulinum toxin is becoming increasingly popular, and application details are being examined in an effort to achieve more satisfactory results with fewer side effects. In the forehead area, the main considerations are the effacement of forehead wrinkles to a desirable extent and the prevention of complications such as ptosis of the eyebrow and upper eyelid. The frontalis muscle necessitates chemodenervation by botulinum toxin at multiple points for the desired effect. The dimensions of foreheads, and thus the frontalis muscle, differ from patient to patient. The effectiveness and side effects change according to whether the forehead is narrow or a wide. Therefore, no single application technique is best for all patients. For this study, the glabella-hairline distance was measured in 90 healthy adults. Patients with a vertical forehead length exceeding 70 mm were regarded as having a wide forehead, and the botulinum toxin was applied in three vertical lines in two split doses. On the other hand, individuals with a vertical forehead length of less than 60 mm were regarded as having a narrow forehead, and the toxin was applied in two split doses in three horizontal lines. The authors have found that in cases of wide or narrow foreheads, the effectiveness of the toxin increased, whereas the side effects such as brow asymmetry and ptosis were not encountered. Thus, they recommend the use of this technique for patients with wide or narrow foreheads.

Adult↗
PubMed2004

Two-plane injection of botulinum exotoxin A in glabellar frown lines.

Botulinum exotoxin A has been used for the treatment of glabellar frown lines. Despite this fact, the effect of the toxin is sometimes either partial or lost in a short time. The muscles responsible for frowning, the corrugator supercilii and depressor supercilii muscles, are attached to the periosteum in the glabellar region under the frontalis muscle deep in the medial aspect. The muscles then course laterally and superficially to insert in the skin superior to the eyebrows. Thus, to get a long-lasting and full effect, the exotoxin has been applied deeply in the medial aspect and superficially in the lateral aspect of the glabellar region. It is concluded that botulinum exotoxin is more effective when it is applied in two planes superficially and deep so that the anatomic course of the corrugator supercilii and the depressor supercilii muscles are followed.

Botulinum Toxins, Type A↗
PubMed2004

Caveats for the use of suspension sutures.

Suspension sutures may be considered a method for elevating ptotic tissue. This method often uses a limited access incision, and commonly is used in cosmetic surgery. The caveats for the technique are not well described. This article describes eight caveats for successful suture suspension. A method for performing this procedure with a spinal needle is described, using the lateral eyebrow as an example.

Blepharoplasty↗
PubMedDate not supplied

Improving the lateral fullness of the upper eyelid.

The lateral fullness of the upper eyelid is its convex surface area from the eyebrow to the eyelid crease. Rejuvenation of upper eyelids can be achieved by accenting their fullness. An S-shaped fusiform skin segment is removed from the upper eyelid, with care taken to spare the orbicularis occuli muscle. Approximately 1 ml of fat tissue is excised from the medial compartment by transmuscular incision. The fat is placed in the crease, and the orbicularis occuli muscle is stitched together over the transplanted fat tissue. Imbrication of the orbicularis occuli muscle and insertion of 1 ml of fat tissue into the muscle layers increase the lateral fullness and significantly emphasizes the aesthetic result of upper eyelid blepharoplasty.

Adult↗
PubMedDate not supplied

Botulinum toxin A and facial lines: the variable concentration.

Our improved understanding of the functional anatomy of the face and of the action of the botulinum toxin A leads us to determine a new injection procedure which consequently decreases the risk of eyebrow and eyelid ptosis, and increases the toxin injection's possibilities and efficiencies. Variable toxin injection concentrations adapted to each injected area are used. Thanks to the new procedure in the upper face, toxin A action is quite close to an endoscopic surgical action. In addition, interesting results are achievable on the nose, upper part of the nasolabial fold, jawline and neck regions. Lastly, a smoothing effect on the skin is obtained by the anticholinergic action of the toxin A on the dermal receptors.

Adult↗
PubMed1997

Psychogenic pseudoptosis.

Three patients with psychogenic pseudoptosis of one eyelid are reported. All showed depression of the eyebrow on the affected side. The clinical course varied: in two patients the symptom resolved spontaneously after positive reassurance; in the third patient it remained unchanged for 2 years.

Adult↗
PubMed2004

Ocular symptoms and signs in patients with ectodermal dysplasia syndromes.

PURPOSE: The ectodermal dysplasia syndromes are underestimated although precise inclusion criteria have been formulated. The purpose is to establish easily detectable ophthalmologic symptoms and signs as reliable criteria for ectodermal dysplasia syndromes. METHODS: Thirty-six patients with confirmed ectodermal dysplasia syndromes were included in an observational case series: hypohidrotic ectodermal dysplasia (30), EEC syndrome (3), AEC syndrome (2), Gorlin-Goltz syndrome (1). Each patient was examined ophthalmologically. The principal outcome measures were ocular symptoms and signs in patients with different ectodermal dysplasia syndromes of varying severity. METHODS: Some 94.4% of the patients suffered from dry eye symptoms. Reduction of eyebrows was seen in 94.4%; the lashes were altered in 91.6%. Changes of the meibomian glands were detected in 95.45%. Corneal changes such as pannus occurred later in life. CONCLUSIONS: Alterations of the meibomian glands, which were detected by meibomianoscopy, are the most reliable ocular sign of ectodermal dysplasia syndromes.

Adolescent↗
PubMed2003

Congenital disorder of glycosylation type 1a in a macrosomic 16-month-old boy with an atypical phenotype and homozygosity of the N216I mutation.

UNLABELLED: We report on a 16-month-old boy with congenital disorder of glycosylation type 1a (CDG-1a; OMIM 212065) showing an atypical phenotype. Whereas failure to thrive is known to be a prominent feature in this condition, our patient developed postnatal macrosomia with increase of weight, length and occipitofrontal circumference (OFC) above the 95th percentile within his 1st year of life. Thereafter, weight and length were close to the 90th and OFC at the 50th percentiles. In contrast to other CDG-1a patients, the child did not have abnormal fat pads or inverted nipples; but unusual eyebrows were present. CDG-1a was confirmed by isoelectric focusing of serum transferrin and measurement of phosphomannomutase activity in leucocytes and cultured fibroblasts (residual activity <5% of controls). Mutation analysis of the phosphomannomutase 2 gene (PMM2) revealed homozygosity for a 647A>T (N216I) mutation in our patient and heterozygosity in his consanguineous parents. CONCLUSION: This is the first report of macrosomia and of homozygosity for the 647A>T (N216I) mutation in a patient with congenital disorder of glycosylation type 1a which may allow further phenotype/genotype comparisons.

Body Mass Index↗
PubMed1997

Osteopathia striata, short stature, and characteristic facies: a previously unknown skeletal dysplasia.

UNLABELLED: We report two sporadic cases of a hitherto undescribed skeletal dysplasia with short stature and characteristic facies. The present patients, a 6-year-old girl and a 15-year-old boy, were almost equally affected. Craniofacial anomalies included a sloping forehead, bitemporal bulging, sparse medial eyebrows, a prominent nasal bridge, hypertelorism, proptosis, a beaked nose, hypoplastic alae nasi and a pointed chin. Shallow orbits, short anterior cranial fossae and bitemporal bossing found on skull radiograph corresponded with the facial dysmorphism. Thickening of the dorsum sellae was another hallmark in the skull. Skeletal survey revealed mild osteopenia, interpediculate narrowing of the lumbar spine with short neural arches and, most important, osteopathia striata of the long tubular bones. There was no sclerosis of the craniofacial bones. The clinical and radiological findings in the present patients were overall inconsistent with those of previously known skeletal dysplasias and congenital malformation syndromes, which possess osteopathia striata as a cardinal feature. CONCLUSION: The unique clinical and radiological constellation of our patients constitutes a hitherto unknown bone dysplasia.

Adolescent↗
PubMed2004

Neurosurgical management of orbital inflammations and infections.

BACKGROUND: We present an overview of the treatment and clinical outcome of 22 orbital inflammations and infections, carried out in our center from 1991 to 2002. METHOD: The surgical approach was determined by the location, and type of the lesion. Lateral orbitotomy was performed in 2 laterally located lesions, a transconjunctival approach in 8 medial, basal, extra-, intraconal lesions. Pterional intradural (5), and extradural (3) approaches were used in case of intracranial involvement or location in the orbital apex and optic canal. Lesions of the lid were operated via eyebrow incision. FINDINGS: Bacterial infections were confirmed in 5 cases (1 mucocele, 3 abscesses, 1 necrotizing inflammation). 15 patients were diagnosed as chronic inflammatory pseudotumors, 6 of whom showed a granulomatous subtype, and 3 involvement of the optic nerve. All patients failed to reveal systemic disease and had a localized orbital inflammatory process. 7 of the patients responded rapidly to systemic corticosteroid treatment with no episodes of recurrence. 3 patients showed recurrence despite corticosteroids. CONCLUSIONS: Orbital infections are cured by antibiotic treatment. The course of inflammatory pseudotumor is variable and requires multidisciplinary treatment. Therapeutic options include surgical biopsy or debulking, corticosteroids, chemotherapy, and radiation therapy.

Abscess↗
PubMed1999

[Risk of oral piercing].

Oral and facial piercing with different kinds of body art are being observed more frequently in medical and dental practices. Principally, piercing is not a new form of body art and is traditional in different geographical areas. Various materials are used. Besides tongue and lip piercing, different locations of the face such as the eyebrows and the nose are anatomical areas of piercing. The aim of this article is to demonstrate different forms of oral piercing, illustrated by own observations. The piercing procedure is briefly described. Piercing is usually performed without local anaesthesia and stepwise. In a literature review, the possible risks and complications are summarised. Postprocedural complications are oedema, haemorrhage and infection. Other complications are foreign body granulomas or allergies, particularly against nickel. Dentists, and oral- and maxillofacial surgeons should be in a position to advise patients with oral or facial piercings or those who plan to have this type of body art performed.

Adult↗
PubMed2004

A 1-Mb critical region in six patients with 9q34.3 terminal deletion syndrome.

Patients with 9q34.3 terminal deletion usually show a clinically recognizable phenotype characterized by specific facial features (microcephaly, flat face, arched eyebrows, hypertelorism, short nose, anteverted nostrils, carp mouth and protruding tongue) in combination with severe mental retardation, hypotonia, and other anomalies. We analyzed six unrelated patients with a various 9q34.3 terminal deletion. While having different-sized 9q34.3 deletions, all of these patients shared several distinctive anomalies. These anomalies are likely to arise from a commonly deleted region at distal 9q34.3. Fluorescence in situ hybridization (FISH) analysis using a dozen BAC clones mapped at the 9q34.13-q34.3 region defined the shortest region of deletion overlap (SRO) as a 1-Mb segment proximal to 9qter containing eight known genes. Possible candidate genes delineating specific phenotypes of the 9q34.3 terminal deletion syndrome are discussed.

Centromere↗
PubMed2002

Analysis of novel and recurrent mutations responsible for the tricho-rhino-phalangeal syndromes.

The tricho-rhino-phalangeal syndromes (TRPS type I, II, and III) are autosomal dominant disorders sharing the following characteristics: slowly growing and sparse scalp hair, medially thick and laterally thin eyebrows, bulbous tip of the nose, long flat philtrum, thin upper lip with vermilion border, and protruding ears. In addition, individuals with TRPS generally share skeletal and bone anomalies, including shortening of the phalanges and metacarpals (mild to severe brachydactyly), cone-shaped epiphyses, hip dysplasia, and short stature. The etiology of the different types of TRPS can result from either single base pair mutations, or the complete deletion of the TRPS1 gene, which encodes a zinc-finger transcription factor located on chromosomal band 8q24.1. We have identified nine heterozygous mutations, five novel and four recurrent, in unrelated families diagnosed with TRPS. The five novel mutations identified show 1- or 2-bp deletions and a single base substitution, whereas all of the recurrent mutations are single base substitutions. Seven of the nine mutations result in a premature stop codon, leading to a truncated, nonfunctional TRPS1 protein. The final two mutations are missense mutations in the GATA DNA binding zinc finger, which is believed to be important for the protein's normal function.

Amino Acid Substitution↗
PubMed2006

A new mark test for mirror self-recognition in non-human primates.

For 30 years Gallup's (Science 167:86-87, 1970) mark test, which consists of confronting a mirror-experienced test animal with its own previously altered mirror image, usually a color mark on forehead, eyebrow or ear, has delivered valuable results about the distribution of visual self-recognition in non-human primates. Chimpanzees, bonobos, orangutans and, less frequently, gorillas can learn to correctly understand the reflection of their body in a mirror. However, the standard version of the mark test is good only for positively proving the existence of self-recognition. Conclusive statements about the lack of self-recognition are more difficult because of the methodological constraints of the test. This situation has led to a persistent controversy about the power of Gallup's original technique. We devised a new variant of the test which permits more unequivocal decisions about both the presence and absence of self-recognition. This new procedure was tested with marmoset monkeys (Callithrix jacchus), following extensive training with mirror-related tasks to facilitate performance in the standard mark test. The results show that a slightly altered mark test with a new marking substance (chocolate cream) can help to reliably discriminate between true negative results, indicating a real lack of ability to recognize oneself in a mirror, from false negative results that are due to methodological particularities of the standard test. Finally, an evolutionary hypothesis is put forward as to why many primates can use a mirror instrumentally - i.e. know how to use it for grasping at hidden objects - while failing in the decisive mark test.

Animals↗
PubMed2006

Do facial gestures, visibility or speed of movement influence gaze following responses in pigtail macaques?

This study investigated whether a human model's facial gestures, speed of head turn and visibility of face influenced gaze-following responses (GFR) in pigtail macaques. A human provided gaze cues by turning her head 90 degrees in one of four directions. Head turns were immediately followed by a facial movement (pucker, eyebrow raise, tongue protrusion, neutral), or were executed swiftly (<0.5 s), slowly (3 s) or whilst facing away from the monkeys. All monkeys reliably followed the gaze in all conditions with no differences between conditions. A greater frequency of GFR was found in females compared to males, and two hypotheses for this finding are discussed.

Animals↗