O Ovveerr 55,,000000 cclliinniiccaall ppaappeerr aabbssttrraaccttss iinn oouurr M Meem mbbeerrss A Arreeaa!! Restylane persisting in lower eyelids for 5 years. Dayan SH, Arkins JP, Somenek M., Chicago Center for Facial Plastic Surgery, Chicago, IL, USA Department of Otolaryngology-Head and Neck Surgery, University of Illinois-Chicago, Chicago, IL, USA DePaul University, Chicago, IL, USA DeNova Research, Chicago, IL, USA..
Clinical Information
J Cosmet Dermatol. 2012 Sep;11(3):237-8. The authors report the case of a 58-year-old woman presenting with "puffiness" in her lower eyelids persisting for approximately 5 years. While dark, puffy eyelid circles following hyaluronic acid placement periorbitally are not uncommon, what is so unusual in our case is that it was noted 5 years after treatment with Restylane. It has been our experience that hyaluronic acid within periorbital tissues can result in a negative cosmetic outcome that can persist for years after the treatment.
Prospective study of lidocaine, bupivacaine, and epinephrine levels and blood loss in patients undergoing liposuction and abdominoplasty. Swanson E. Leawood, Kan. From private practice. Plast Reconstr Surg. 2012 Sep;130(3):702-22. BACKGROUND: Bupivacaine levels have not been measured in cosmetic surgery patients to establish safety. Blood loss has been underestimated using the small volumes present in the aspirate. The proportion of wetting solution removed by liposuction has not been reliably ascertained. METHODS: To remedy these deficiencies, a prospective study was undertaken among 322 consecutive patients presenting for superwet ultrasonic liposuction and/or abdominoplasty, and other combined procedures, using infusions containing 0.05% lidocaine (liposuction) and/or 0.025% bupivacaine (abdominoplasty) with 1:500,000 epinephrine. Plasma levels of lidocaine, bupivacaine, and epinephrine were studied in a subset of 76 consecutive patients, including hourly intraoperative samples in 39 consecutive patients. Anesthetic levels were also measured in 12 consecutive patients during the 24-hour period after infusion. RESULTS: The maximum lidocaine dose was 3243 mg and the maximum level was 2.10 μg/ml. The maximum bupivacaine dose was 550 mg and the maximum level was 0.81 μg/ml. No clinical toxicity was encountered. Estimated blood loss from liposuction was 217.5 cc + 187 cc/liter of aspirate (r = 0.65). Abdominoplasty added 290 cc of blood loss, on average. The mean proportion of wetting solution removed by liposuction was 9.8 percent. CONCLUSIONS: Bupivacaine may be safely used in cosmetic surgery. A concentration of 1:500,000 epinephrine is safe and effective when administered as part of a wetting solution that is limited to less than 5 liters. Estimated blood loss is higher than previous estimates based on lipocrits. Combination procedures are safe..
Botox® after Botox® - a new approach to treat diplopia secondary to cosmetic botulinic toxin use: case reports. Isaac CR, Chalita MR, Pinto LD. Universidade de Brasília, Brasília, DF, Brazil. Arq Bras Oftalmol. 2012 Jun;75(3):213-4. A new technique for the treatment of diplopia secondary to cosmetic botulinum toxin A use is described. In this interventional case reports, two consecutive patients who developed diplopia after periocular cosmetic use of botulinum toxin A were treated with intramuscular botulinum toxin A injection into the antagonist extraocular muscle. Diplopia resolved in both patients in less than 1 week with no side effects or complications. In conclusion, the injection of intramuscular botulinum toxin A is an encouraging option for treatment of diplopia secondary to botulinum toxin A use for facial lifting.