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The anatomic mechanism of ophthalmic artery embolism is the anastomoses among the related arteries and ophthalmic artery. Based on the findings of the study, injections in periosteum layer at glabellar region or sub-superficial musculo aponeurotic system layer of nasal dorsum and nasolabial fold are not advised.

The Nd:YAG laser has a definite lipolysis effect on compact adipose tissue and is a more effective approach for the treatment of localized adiposis than conventional liposuction.

No abstract

Background Blindness caused by ophthalmic artery embolism is the most catastrophic complication of facial hyaluronic acid (HA) injections. Extravascular (retrobulbar) injection of hyaluronidase has been suggested as a salvage in this calamitous situation. However, the effectiveness of this treatment still lacks consensus. Objectives The aim of this study was to investigate the role of extravascular hyaluronidase in dissolving intravascular HA occlusion. Methods Two different animal experiments were performed: (1) isolated rabbit abdominal aorta segments filled with HA were treated with extravascular immersion of highly concentrated hyaluronidase for 90 minutes, followed by gross observation, microscopic examination, particle size analysis, and immunohistochemical staining; and (2) live rabbit auricular arteries were first occluded with HA and then immediately treated with extravascular injection of hyaluronidase. The ears were then evaluated by gross observation, microscopic examination, and perfusion studies after 60 minutes and again after 90 minutes. Results The HA within the aorta segments showed no gross or microscopic changes after treatment with extravascular hyaluronidase. Hyaluronidase could only be detected in adventitia of the aortae, instead of in vascular smooth muscle, tunica intima, or vascular lumen. The occluded auricular arteries showed no reperfusion after extravascular injection of hyaluronidase. Conclusions In this rabbit model, extravascular hyaluronidase was unable to penetrate into the arterial lumen of the isolated abdominal aorta nor the live auricular artery of the rabbit to dissolve intravascular HA within a 90-minute time limit, thus casting doubt on whether extravascular (retrobulbar) hyaluronidase injection has a role in treating ophthalmic artery embolism caused by HA injections.

DEXA is a feasible alternative for the evaluation of liposuction results.

The findings show that the combined anchor suture with external surgery is a reliable approach to Asian upper eyelid blepharoplasty both in young creaseless eyelids and in eyelids with laxity due to aging. We suggest that the anchor suture could be used as a routine procedure in Asian blepharoplasty.

Background Vision loss is a serious complication of hyaluronic acid filler injections, and long-term observations regarding the prognosis, particularly with angiography, is rare. Objectives This study aimed to investigate the long-term prognosis and living status of patients with visual defects due to hyaluronic acid filler injections. Methods Nine patients with vision loss caused by hyaluronic acid filler injections and receiving different treatments were included and followed up for 2–6 years after the accident. Follow-ups, including outpatient ophthalmologic examinations, were performed in this study. Results In our follow-up observation, all patients had reintegrated into society and work. The prognosis was similar for all hyaluronidase treatments, including retrobulbar injections and superselective ophthalmic artery thrombolysis. The facial appearance was not remarkably affected, and only three patients reported slight scarring. Ptosis disappeared in all the patients, and slight strabismus was found in five patients. However, vision improvement was very limited, even in the patients whose occluded retinal central artery received reperfusion. Conclusions Our long-term follow-up showed that the patients with vision loss caused by hyaluronic acid filler injections could reintegrate into society after treatment. Although the embolization of the retinal central artery led to reperfusion, vision was not restored, which further demonstrated the difficulty of recovering vision with the current treatment and the importance of prophylaxis. In the future, we envision developing autohydrolysis HA by incorporating hyaluronidase-containing stimuli-responsive nanoparticles and a dual-pipe syringe to address this catastrophic event.