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Facial Trauma
Published in Dorian Hobday, Ted Welman, Maxim D. Horwitz, Gurjinderpal Singh Pahal, Plastic Surgery for Trauma, 2022
Dorian Hobday, Ted Welman, Maxim D. Horwitz, Gurjinderpal Singh Pahal
If you do not suspect damage to any of the above key structures the wound is likely amenable to primary closure under LA in ED. Using local anaesthetic with adrenaline helps control bleeding so makes for easier visualisation and repair (e.g. Lignospan – 2% lidocaine + 1:80,000 adrenaline or Xylocaine with adrenaline – 1%/2% lidocaine + 1:200,000 adrenaline). It can be useful to use a regional block for larger lacerations [pp] in addition to local infiltration. Examples of this are supraorbital, infraorbital blocks or mental nerve block. Good lighting and loupe magnification make a good quality repair easier.Forehead lacerations from falls often penetrate to the periosteum, so it is important to clean these wounds thoroughly and repair the muscle layer as well as the skin.In lacerations involving the eyebrow do not shave the eyebrow as it often does not grow back.For lacerations of the pinna, repair of the overlying skin and coverage of the cartilage is usually sufficient and suturing through the cartilage is rarely required.
Eyebrow Enhancement or Instability?
Published in Yates Yen-Yu Chao, Optimizing Aesthetic Toxin Results, 2022
The shape of the eyebrow is the entire presentation of the distribution pattern, amount, density, and flow of the brow hair. Brow shapes often relate to local topography, the protrusion and shape of bone, and the fullness of soft tissue below the skin. The eyebrow is a mobile structure pulled by surrounding muscles as a part of expression and communication. As toxin is used for the moderation of the muscles dragging this piece of hair up and down, the favoring of an upward vector is adopted as the treatment of brow lifting. Partial moderation favoring the contraction up or down is attempted to twist the brow into a different shape.
Botulinum toxin practical skills
Published in Michael Parker, Charlie James, Fundamentals for Cosmetic Practice, 2022
Standard practice for treating the frontalis muscle is to administer four injections in a horizontal line across the forehead. Never inject lateral to the mid-pupillary line due to risk of accidentally paralysing the temporalis muscles which confers an increased risk of ptosis and/or eyebrow drooping. There are two schools of thought regarding where you should administer your toxin, and neither is incorrect. You may choose to assess where the greatest amount of forehead wrinkling is on raising the eyebrows and inject in a line across that site. The other technique you may wish to employ is to calculate the midline between the eyebrows and the hairline and inject horizontally along there.
Translational impact of omics studies in alopecia areata: recent advances and future perspectives
Published in Expert Review of Clinical Immunology, 2022
F. Buket Basmanav, Regina C. Betz
The molecular studies in AA which have yielded important insights into the pathogenesis of AA have provided support and contributed to the consideration of novel therapeutic modalities for AA. The outcomes of these trials were variable with some of them being unsatisfactory or contradictory and others being more promising. The finding that IL-23 subunits p40 and p19 were highly upregulated in AA scalp skin provided rationale for the repurposing of ustekinumab, an IL-12/IL-23p40 monoclonal antibody used for treatment of psoriasis and Crohn’s disease, for treatment of AA. Despite initial reports of some degree of success in pediatric and adult patients, lack of efficacy as well as development of AA coinciding with use of ustekinumab to treat other conditions was also reported [106]. Similarly, the results varied regarding the efficacy of PDE4 inhibition in AA patients treated by an oral PDE4 inhibitor, namely, apremilast, approved for the treatment of psoriasis, psoriatic arthritis, and Behçet’s disease [107]. In the recently published outcome of the open-label clinical trial of abatacept, the CTLA4-mimetic (NCT02018042), complete scalp hair re-growth was observed in one of the fourteen participants who completed the trial. In the other participants low (~3-10% hair re-growth, n = 4), intermediate (~15-25% hair re-growth, n = 4), or no response (n = 4) was noted and one patient showed regrowth of the eyebrows but not the scalp hair.
Cronkhite-Canada syndrome: a retrospective analysis of four cases at a single medical center
Published in Scandinavian Journal of Gastroenterology, 2022
Xing Yu, Chengdang Wang, Mi Wang, Yinchen Wu, Linlin Zhang, Qinyu Yang, Long Chen
Digestive symptoms were the initial clinical symptoms in all the four patients. The main digestive symptoms were diarrhea (4/4), abdominal pain (2/4), abdominal distension (1/4), hypogeusia (2/4), and bloody stool (1/4). The diarrhea usually occurred 3–5 times per day and occasionally up to 8–10 times with mushy or watery stools. All the patients had at least one symptom of ectodermal dysplasia, including alopecia (3/4) (Figure 1(A)), nail dystrophy (4/4) (Figure 1(B)) and skin hyperpigmentation (3/4), and two patients had all ectodermal symptoms. Scalp hair loss was the most common type of hair loss, which also occurred in the eyebrows, pubic hair, and armpits. Nail dystrophy was characterized by thinning and shedding of nails. Skin hyperpigmentation was mainly observed on the face and limbs. Weight loss (4/4) and edema (2/4) also occurred.
The eye area as the most difficult area of activity for esthetic treatment
Published in Journal of Dermatological Treatment, 2022
Anna Kołodziejczak, Helena Rotsztejn
IFUS is the esthetic skin-tightening procedure for infraorbital laxity of periorbital skin. In 2009, IFUS (Ulthera System; Ulthera Inc., Mesa, AZ, USA) was approved by the United States Food and Drug Administration for the brow-lift procedure. Pak at al. believe that this method can replace surgical procedures, such as lower blepharoplasty, due to the fact that IFUS causes thermal trauma not only in the deep dermis, but also in the superficial muscular aponeurosis, while omitting the epidermis. Eyebrow raising can be achieved by applying the cartridge to the lateral part of the forehead report above 2/3 of the eyebrow arch, which produce vectoring and consequently an eyelid lifting. In the study performed by……. subjects were treated with the use of 1.5 and 3.0 mm probes. The 1.5 mm probe was used to tighten the loose eyelid skin and deep dermis, whereas the 3.0 mm probe was used to tighten the orbicularis oculi muscle and the orbital septum 2–3 mm below the ciliary margin to the inferior lower orbital rim (40).