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Facial Plastic Surgery: FPS

Houmehr Hojjat, Peter F Svider, Syed N Raza, Giancarlo Zuliani, Michael A Carron, Mahdi A Shkoukani
No abstract text is available yet for this article.
July 10, 2018: Facial Plastic Surgery: FPS
Mirco Raffaini, Raffaella Perello, Marco Conti, Federico Hernandèz-Alfaro, Tommaso Agostini
The sagittal split osteotomy (SSO) is an indispensable tool in the correction of dentofacial abnormalities. In elective orthognathic surgery, it is important that surgeons inform patients about the risk of complications related to inferior alveolar nerve damage and unfavorable split. The purpose of this article is to describe a novel, hybrid technique to SSO by combining a reciprocating saw and piezoelectric devices with several advantages over traditional "pure" methods (osteotomies performed by reciprocating saw or piezoelectric devices only) in terms of precision, rapidity, easier splitting, and decreased complications related to inferior alveolar nerve damage and bad split with reduced overall morbidity...
June 28, 2018: Facial Plastic Surgery: FPS
Jen-Wu Huang, Chih-Sheng Huang, Szu-Hsien Wu, Yu-Chung Shih, Yi-Ying Lin, Cherng-Kang Perng
Without well recognizing the vascular territories of the perforator, surgery might damage the pedicle and diminish flap survival. This study described a transillumination method for intraoperative mapping of the subfascial plexus of the perforator in the head and neck reconstruction with an anterolateral thigh (ALT) flap and also compared the perioperative outcomes and complications of the method with those of the conventional two-pedicle ALT flap. Between January 2011 and December 2017, 26 patients who underwent head and neck reconstruction with ALT flaps were evaluated as follows: 13 underwent the transillumination method (case group), and 13 (age- and sex-matched) underwent standard two-pedicle flap procedures (control group)...
June 28, 2018: Facial Plastic Surgery: FPS
Houmehr Hojjat, Peter F Svider, Syed N Raza, Giancarlo Zuliani, Michael A Carron, Mahdai A Shkoukani
A decision tree was constructed to determine the incremental cost-effectiveness ratio (ICER) of grafting techniques used to prevent Frey Syndrome. The authors performed a sensitivity analysis to calculate what the probability of preventing Frey Syndrome would have to be and maximum costs associated with using grafting techniques to warrant their use as more "cost-effective" choice than using neither. Decision pathways utilized were uses of (1) free fat graft (FFG), (2) acellular dermis, and (3) no grafting...
June 28, 2018: Facial Plastic Surgery: FPS
Robert Glasgold, Joelle Rogal, Lesley A Rabach, Mark Glasgold
The subciliary and skin pinch approaches are the most widely accepted techniques for treating dermatochalasis of the lower eyelid. Direct excision (DE) is an accepted method for treating festoons; however, it is not a popular technique for the treatment of dermatochalasis and pigment of the lower lid. DE of the lower lid offers a safe and excellent aesthetic result for dermatochalasis and pigment of the lower lid, without causing lower lid malposition, which can occur with more traditional methods. In addition to being able to remove significantly more skin without risking lower lid malposition, this procedure allows for removal of the most pigmented and poorly textured skin overlying the nasojugal groove...
June 28, 2018: Facial Plastic Surgery: FPS
Jenny X Chen, Natalie Justicz, Linda N Lee
The use of platelet-rich plasma (PRP) has become increasingly commonplace in facial plastic surgery for the treatment of androgenic alopecia (AGA). However, this treatment remains novel with a range of application techniques and outcomes described in the literature. Herein, the authors systematically review the existing literature on the use and efficacy of PRP for AGA. Systematic review of PubMed, Embase, and Cochrane databases was performed. Case reports were excluded. Twenty-four papers met inclusion criteria for this study: 8 randomized control trials and 16 prospective cohort studies...
June 28, 2018: Facial Plastic Surgery: FPS
S B Kant, C Colla, E Van den Kerckhove, R R W J Van der Hulst, A Piatkowski de Grzymala
Treatment of facial hypertrophic scars and deformities has developed from the use of elastic fabric hoods to transparent facemasks. The clinical effects of these masks have been described. However, the psychological impact of wearing such a mask is not well documented. The aim of this study was to assess patients' satisfaction with their current facial appearance, to assess the end result of facemask therapy, and to assess the decision to have undergone facemask therapy by means of four different FACE-Q questionnaires...
June 1, 2018: Facial Plastic Surgery: FPS
Vasanthakumar Packiriswamy, Pramod Kumar, Mounir Bashour
In oculoplastic operations, knowledge of the dimensions of periorbital features based on age, gender, and race is essential for achieving better aesthetic result. This article seeks to determine the racial and gender differences of periorbital features among Malaysian Malay (MM), Malaysian Indian (MI), and Malaysian Chinese (MI) subjects. Evaluation of periorbital features was done on photographs of 200 MM, 200 MI, and 200 MC subjects, aged 18 to 26 years. The measured values were evaluated by an independent t -test...
May 3, 2018: Facial Plastic Surgery: FPS
Erin Ostby, Joshua Surowitz, Farhad Ardeshirpour
No abstract text is available yet for this article.
June 2018: Facial Plastic Surgery: FPS
Xiaona Lu, Fei Fan
No abstract text is available yet for this article.
June 2018: Facial Plastic Surgery: FPS
Ilker Uyar, Sibel Burçak Şahin Uyar, Zeynep Altuntas
No abstract text is available yet for this article.
June 2018: Facial Plastic Surgery: FPS
Tsung-Yen Hsieh, Raj Dedhia, Travis T Tollefson
Rhinoplasty, as a surgical procedure to improve the appearance of the nose while preserving or improving function, is complicated and difficult to master. Revision cleft rhinoplasty offers another tier of challenge. The symmetry, proportions, and definition of the nose are affected by the native cleft deformity but also previous surgical scars, cartilage grafts, and skin excisions. Our preferred approach is to use structural cartilage grafting to establish septal and lower lateral cartilage resiliency. Internal lining deficiency is addressed with skin or lining transfer, while excess nasal tip thickness is contoured to improve definition...
June 2018: Facial Plastic Surgery: FPS
Benjamin C Marcus
Rhinoplasty is widely acknowledged to be a challenging operation. The success of the operation has long been measured in anecdotal ways. As the surgeon-do I think the outcome is good? Does the patient tell me they are happy? At hand is an obvious issue with patients sometimes not returning to their original doctor. Other times they may have minor concerns that take minimal effort to correct. Does that constitute a revision? In most circles, the ultimate definition of revision rhinoplasty is a return to surgery with the intent to correct a functional or aesthetic concern that arose after the original procedure...
June 2018: Facial Plastic Surgery: FPS
Jeffrey S Moyer
Dissatisfaction with the appearance of the nasal tip is a common compliant in patients seeking revision surgery after rhinoplasty. Revision rhinoplasty is more technically difficult and unpredictable given the frequent presence of scar contracture, impaired skin envelope quality, and missing alar cartilage. This article describes some of the more common causes for tip revision surgery and techniques to address these abnormalities.
June 2018: Facial Plastic Surgery: FPS
Theda C Kontis
Rhinoplasty surgery is known to have revision rates up to 20%. Surgical revisions include the risk of anesthesia and scarring. The skilled injector may offer nonsurgical alternatives to patients when considering revision surgery. Injections can be done to improve symmetry or improve/camouflage deformities that are possibly too minor for surgery but bothersome to the patient. Injections can be performed using different filler materials, but these treatments also carry inherent risks.
June 2018: Facial Plastic Surgery: FPS
Grant S Hamilton
The nasal dorsum is an important component of a rhinoplasty and may be the primary motivation for seeking surgery. The nasal dorsum is a complex three-dimensional shape that is shrouded by local anesthetic and edema during surgery. This makes an accurate assessment of the surgical changes challenging. Complications related to dorsal modification include imbalances from over- or underresection of the structures of the nasal dorsum, inadequate or overaugmentation, an open-roof deformity, pollybeak, saddle nose, inverted-V, warped cartilage, visible grafts, contour problems, graft malposition, and extrusion...
June 2018: Facial Plastic Surgery: FPS
Joseph R Gonzalez, Andrew A Winkler
Septorhinoplasty is among the most common facial plastic and reconstructive surgeries and its complexities are reflected in a relatively high revision rate. The patient with a postoperative twisted nose presents an additional challenge and requires that the surgeon display empathy and possess a deep knowledge of the aesthetic and functional intricacies of the nose. Correction of the twisted nose should be approached in a systematic fashion with unique considerations for each "third" of the nose. While there are many options in the overall surgical armamentarium, each surgeon will find specific techniques that are most efficacious and reproducible for their individual practice...
June 2018: Facial Plastic Surgery: FPS
Yong Ju Jang, Shin Ae Kim, Sami Alharethy
Dorsal augmentation with synthetic implants is the most commonly performed rhinoplasty procedure, especially in the East-Asian region. However, as in all other surgical procedures, complications are inevitable. Complications that need to be managed surgically include displacement, deviation, suboptimal aesthetic outcome, extrusion, inflammation, infection, and changes in skin quality. Most complications can be easily managed with revision surgery. After the removal of the synthetic implant from the nasal dorsum, different dorsal implant materials such as dermofat, alloderm, or fascia-wrapped diced cartilage, conchal cartilage with perichondrial attachment, and costal cartilage are preferred...
June 2018: Facial Plastic Surgery: FPS
Leo Wang, Oren Friedman
As rhinoplasty procedures become more common, the need for revision surgeries increases as well. Unlike primary rhinoplasties, revision rhinoplasties can be more challenging because of anatomic differences from initial surgery, a lack of available cartilage, tissue remodeling responses, and other complications. As such, surgeons should be prepared to address revision rhinoplasty patients differently from primary rhinoplasty patients. Here, the authors describe a generalizable approach to revision functional rhinoplasty patients and detail some of the surgical techniques that can be employed to achieve optimal outcomes, with particular attention paid to procedures that can be used in the middle vault...
June 2018: Facial Plastic Surgery: FPS
Du Taichao, Luo Fuling, Zhao Hengguang
The cosmetic and functional deformities induced by thickened folds and furrows are the main complaints of patients in pachydermoperiostosis (PDP). However, traditional drug therapy only has a limited effect for its unclear genetic pathogenesis. Surgical treatment has now become one of the optimal strategies mainly aiming for its cosmetic improvement. Here we describe a comprehensive management of PDP approached with surgical procedure thereby showing markedly improved cosmetic outcome. Experientially, the surgical treatment of PDP is effective and may be preferentially recommended for PDP patients especially of severe degree...
June 2018: Facial Plastic Surgery: FPS
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