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Quest’anno Agorà, con l’obiettivo della ricerca di un costante miglioramento e progresso scientifico, ha voluto approfondire la bibliografia di riferimento per le tematiche delle Sessioni Coordinate e metterle disposizione dei partecipanti alla Sessione in Sede Congressuale.

In questa pagina troverete a disposizione gli abstract degli articoli che Agorà ha selezionato come bibliografia di riferimento per la sessione coordinata "TECNICHE INIETTIVE, RIGENERATIVE E CHIRURGICHE PER IL RIMODELLAMENTO DEL SOPRACCIGLIO E RINGIOVANIMENTO DELL'AREA PERIOCULARE". I Soci Agorà avranno inoltre la possibilità di scaricare gli articoli originali in versione integrale.



Facial Plastic Surgery Clinics of North America

2021 May; 29(2):335-348

PMID: 33906765

Eyelid and periorbital dermal fillers: products, techniques and outcomes

Josè Raul Montes, Elizabeth Santos, Claudia Amaral

ABSTRACT: A retrospective observational case study and a literature review were conducted to evaluate how anatomic findings, especially those related to the periorbital zone, serve as a guiding compass for injectable implants. Treatment techniques and product selection will be discussed for patients with negative vector, shallow orbit, and deep set eyes. Versatility of injectables will be demonstrated on patients with peanut face, iatrogenically altered anatomy (after surgery), and trauma.


2022 January

Mid forehead brow lift

Bhupendra C. Patel, Raman Malhotra

ABSTRACT: Many medical conditions rely upon strict numerical definitions to provide a diagnosis: diabetes mellitus and hyperlipidemia, for example. In the case of brow ptosis, diagnosis is determined predominantly by the judgment and experience of the examining physician. Brow ptosis exists when inferior malposition of the brow interferes with aesthetics or function; therefore, the brow level deemed low in one person may be perfectly acceptable or "normal" in another. With the brow being a mobile structure and prone to the secondary effects of age, solar elastosis, muscle action, trauma, and gravity, some degree of brow descent will eventually occur in everyone. Ideal brow position is regarded differently in different genders, races, ages, and even generations. In some communities, the concept of changing the brow's position or shape is considered anathema; in many Western societies, however, it is considered routine. This activity describes the pathophysiology of brow ptosis, its presentation, and the role of mid-forehead brow lift to reverse ptosis.


  • Describe the causes of brow ptosis.

  • Review the indications for brow lifting.

  • Summarize the complications of the mid-forehead brow lift procedure.

  • Outline the importance of enhancing care coordination among interprofessional team members to improve outcomes for patients who undergo mid-forehead brow lifting.

Access free multiple choice questions on this topic.


2022 August; 14(8):1617

PMID: 36015243

PMCID: PMC9413293

Swiss medical devices for autologous regenerative medicine: from innovation to clinical validation

Farid Gomri, Solange Vischer, Antoine Turzi, Sarah Berndt

ABSTRACT: Regenerative medicine, based on the use of autologous tissues and embryonic, stem or differentiated cells, is gaining growing interest. However, their preparation, in a manner compliant with good practices and health regulations, is a technical challenge. The aim of this manuscript is to present the design of reliable CE marked medical devices for the preparation of standardized platelet-rich plasma (PRP) and other autologous biologics intended for therapeutic uses. There are numerous PRP isolation processes. Depending on the methodology used, PRP composition varies greatly in terms of platelet concentration, platelet quality, and level of contamination with red and white blood cells. This variability in PRP composition might affect the clinical outcomes. The devices presented here are based on a specific technology, patented all over the world, that allows the precise separation of blood components as a function of their density using thixotropic separator gels in closed systems. This allows the preparation, in an automated manner, of leukocyte poor PRP with a standardized composition. Production of different forms of PRP is a clinical asset to suit various therapeutic needs. Therefore, we are offering solutions to prepare PRP either in liquid or gel form, and PRP combined with hyaluronic acid. These biologics have been successfully used in many different therapeutic domains, resulting in more than 150 published clinical studies. We also developed the CuteCell technology platform for cell culture expansion for further autologous cell therapies. This technology enables the safe and rapid in vitro expansion of cells intended for therapeutic use in good manufacturing practices (GMP) and autologous conditions, using blood-derived products as culture media supplementation. We summarize in this article our 20 years' experience of research and development for the design of PRP devices and, more recently, for PRP combined with hyaluronic acid.


2022 April; 14(4):268

PMID: 35448877

PMCID: PMC9032255

Anatomical proposal for botulinum neurotoxin injection for glabellar frown lines

Kyn-HO Yi, Ji-Hyun Lee, Hye-Won Hu, Hee-Jin Kim

ABSTRACT: Botulinum neurotoxin injection for treating glabellar frown lines is a commonly used method; however, side effects, such as ptosis and samurai eyebrow, have been reported due to a lack of comprehensive anatomical knowledge. The anatomical factors important for the injection of the botulinum neurotoxin into the corrugator supercilii muscle has been reviewed in this study. Current understanding on the localization of the botulinum neurotoxin injection point from newer anatomy examination was evaluated. We observed that for the glabellar-frown-line-related muscles, the injection point could be more accurately demarcated. We propose the injection method and the best possible injection sites for the corrugator supercilii muscle. We propose the optimal injection sites using external anatomical landmarks for the frequently injected muscles of the face to accelerate effective glabellar frown line removal. Moreover, these instructions would support a more accurate procedure without adverse events.

Photomedicine and Laser Surgery

2018 October; 36(10):541-547

PMID: 30234414

PMCID: PMC6199626

Resurfacing with ablation of periorbital skin technique: indications, efficacy, safety and 3D assessment from a pilot study

Stefania Guida, Steven Paul Nisticò, Francesca Farnetani, Ester Del Duce, Nathalie De Carvalho, Flavia Persechino, Tommaso Verdina, Luca Giannetti, Martina D'Alessandro, Giacomo Giovanni Urtis, Giovanni Pellacani, Giovanni D'Alessandro

OBJECTIVES AND BACKGROUNDS: Nowadays, several approaches for skin rejuvenation of the lower eyelid are available. We present a new technique of resurfacing with ablation of periorbital skin (RAP) performed in a single session.

METHODS: This is a retrospective study involving 20 patients showing skin elastosis with or without evidence of the nasojugal fold and atrophic and dyschromic skin or needing a combined approach of transconjuntival lower blepharoplasty for fat bag removal. RAP technique is assessed in terms of efficacy, safety, and 3D evaluation of results at 6 months' follow-up.

RESULTS: Global Assessment Improvement Scale results highlighted an improvement in all cases, for both physicians (blinded to treatment) and individual subjects. Only minor adverse events (edema, erythema, and discoloration) were reported in almost all patients, lasting 2-3 weeks after treatment, and were resolved without intervention. A 3D imaging tool revealed the reduction of medium protrusions and depressions and an improved texture at 2 months. Skin recovery was inversely correlated with hemoglobin reduction.

CONCLUSIONS: RAP seems to offer expert dermatologists a safe and clinically effective technique for skin rejuvenation of lower eyelids, without significant adverse events. Further studies will be performed to confirm our results.

Aesthetic Plastic Surgery

1998 April; 22(2):120-125

PMID: 9502844

Browlifting with thread: the technique without undermining using minimum incisions

A. C. Graziosi, Beer SMC

ABSTRACT: The position of the eyebrows exerts great influence over the upper eyelids, both in terms of skin excess as well as in the overall aesthetics of the lid/orbit region. Based on the need to associate the treatment of the eyelids with that of the eyebrows, the author developed an essentially simple surgical technique for browlifting. Through minimal incisions in the scalp and in the superior margin of the eyebrow, an anchor is made and traction is exerted with 00 cotton thread, without undermining in the frontal region, exception made by the thread line which is subgaleal. The main difference between this and other techniques is its use of the glide of the eyebrow over deep soft tissues, without the necessity of undermining. The follow-up ranged from 6 to 16 months, during which the lift remained at acceptable levels in most patients, while in a few cases it dropped down a little. This procedure was well accepted by the patients, making it a good alternative for the treatment of brow ptosis.

Indian Journal of Plastic Surgery

2021 October; 54(4):489-494

PMID: 34984090

PMCID: PMC8719974

Hair transplant for eyebrow restoration

Rajendrasingh J. Rajput

ABSTRACT: Eyebrow restoration can be best done with individual single hair follicles grafts harvested by FUE. Understanding the male and female eyebrow allows us to plan an aesthetic reconstruction, requiring 70 to 120 grafts. Selection of donor hair, angle of placement, alignment and direction within the rows influences the results, as does scarring and perfusion of the skin. Details of planning, technique, anesthesia and postoperative care, as well as drawbacks of older methods, are discussed in the article.

Facial Plastic Surgery

2020 June; 36(3):226-234

PMID: 31910465

A novel endoscopic forehead lift technique for patients with upper facial wrinkles: morphometric evaluation and patient-reported outcome using FACE-Q scales

Guanhuier Wang, Liyuan Tao, Hongbin Xie

ABSTRACT: Chinese patients more frequently complain of forehead wrinkles than eyebrow and upper eyelid ptosis. Besides the commonly used brow-lifting technique, a novel technique to satisfy the demands of Chinese patients is needed. In this article, we introduce our novel endoscopic forehead lift procedure and analyze the morphometric evaluation and patient-reported outcomes. From January 2010 to January 2017, 171 Chinese patients underwent endoscopic forehead lift in which two parallel incisions were made on the frontalis muscle to relieve forehead wrinkles. Biopsy forceps were used to bite off the glabella muscles to relieve wrinkles between the eyebrows. Lifting devices were not used. Morphometric evaluations of eyebrow locations were performed, and the vertical distance of the upper eyebrows was measured post- and preoperatively to evaluate the elevation range. FACE-Q scales were sent to patients who were still being followed-up. A total of 46 patients underwent the morphometric evaluation, which suggested that the eyebrows were elevated effectively. At 12 to 36 months postoperatively, the median post-/preoperative ratio was 118.4, 112.5, and 111.8% in the medial, middle, and lateral eyebrows, respectively. In the same patients, at 37 to 84 months postoperatively, the median post-/preoperative ratio was 116.6, 112.2, and 108.9% in the medial, middle, and lateral eyebrows, respectively. Sixty-five patients completed the FACE-Q scales, demonstrating high satisfaction levels with the forehead and eyebrow, outcome, and decisions, with a median score of 100 for each. Postoperative appraisal revealed that the lines in the forehead and between the eyebrows had a good outcome with scores of 86 and 93, respectively. The median number of years younger that patients thought they appeared was 7. The most frequent self-claimed recovery symptom was temporary forehead skin numbness (83.1%) followed by a receding hairline (46.2%). Our endoscopic forehead lift procedure was effective in relieving forehead and glabella wrinkles and lifting the eyebrows. This was a level of evidence III study.

Journal of Cosmetic Dermatology

2021 October; 20(10):3181-3189

PMID: 34028173

Use of hyaluronic acid fillers in treatment of periorbital melanosis induced by tear trough deformity: anatomical considerations, patient satisfaction, and management of complications

Soni Nanda, Shikha Bansal, Ridhima Lakhani

BACKGROUND: Periocular melanosis (POM) due to shadow effect of tear trough deformity (TT) does not respond to the conventional treatment modalities. Hyaluronic acid (HA) fillers are a favurable treatment modality. This area is a high risk for injectables due to its unique anatomy.

AIMS: To find role of HA fillers in treatment POM due to TT deformity with special emphasis on practical anatomy, patient satisfaction rate, and management of complications. A correlation of the grade of TT, age of the patient, and patient satisfaction was done. A follow-up at 1 year was done to assess longevity of results.

METHODS: Retrospective study of 60 cases of clinically diagnosed POM (120 TT) due to TT deformity was performed. Each patient was injected with 1 ml, cross-linked HA 22.5 mg/ml in under-eye area using 30 G needle or a 25 G cannula. Follow-up was done at 2 weeks, 4 weeks, and 1 year.

RESULTS: Mean age of patients was 36.4 years. Majority of patients, that is, 31 (52%) were in the age group of 30-40. As per Hirmand's classification, 46.6% (28/60) had grade 2 TT which was most common. We graded results in the form of VAS and 80% patients had VAS > 7. There were no major side effects.

CONCLUSION: Hyaluronic acid fillers are promising treatment modality without any major side effects. Both needle and cannula can be used effectively. Patient satisfaction is higher in younger patients with low grade of TT and results persisted in all cases for a minimum of 1 year.

Survey of Ophtalmology

2022 June; 67(3):741-757

PMID: 33933438

Complications and adverse effects of periocular aesthetic treatments

Sonali T. Nagendran, Mohammad J. Ali, Murat Dogru, Raman Malhotra

ABSTRACT: The popularity and variety of temporary and permanent periocular aesthetic treatments has increased over the past decade. Patients frequently present to eye clinics with ocular complications and side effects following these treatments, their severity ranging from ocular irritation from dry eyes to visual loss from vascular occlusion. A careful, thorough history is essential, as many patients may not associate aesthetic procedures with ocular complications, and some may be embarrassed to disclose this information. All ophthalmologists should understand the potential ocular sequelae of these treatments and be able to initiate treatment in sight-threatening cases. We summarize the current literature on ophthalmic complications of the most common periocular aesthetic treatments.



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