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Facial Plast Surg 2024; 40(01): 101-105
DOI: 10.1055/a-2098-6188
Original Research

Can Local Infiltration Influence Postoperative Recovery in Upper Blepharoplasty? A Case Series Study on Two Different Infiltration Methods

Roberto Dell'Avanzato
1   Plastic, Reconstructive and Aesthetic Surgery, La Madonnina Clinic, Milan, Italy
,
Benedetta Agnelli
2   Department of Plastic, Reconstructive and Aesthetic Surgery, Humanitas University, Milan, Italy
,
Janos Cambiaso-Daniel
3   Department of Plastic, Reconstructive and Aesthetic Surgery, Milano Face Institute, Milan, Italy
,
Jonatann Gatti
3   Department of Plastic, Reconstructive and Aesthetic Surgery, Milano Face Institute, Milan, Italy
,
Alessandro Gualdi
4   Department of Plastic, Reconstructive and Aesthetic Surgery, Milano Face Institute, Università Vita Salute San Raffaele, Milan, Italy
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Abstract

Upper blepharoplasty is a common aesthetic surgery procedure which is frequently performed wide awake, under local anesthesia. However, advancements concerning the patients' perception during and after the procedure are still needed. This study aimed to evaluate the efficacy of a new method for local anesthetic infiltration in the upper eyelid comparing it to the traditional needle injections.

A prospective, randomized, and clinical trial was conducted on 20 patients who underwent upper eyelid blepharoplasty in local anesthesia. After randomization, one eyelid was infiltrated using a Nanosoft technology needle, while on the contralateral side traditional needle injections were performed. Preoperative demographics, Fitzpatrick, and SNAP test were recorded. Postoperative patients visual analog scale (VAS) scores for both infiltration methods and ecchymosis and edema were recorded.

Our results showed that the mean VAS scores for perceived pain were significantly lower on the eye infiltrated with Nanosoft technology (p < 0.05). Furthermore, the rate of postoperative ecchymosis and edema were also significantly lower with Nanosoft technology (p = 0.0012 and 0 = 0.0197, respectively). All 20 patients were satisfied with outcomes, and there were no major complications or need for a revision.

Our case series study suggests that Nanosoft technology may be a more effective and efficient method for the local anesthetic infiltration in upper eyelid blepharoplasty in reducing discomfort and downtime for the patient.

Keywords

nanosoft - upper blepharoplasty - local anesthesia


Publication History

Accepted Manuscript online:
24 May 2023

Article published online:
04 July 2023

© 2023. Thieme. All rights reserved.

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  • Reference

  • 1 Global Survey 2020: Full Report and Press Releases (English) | ISAPS. Accessed January 29, 2023 at: https://www.isaps.org/discover/about-isaps/global-statistics/reports-and-press-releases/global-survey-2020-full-report-and-press-releases-english/
    Google Scholar
  • 2 Strazar AR, Leynes PG, Lalonde DH. Minimizing the pain of local anesthesia injection. Plast Reconstr Surg 2013; 132 (03) 676-679
    Google Scholar
  • 3 Arndt KA, Burton C, Noe JM. Minimizing the pain of local anesthesia. Plast Reconstr Surg 1983; 72 (05) 676-679
    Google Scholar
  • 4 Harley DH, Collins Jr DR. Patient satisfaction after blepharoplasty performed as office surgery using oral medication with the patient under local anesthesia. Aesthetic Plast Surg 2008; 32 (01) 77-81
    Google Scholar
  • 5 Metzinger SE, Rigby PL, Bailey DJ, Brousse RG. Local anesthesia in blepharoplasty: a new look?. South Med J 1994; 87 (02) 225-227
    Google Scholar
  • 6 Mckee D, Lalonde D. Minimal pain local anesthetic injection with blunt tipped cannula for wide awake upper blepharoplasty. Plast Reconstr Surg Glob Open 2017; 5 (05) e1310
    Google Scholar
  • 7 Yu W, Jin Y, Yang J. et al. Occurrence of bruise, hematoma, and pain in upper blepharoplasty using blunt-needle vs sharp-needle anesthetic injection in upper blepharoplasty: a randomized clinical trial. JAMA Facial Plast Surg 2017; 19 (02) 128-132
    Google Scholar
  • 8 Welch MN, Czyz CN, Kalwerisky K, Holck DEE, Mihora LD. Double-blind, bilateral pain comparison with simultaneous injection of 2% lidocaine versus buffered 2% lidocaine for periocular anesthesia. Ophthalmology 2012; 119 (10) 2048-2052
    Google Scholar
  • 9 Kotlus BS, Heringer DM, Dryden RM. Evaluation of homeopathic Arnica montana for ecchymosis after upper blepharoplasty: a placebo-controlled, randomized, double-blind study. Ophthal Plast Reconstr Surg 2010; 26 (06) 395-397
    Google Scholar
  • 10 Patrocinio TG, Loredo BAS, Arevalo CEA, Patrocinio LG, Patrocinio JA. Complications in blepharoplasty: how to avoid and manage them. Rev Bras Otorrinolaringol (Engl Ed) 2011; 77 (03) 322-327
    Google Scholar
  • 11 McCord CD, Kreymerman P, Nahai F, Walrath JD. Management of postblepharoplasty chemosis. Aesthet Surg J 2013; 33 (05) 654-661
    Google Scholar
  • 12 Ohana O, Ayala-Haedo J, Anagnostopolous A, Lee WW. Local anesthesia injection in upper blepharoplasty surgery: a side at a time or both sides at once? A prospective randomized study. Dermatol Surg 2021; 47 (02) 241-244
    Google Scholar
  • 13 Cao L, Zhu F. Comparison of tumescent local anesthesia vs normal anesthesia technology in upper blepharoplasty in Asian women. J Cosmet Dermatol 2021; 20 (07) 2264-2269
    Google Scholar
  • 14 Pool SMW, Struys MMRF, van der Lei B. A randomised double-blinded crossover study comparing pain during anaesthetising the eyelids in upper blepharoplasty: First versus second eyelid and lidocaine versus prilocaine. J Plast Reconstr Aesthet Surg 2015; 68 (09) 1242-1247
    Google Scholar
  • 15 Steele EA, Ng JD, Poissant TM, Campbell NM. Comparison of injection pain of articaine and lidocaine in eyelid surgery. Ophthal Plast Reconstr Surg 2009; 25 (01) 13-15
    Google Scholar
  • 16 Botti G, Botti C, Rossati L. et al. “Dynamic Canthopexy” drill hole canthal repositioning. Aesthet Surg J 2019; 39 (12) 1284-1294
    Google Scholar
  • 17 Pascali M, Gualdi A, Bottini DJ, Botti C, Botti G, Cervelli V. An original application of the Endotine Ribbon device for brow lift. Plast Reconstr Surg 2009; 124 (05) 1652-1661
    Google Scholar
  • 18 Best CA, Best AA, Best TJ, Hamilton DA. Buffered lidocaine and bupivacaine mixture—the ideal local anesthetic solution?. Plast Surg (Oakv) 2015; 23 (02) 87-90
    Google Scholar
  • 19 Gualdi A, Cambiaso-Daniel J, Gatti J. et al. Double triangular cartilage excision otoplasty. Plast Reconstr Surg 2018; 141 (03) 348e-356e
    Google Scholar
  • 20 Dell'Avanzato R, Gualdi A, Vescovi E. et al. Facial rejuvenation using a microneedle-based device with a revitalizing solution and free hyaluronic acid. J Cosmet Dermatol 2021; 20 (11) 3701-3703
    Google Scholar