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.

Hyaluronic acid filler injections can successfully treat cicatricial ectropion by expanding the tethered anterior lamella of the skin. This provides an effective alternative to surgical correction of the lid. The treatment is quick, safe, and easy to learn.

Background Precise injection technique is vital for avoiding suboptimal eyebrow position when treating glabellar lines with botulinum toxin type A. Objectives The aim of this study was to evaluate the impact of glabellar injection technique on eyebrow position in patients treated with DaxibotulinumtoxinA for Injection (DAXI). Methods This retrospective post hoc analysis involved 60 adults who received a single treatment with DAXI 40 U to the glabella and had standardized facial photography. Median vertical and horizontal displacement of the brows (at rest) at baseline and 2 weeks after glabellar injection were measured. Brow position outcomes were evaluated by an oculoplastic surgeon and expert anatomist. Investigators were interviewed to ascertain individual injection techniques. Results Precise injection location and depth, and median resting brow position following treatment varied between investigators. Positive brow outcomes were achieved with deep DAXI injections into the medial corrugator, superficial lateral corrugator injections placed between the midpupil and lateral limbus, and deep midline procerus injections. Glabellar injection technique that more precisely targeted the corrugator muscles resulted in longer glabellar line treatment duration compared to a less targeted technique. Medial corrugator injections above the medial brow; lateral corrugator injections administered deeply or more medially, toward the medial third of the brow; and procerus injections superior to the inferomedial brow tended to be associated with suboptimal outcomes that were more apparent during dynamic expression. Conclusions Aesthetically pleasing brow outcomes and greater duration of efficacy can be achieved with an injection pattern that precisely treats the anatomic location of the corrugator supercilii and procerus muscles, avoiding the frontalis. Level of Evidence: 4

The sigmoid upper eyelid blepharoplasty technique recreates a truly youthful eyelid with novel eyelid concepts. The surgery is safe and reproducible, and consistent results are achievable.

This study numerically confirmed that the lower eyelid length vertically increases with age. Documenting that the lower lid does lengthen every decade of life and obtaining average numerical values of lower lid length allows physicians insight into the expected aging changes and typical amount of lower lid lengthening at each decade. This also provides blepharoplasty surgeons another tool to more accurately define the aging process and creates a baseline and a potential goal in restoring a more youthful lid.