Archives of Facial Plastic Surgery

OBJECTIVE: To compare objective outcomes and complications following temporalis tendon transfer in patients with and without a history of radiation to the parotid bed. METHODS: Retrospective medical chart review comparing dynamic movement of the oral commissure and resting symmetry achieved in 7 irradiated patients (group R) and 7 nonirradiated patients (group N) after temporalis tendon transfer for unilateral facial paralysis. RESULTS: There were no significant differences between the 2 groups of patients in terms of age, additional facial reanimative procedures, baseline lip position, or follow-up time...

OBJECTIVES: To analyze the nasal superficial arterial vasculature and to compare these anatomic findings with the results of ultrasonography Doppler investigations to evaluate nasal blood flow in physiological and pathologic conditions. METHODS: We performed 40 ultrasonography Doppler investigations in patient volunteers, 20 facial anatomic dissections in fresh cadavers, and a review of the literature on nasal blood supply. In cadavers, facial arteries were dissected to analyze nasal arterial supply...

Although the practice of medicine is built on a foundation of ethics, science, and common sense, the increasing complexity of medical interventions, social interactions, and societal norms of behavior challenges the ethical practice of aesthetic surgeons. We report a survey of the opinions, practices, and attitudes of experienced and novice facial plastic surgeons. The survey consisted of 15 clinical vignettes addressing ethical quandaries in aesthetic rhinoplasty. The vignettes are based on the experience and observations of the senior author (P...

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OBJECTIVE: To conduct objective quantitative and qualitative evaluations of the long-term result in endoscopic forehead-lift. METHODS: Medical charts of 143 patients who underwent endoscopic forehead-lift between 1994 and 2007 were reviewed for postoperative complications and the duration of complaints. Patients received a questionnaire to evaluate satisfaction and social restriction after surgery. Objective photographic preoperative and postoperative eyebrow-to-eye distances in a relaxed position and during muscle contractions were obtained...

OBJECTIVES: To assess the cross-sectional area and angle of the internal nasal valve more accurately by reformatting computed tomography (CT) scans of the nasal airway according to a more appropriate orientation than scans traditionally sectioned in the coronal plane and then to compare the results with clinical data on the nasal valve obtained from physical examination. METHODS: We performed a retrospective review of the medical records of 24 rhinoplasty patients treated at a private practice facial plastic surgery office affiliated with a tertiary care university hospital...

BACKGROUND: Rhinoplasty and septal surgery often require the use of cartilage grafts. Autologous cartilage may be thin or deviated, and the use of an absorbable scaffold material to support the reimplanted cartilage during healing can improve technique and outcomes. OBJECTIVE: To describe the use of a polydioxanone plate not only as a template in extracorporeal septoplasty but also for various other grafts commonly used in rhinoplasty and for the repair of septal perforations...

OBJECTIVES To evaluate the efficacy of placing spreader grafts via an endonasal approach and to examine the immediate and long-term functional results. METHODS A retrospective review was performed of 41 consecutive cases involving adult patients who underwent nasal valve reconstruction. Medical history and clinical examination established the cause of nasal obstruction, with internal valve dysfunction confirmed through endoscopic evaluation and the modified Cottle maneuver. Surgical correction involved a spreader graft harvested from autologous cartilage and placed endonasally...

OBJECTIVES: To present the aesthetic and functional outcomes of nasal alar reconstruction in Asian patients and to propose a working surgical algorithm. METHODS: Seventeen patients underwent nasal alar reconstruction at a university-based facial plastic surgery practice from March 1, 1998, through February 28, 2010. The male-female ratio was 10:7, with a median age of 59 years (range, 34-78 years), and the mean follow-up duration was 64 months. RESULTS: The defect was mostly caused by basal cell carcinoma resection (14 of 17 [82%]), followed by the resection of squamous cell carcinoma, trauma, and excision of a previous scar...

Objective To investigate the association between velopharyngeal insufficiency (VPI), a common finding after cleft palate repair, and various risk factors, including cleft width.Methods We performed a retrospective cohort study of patients with isolated cleft palates repaired from 2003 to 2008 at a tertiary children's hospital. Patients were observed postoperatively for development of VPI and palatal fistula. The primary risk factor was cleft width. Covariates included cleft length, age at surgery, and presence of associated syndrome...

OBJECTIVES: To demonstrate the effect of individual components of functional nasal airway surgery in a patient with multifactorial obstruction and to discuss the potential benefit of computational fluid dynamics (CFD)–aided virtual surgery. METHODS: A 53-year-old woman underwent septoplasty,turbinate reduction, and nasal valve repair. Presurgery and postsurgery digital nasal models were created from computed tomographic images, and nasal resistance was calculated using CFD techniques...

Objective To further delineate the anatomy of the motor nerve to the vastus lateralis (MNVL) in the context of its use as a possible interpositional nerve graft in facial nerve rehabilitation.Methods Twelve fresh human cadaveric thighs were dissected to investigate the anatomic location and branching pattern of the MNVL muscle.Results There were 3 to 6 primary nerve branches (mean, 4.4) supplying the vastus lateralis. The mean primary branch length was 93.8 mm (range, 51-196 mm), and each primary branch had a mean of 2...

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