Transcript Nonsurgical Considerations for Addressing Periocular AestheticsA

From: Nonsurgical Considerations for Addressing Periocular AestheticsA Conceptual Dimensional Approach
JAMA Facial Plast Surg. 2014;16(6):451-456. doi:10.1001/jamafacial.2014.498
Figure Legend:
Aesthetic Parameters Viewed in the 2-Dimensional Frontal PlaneA, Margin reflex distance 1 (MRD1): the distance from the central
corneal light reflex to the central upper eyelid margin; B, tarsal platform show: the distance from the eyelid margin to the eyelid fold;
C, brow fat span: the distance from the eyelid fold to the eyebrow; D, eyebrow position; E, lower eyelid margin position quantitated
as scleral show when eyelid retraction is present; and F, orbital rim hollow.
Date of download: 3/23/2017
Copyright © 2017 American Medical
Association. All rights reserved.
From: Nonsurgical Considerations for Addressing Periocular AestheticsA Conceptual Dimensional Approach
JAMA Facial Plast Surg. 2014;16(6):451-456. doi:10.1001/jamafacial.2014.498
Figure Legend:
Nonsurgical Management of the Eyebrow RegionA, Botulinum toxin A injection pattern for a “chemical brow lift.” Chemodenervation
of the corrugator-procerus muscle complex can be achieved with on average 5 injections of 5 units per injection of botulinum toxin A
and chemodenervation of the lateral orbital orbicularis muscle with on average 2 injections of 2.5 units of botulinum toxin A per
injection site. B, An average of 5 injections of 2.5 units per injection of botulinum toxin A can readily allow for brow lowering by
weakening the frontalis muscle. C, A 59-year-oldCopyright
woman with
eyebrow
asymmetry,
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American
Medical relative ptosis on the left, and relative retraction
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on the
before3/23/2017
and after botulinum toxin A injection
to
relatively
lower
the
right brow and relatively raise the left brow. D, Titrated
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injection of hyaluronic acid gel filler along the inferior border of the eyebrow fat pad in the suborbicularis oculi plane can volumize the
From: Nonsurgical Considerations for Addressing Periocular AestheticsA Conceptual Dimensional Approach
JAMA Facial Plast Surg. 2014;16(6):451-456. doi:10.1001/jamafacial.2014.498
Figure Legend:
Nonsurgical Management of the Upper Eyelid RegionA, Botulinum toxin A at low doses (an average of 2 injection sites with 2 units
per site) injected into the pretarsal orbicularis muscle can subtly raise a relatively ptotic eyelid. B, A 24-year-old woman with left
residual upper eyelid ptosis despite 2 prior surgical procedures with improved left upper eyelid ptosis after injection of botulinum
toxin A. C, Conversely, a relatively retracted upper eyelid can be lowered with the use of titrated hyaluronic acid gel (HAG) filler. D, A
48-year-old woman with relative left upper eyelidCopyright
retraction
to thyroid
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2017 American
Medicaleye disease with improved left upper eyelid position
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after of
HAG
injection.
E, Titrated injection of HAG inAssociation.
the lateral and
central
subbrow
region to improve supratarsal volume loss. F, A
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67-year-old Asian patient with superior sulcus volume loss and hollowing before and after HAG injection. G, A 38-year-old Asian
From: Nonsurgical Considerations for Addressing Periocular AestheticsA Conceptual Dimensional Approach
JAMA Facial Plast Surg. 2014;16(6):451-456. doi:10.1001/jamafacial.2014.498
Figure Legend:
Nonsurgical Management of the Lower Eyelid Region and Eyelid-Cheek JunctionA, Lower eyelid retraction addressed with
hyaluronic acid gel (HAG) injected in small aliquots through multiple injection sites across the length of the lower eyelid. B, A 67year-old patient with right greater than left lower eyelid retraction before and after HAG injection to improve the lower eyelid position
and lessen scleral show. C and D, Orbital rim hollow in a 44-year-old woman before and after 0.5 mL per side of HAG filler. E,
Titrated injection of HAG in the malar region canCopyright
improve ©
the
3-dimensional
aesthetics of the entire midface and eyelid cheek
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American Medical
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of download:
3/23/2017
junction.
F, A 53-year-old
woman before and after Association.
HAG injection,
1
mL,
to
the
right malar region. Note upper cheek/malar fullness,
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natural softening of the nasolabial fold, and relative shortening of the lower eyelid appearance.