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Aesthetic Plastic Surgery Feb 2022Currently, botulinum toxin (BoNT) injections are the most commonly performed non-invasive procedure for rejuvenation on the upper face. The therapeutic use of botulinum... (Review)
Review
BACKGROUND
Currently, botulinum toxin (BoNT) injections are the most commonly performed non-invasive procedure for rejuvenation on the upper face. The therapeutic use of botulinum toxin has generally been safe and well tolerated. Adverse effects are considered mild, transient, and self-limited. However, as with all other injectable procedures, this one is also susceptible to adverse events and complications. When the safety zones are respected, the chance of any of these complications is practically null. Thus, this review aims to describe the main complications of treatment with BoNT on the upper face and to present a practical guide based on current evidence on how to avoid them.
METHODS
The literature research considered published journal articles (clinical trials or scientific reviews). Studies were identified by searching electronic databases (MEDLINE and PubMed) and reference lists of respective articles.
RESULTS
The main complications secondary to BoNT injections on the upper face are: ptosis of eyelid or eyebrow, eyebrow asymmetry, diplopia, Lakeophthalmos, Palpebral ectropion, and prominence of the palpebral bags. To avoid such complications, it is necessary to have knowledge of the anatomy of this region and adequate and individualized planning based on the existing patterns of the frontalis muscle, glabella, and crow's feet. This review presents the specificities of each of these regions and practical suggestions to obtain satisfactory results, avoiding complications.
CONCLUSION
Particularly on the upper face treatment with BoNT offers predictable results, has few adverse effects, and is associated with high patient satisfaction. However, it is suggested that the commented parameters and safety areas be incorporated into daily practice so that the possibilities of complications are minimized as much as possible.
LEVEL OF EVIDENCE III
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
Topics: Botulinum Toxins, Type A; Face; Forehead; Humans; Rejuvenation; Skin Aging
PubMed: 34341857
DOI: 10.1007/s00266-021-02483-1 -
Tidsskrift For Den Norske Laegeforening... Jan 2024In ectropion, the eyelid margin - typically the lower eyelid - is turned outward. This condition is becoming increasingly common due to the ageing population. Ectropion... (Review)
Review
In ectropion, the eyelid margin - typically the lower eyelid - is turned outward. This condition is becoming increasingly common due to the ageing population. Ectropion is classified as either acquired or congenital, with the former being the most prevalent. Acquired ectropion is further divided into involutional, paralytic, mechanical and cicatricial subtypes. Involutional ectropion is the most common where there is no patient population bias. This clinical review provides an overview of ectropion.
Topics: Humans; Aging; Ectropion
PubMed: 38258716
DOI: 10.4045/tidsskr.23.0309 -
The Turkish Journal of Gastroenterology... Jan 2019Chanarin Dorfman syndrome is a multisystem, very rare, autosomal recessive lipid storage disorder, characterized by the accumulation of lipid vacuoles in neutrophils,...
Chanarin Dorfman syndrome is a multisystem, very rare, autosomal recessive lipid storage disorder, characterized by the accumulation of lipid vacuoles in neutrophils, and was first described by Dorfman in 1974. Due to a mutation in the ABHD5 gene of the short arm of chromosome 3, lipid is stored in the granulocytes at various sites in the human body, such as the muscle, liver, eye, ear, central nervous system, and bone marrow. Clinically, the disease is presented with ichthyosis, hearing loss, hepatomegaly, splenomegaly, cirrhosis, cataract, keratopathy, myopathy, and mental retardation. A 38-year-old male patient was referred to our Internal Medicine Clinic for consultation with laboratory findings as follows: high aspartate aminotransferase (AST; 203 U/L), alanine aminotransferase (ALT; 151 U/L), gamma-glutamyl transferase (GGT; 167 U/L), creatine kinase (CK; 1127 U/L) levels and low platelet levels (108000). After ultrasonography and gastroscopy, the patient was diagnosed with liver cirrhosis. Bilateral mixed-type hearing loss on audial tests and bilateral punctuate keratopathy, ectropion, and cataract in the left eye on ophthalmological tests were found. For the definitive diagnosis of Chanarin Dorfman syndrome, peripheral blood was examined, which revealed lipid accumulation in the neutrophils (Jordan's anomaly). We emphasize that if a patient has unusual findings, such as ichthyosis, hearing loss, hepatomegaly, splenomegaly, cirrhosis, cataract, keratopathy, myopathy, and mental retardation, the possibility of Chanarin Dorfman syndrome should be considered.
Topics: Adult; Cataract; Diagnosis, Differential; Fibrosis; Hearing Loss; Hepatomegaly; Humans; Ichthyosiform Erythroderma, Congenital; Ichthyosis; Intellectual Disability; Lipid Metabolism, Inborn Errors; Male; Muscular Diseases; Splenomegaly
PubMed: 30457558
DOI: 10.5152/tjg.2018.18014 -
Eye (London, England) Mar 2021To report the outcomes of using a modified Bick's procedure (MBP) combined with a monopedicle myocutaneous flap (MMCF) or full-thickness skin grafting (FTSG) to correct...
AIMS
To report the outcomes of using a modified Bick's procedure (MBP) combined with a monopedicle myocutaneous flap (MMCF) or full-thickness skin grafting (FTSG) to correct lower eyelid cicatricial ectropion.
PATIENTS AND METHODS
A retrospective case-note review of patients undergoing cicatricial ectropion repair between 2012 and 2016 was undertaken. Patient demographics, clinical features, the type of surgery, and outcomes were analysed.
RESULTS
Twenty-four eyelids of 21 treated patients (17 males; 81%) with lower eyelid cicatricial ectropion were identified. They presented at an average age of 79.8 years (median 78; range 58-92). The commonest symptom was epiphora (15 eyelids; 63%), 12 patients (50%) experienced intermittent irritation, and 2(8%) had mucoid discharge. The aetiology included actinic cicatricial ectropion with midface descent (n = 19, 79%), previous tumour resection (n = 3, 13%), trauma (n = 1) and other previous eyelid surgery (n = 1). At a mean follow-up period of 15.3 months (median 6; range 6-52), 22 eyelids (92%) had anatomical success with good cosmesis and two eyelids (8%) had mild residual punctal ectropion. Twenty-one patients (87%) experienced functional success. Comparing the outcomes of MBP + FTSG versus MBP + MMCF, there was no statically significant difference in terms of anatomical (p = 0.48) and functional (p = 1.0) success rates. No cases of failure or recurrence were noted during the follow-up period.
CONCLUSIONS
Anterior lamellar deficit ectropion occurs in the absence of overt scarring. It is crucial to fully address both the horizontal laxity and the anterior lamellar deficit associated with such ectropion to minimise the risks of early failure and recurrence. MBP combined with FTSG or MMCF is a safe and effective treatment for such 'cicatricial ectropion' and has a low early recurrence rate.
Topics: Aged; Cicatrix; Ectropion; Eyelids; Humans; Male; Retrospective Studies; Skin Transplantation; Surgical Flaps
PubMed: 32494043
DOI: 10.1038/s41433-020-0998-6