Comment on: Quantitative Analysis of the Histological Features of Tuberous Breast

Atiyeh, Bishara S.; Emsieh, Saif

doi:10.1007/s00266-022-03149-2

Cited by 3 publications

(1 citation statement)

References 8 publications

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“…34,55 Ultimately, technologically advanced measures such as periorbital wrinkles measurement by 3-D imaging 34,56 or ultrasonographic analyses of crow's feet 57 could provide a basis for meaningful and objective comparison of various studies. Furthermore, rather than PROMs that may be somewhat biased and subjective, patients' satisfaction analysis by artificial intelligence (AI) 58 and eye-tracking (ET) 59 may prove to be better measuring tools in the future. Some AI and ET application are capable of objectively measuring and quantitating PROMs and defining aesthetic interventions success from the patients' perspective.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Improvement of Crow's Feet Wrinkles in Combination With Cervicofacial and Temporal Lifting

Atiyeh,

Ghanem,

Oneisi

et al. 2023

Ann Plast Surg

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Background The lateral orbital crow's feet area is one for which rejuvenation is most frequently requested by patients. Moreover, lateral canthal wrinkles are a common source of dissatisfaction after rhytidoplasty. Botulinum toxin injection has emerged as a most popular, easy, and effective solution; nevertheless, repeated injections are required periodically for long-term effect. Other nonsurgical options have also been described to have some demonstrable advantages. Orbicularis oculi surgical manipulations have been described as well. Material and Methods A systematic PubMed literature search was conducted to identify clinical cohort studies including more than 10 patients describing surgical approaches for improvement of crows' feet wrinkles in combination with face and/or temporal lifts. The search was complemented by Embase, Medline, and Cochrane searches in addition to screening of reference lists of selected studies and simple term searches about surgical treatment of crow's feet. Results Fourteen studies satisfied the inclusion criteria and were included in this review describing various muscle excision techniques including vertical strip excision, lateral partial resection, wedge resection, muscle resection in “C” pattern, and enlarged myectomy of about one-third of the whole orbital extension in addition to muscle manipulation modalities, including muscle splaying, muscle division, muscle division and splaying, muscle undermining with partial denervation, and muscle suspension. Interposition of fascia between orbicularis muscle and overlying skin was also reported. Conclusion View the few studies retrieved and the wide spectrum of reported techniques, it is not possible to determine from this review the most effective modality. Nevertheless, it seems that subcutaneous undermining of the lateral canthal area combined with splaying and traction of the orbicularis oculi muscle and fixation to the temporalis fascia with or without muscle division would yield the best long-term results. This review indicates also that surgical correction of crow's feet during rhytidectomy or temporal lift could be a positive complement to improve aesthetic outcome. Unfortunately, if not underreported, it is definitely neglected. We believe that this review may be an eye-opener for surgeons.

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