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Background: The inframammary fold (IMF) is an important landmark in breast aesthetic surgery. In augmentation mastopexy procedures, secure and accurate placement of the IMF is essential to aesthetic outcomes and to allow the new IMF to heal in the correct position without displacement. The authors present a simple and efficient four-layer wound closure technique using barbed sutures for closure of the repositioned IMF in augmentation mastopexy procedures. This method was previously described by the first author for reset of the IMF in breast augmentation surgery and has been adapted to the longer IMF incision in augmentation mastopexy procedures. Methods: A retrospective review was undertaken of 335 patients who underwent bilateral breast augmentation mastopexy procedures with a Wise pattern technique at a single unit. The newly reset IMF was closed using barbed sutures and a four-layer closure technique. Results: There were no cases of complications related to wound healing or wound dehiscence. One patient required explantation for an infected implant. Conclusion: The four-layer wound closure technique with barbed sutures provides a quick and efficient method for accurate closure of the newly reset IMF, with positive outcomes related to wound healing. Secure and accurate placement of the inframammary fold is crucial in augmentation mastopexy procedures. The use of a four-layer wound closure technique with barbed sutures provides an efficient method for accurate closure of the newly reset inframammary fold. This method was previously described by the first author for reset of the IMF in breast augmentation surgery and has been adapted to the longer IMF incision in augmentation mastopexy procedures. Level of Evidence V: 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. [ABSTRACT FROM AUTHOR]

Background: Periorbital aging is characterized by dermatochalasis, lateral hooding and malformation of multiple eyelid creases. Rejuvenation of periorbital region is of great concern in aging Asians, especially for the females. However, the conventional subbrow blepharoplasty was indicated for mild or moderate skin laxity. For severe laxity, double-eyelid incision is necessarily to be involved. This study aims to improve the severe upper eyelid dermatochalasis through an extended subbrow single-incision approach with desirable outcomes. Methods: Patients underwent this surgical method from October 2020 to April 2022 were retrospectively reviewed. The redundant skin and orbicularis oculi muscle were excised through a spindle-like subbrow incision delicately designed in the sitting position. Surgical outcomes were evaluated by heights of designed line from the palpebral margin to the pupil center (HPPC), medial cornea (HPMC), and lateral canthus (HPLC) at different follow-ups. The overall satisfaction score of cosmetic outcomes was assessed by an independent surgeon and patients themselves based on the evaluation of: subbrow scar, eyelid symmetry, lateral hooding lifting, visual block improvement and brow shape. Results: A total of 75 cases were reviewed, including 3 men and 72 women. The preoperative HPPC, HPMC, and HPLC were 4.27 ± 0.40, 4.72 ± 0.45 and 3.41 ± 0.35 mm. The values were postoperatively improved to 7.01 ± 0.46, 6.57 ± 0.34 and 5.69 ± 0.26 mm, respectively, presenting significantly different (p < 0.05). The mean surgeon satisfaction scores were 3.6 ± 0.6 (range, 2.0–4.0), and patient satisfaction scores were 3.5 ± 0.6 (range, 2.0–4.0). No hypertrophic scar, sunken upper eyelids or other complications was found. Conclusions: The modified subbrow blepharoplasty method is an effective and safe alternative for correcting severe upper eyelid skin laxity, which can achieve both good cosmetic outcomes and functional improvement. Level of Evidence IV: 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. [ABSTRACT FROM AUTHOR]

Background: Blepharoptosis is defined as the drooping or lower displacement of the upper eyelids. Various kinds of surgical techniques and modifications have been introduced to improve the surgical outcomes, but the high recurrence rate and unsatisfying cosmetic results remain as a common problem. Purpose: To solve the problem mentioned above, we came up with our new surgical technique and conducted a retrospective review to verify its effectiveness. Patients and Methods: A retrospective review was conducted among the patients diagnosed as genuine congenital blepharoptosis and receiving the surgical treatments where our unique technique was used between January 2016 and January 2019. The clinical records and preoperative and postoperative photographs were collected and evaluated. Results: A total of 83 patients were included in our study, 78 (94%) of them acquired good surgical outcomes, while 4 (4.8%) of them got fair results, and 1 (1.2%) of them got a poor result. No long-term lagophthalmos, ectropion, entropion and fornix conjunctival prolapse were noted. Conclusions: Our surgical technique introduced here is effective in the management of genuine congenital blepharoptosis. Level of Evidence III: 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. [ABSTRACT FROM AUTHOR]

Background: Subbrow blepharoplasty (SBB) addresses lateral hooding of the upper eyelid skin, a shortcoming of classical upper blepharoplasty. Therefore, SBB is widely used by plastic surgeons in Korea and Japan. The aim of this study is to improve postoperative results and to minimize a relapse of existing SBB by the use of a supraorbital rim periosteal suture fixation technique. Methods: An upper incision is made along the inferior margin of the eyebrow. A lower incision, which is determined according to necessary amount of skin excision, is made vertically, deep to the posterior fascia of the obicularis oculi muscle (OOM). Then, skin, OOM, and posterior fascia of the OOM are excised en bloc. An upper skin flap dissection is extended to the width of 1 cm. The posterior fascia of the OOM in the inferior flap is pulled up and three transverse 5-0 nylon sutures are placed to fix it to the periosteum and the sub-brow fat of the supraorbital rim temporally to the supraorbital nerve. A margin of upper flap level is usually a suitable position for fixation. Thirty-six patients underwent SBB using the supraorbital rim periosteal suture fixation technique from July 2007 to June 2012. Results: Thirty-six patients underwent SBB and were followed up for an average of 27 months. The follow-up period ranged from 8 months to 6 years. Their mean age at the time of surgery was 55 years. Thirty-four patients (94.4 %) were satisfied with the surgical results, however, two patients (5.6 %) complained about dimpling at the periosteal suture fixation point. Administration of two focal injections of triamcinolone acetonide resulted in relief and disappearance of the dimpling. Conclusion: We report our experience with a subbrow blepharoplasty using suture fixation of the OOM in the inferior flap to the supraorbital rim periosteum at the margin of the upper flap after an elliptical excision of subbrow skin. Our method of SBB has the advantage of ensuring the continuance of surgical results and minimizing the risk of relapse by placement of suraorbital rim periosteal fixation sutures. Level of evidence IV: 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 . [ABSTRACT FROM AUTHOR]

Closure techniques for breast augmentation incisions can affect wound healing with significant consequences if the incision does not heal properly. Suturing methods and materials include absorbable and nonabsorbable sutures and interrupted and continuous techniques. These choices can affect wound healing, wound strength, and wound integrity, and postoperative care. The goal of long-term incision support during wound healing, eliminating a suture knot within the incision, and decreased risk of compromise of wound healing are desired. A closure method called the “remote-knot” technique, which can be applied to other incision types, has been developed. [ABSTRACT FROM AUTHOR]