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Cosmetic Facial Interventions
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
A rhytidectomy (facelift) is an operation that corrects the visible signs of aging primarily in the lower two-thirds of the face and upper neck. This includes redundant facial skin and deep rhytids, jowling or loss of a well-defined mandibular border and improvement of prominent nasolabial folds. Extrinsic aging derives mainly from solar ultraviolet radiation (photoaging), which damages the DNA, and smoking. Skeletal deflation results in poor ligamentous support, resulting in tissue sagging exaggerated by gravity.
Cosmetic dermatology
Published in Ronald Marks, Richard Motley, Common Skin Diseases, 2019
The first treatments for ageing skin were, in the most part, rather crude in their effects. A ‘face-lift’ or rhytidectomy consists of removing a segment of cheek skin immediately anterior to the ears, undermining the skin of the cheek, and suturing the remaining skin more tightly across the face. In extreme cases the skin, which had lost all elasticity, was so tightened across the face that natural movement and facial expressions were impossible. The ‘improved’ appearance might look impressive at rest, but artificial and awkward when the person was animated.
Surgical Rejuvenation of the Ageing Face
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Gregory S. Dibelius, John M. Hilinski, Dean M. Toriumi
It is imperative the patient and surgeon are in complete agreement on the indications for surgery and the resulting anticipated changes. Rhytidectomy is an excellent technique to correct visible signs of ageing in the lower two-thirds of the face and upper neck. This includes redundant facial skin and deep rhytids, jowling or loss of a well-defined mandibular contour, and modest improvement of prominent nasolabial folds. Patients should be counselled that rhytidectomy is not effective for superficial rhytids resulting from solar damage or minor depressions secondary to acne scarring. These abnormalities are more appropriately treated with adjunctive techniques, such as laser resurfacing or dermabrasion.
Effectiveness and safety of nonablative fractional laser and infrared bipolar radiofrequency for treating periorbital wrinkles
Published in Journal of Cosmetic and Laser Therapy, 2022
Xianglei Wu, Qingqing Cen, Jiafang Zhu, Ying Shang, Xiaoxi Lin
Since 2002, when RF was approved by the FDA to improve wrinkles and laxity of periorbital skin, many studies have been conducted using different RF, including monopolar, bipolar, or unipolar devices. Bipolar RF travels from the positive pole to the negative pole, which is typically built into the handpiece. It is not as penetrating (1–4 mm) as a monopolar RF, whereas it is less painful (15). Fitzpatrick et al. conducted monopolar RF treatment in patients with periorbital wrinkles. After 6 months of follow-up, the Fitzpatrick score in 83.2% (99/119) of the patients with periorbital rhytidectomy improved by at least 1 point (19). Akita et al. used bipolar RF (eMatrixTM, Syneron & Candela, USA) to treat 10 older Japanese women (mean age: 58.6 years) with wrinkles of the lateral canthus and lower eyelid. Eight subjects indicated ‘very good’ outcomes (improvement by > 50%) in the wrinkle improvement (20).
Clinical efficacy and safety of a focused-radiofrequency device on middle and lower face rejuvenation: a retrospective clinical study
Published in Journal of Cosmetic and Laser Therapy, 2021
Yiqiu Zhang, Min Yan, Jing Mi, Ying Zeng, Huyan Lin, Min Yao, Jiying Dong, Shen Wang
Skin aging is a natural process characterized by facial sagging, obvious wrinkles, and decreased skin quality from hereditary diseases, increased age, and external environmental factors, such as chronic ultraviolet radiation exposure (1). Age-related facial skin changes create a less-appealing appearance and lead to quests for a more youthful appearance using clinical intervention (2,3). Although surgical rhytidectomy as the traditional invasive procedure remains an extremely effective treatment approach for severe facial laxity and static rhytide reduction, it can have side effects, such as pain, postsurgery hematoma, scarring, and undesirable skin texture changes (4); therefore, plastic surgeons and dermatologists are seeking a safe and new micro-invasive or noninvasive treatment for skin rejuvenation, including energy and nonenergy treatments. Most popular nonenergy methods include botulinum neurotoxin injections, which dramatically eliminate dynamic lines but not static lines (5), and local syringe-based fillers to restore facial volume loss instead of restoring texture and tightening (6). These nonenergy devices have the common disadvantages of being short term and resulting in only minor facial rejuvenation. Thus, various energy devices have become popular with patients and have excellent clinical efficacy with minimal risks, rare postsurgery complications, and a quick recovery (7).
Surgical applications of intracorporal tissue adhesive agents: current evidence and future development
Published in Expert Review of Medical Devices, 2020
Nicholas Gillman, David Lloyd, Randy Bindra, Rui Ruan, Minghao Zheng
ARTISS® sealant has a separate indication for adhesion of autologous skin grafts or tissue flaps to surgically prepared wound beds in facial rhytidectomy surgery [77]. ARTISS® sealant has also been successfully trialed as a replacement for staples in patients undergoing split-thickness skin grafts (STSG) on the dorsum of hands and fingers [78] and has been found to reduce post-reconstructive morbidity when used to close large debridement wound flaps after Fourneir’s gangrene [79]. Study of intraoperative feasibility showed that ARTISS® sealant was technically easy to administer [80], and the preparation time of ARTISS® to be significantly less than that of Tisseel® [81]. ARTISS® sealant has also been found to reduce fluid production at the surgical site of application [82–84], however, does not cause a major decrease in seroma formation [78,83,84]. The adhesive has a low thrombin concentration and should not be used as an adjunct to hemostasis. Moreover, ARTISS® is not recommended for laparoscopic/endoscopic use [72], which may prevent integration with modern surgical techniques.