- •Foreword
- •Preface
- •Contents
- •1: Facial Anatomy
- •1.1 Introduction
- •1.2 Facial Skeleton
- •1.5 Retaining Ligaments
- •1.6 Mimetic Muscles
- •1.7 Deep Plane Including the Deep Fat Compartments
- •1.8 Facial Nerve
- •1.9 Sensory Nerves
- •1.10 Arteries of the Face
- •References
- •2: Facial Proportions
- •2.1 Introduction
- •2.2 Surface Markings
- •2.3 Proportions
- •2.4 The Golden Ratio
- •2.5 Planes and Angles
- •2.6 Conclusions
- •References
- •3.1 Introduction
- •3.2 Details of Zones
- •3.2.1 Zone 1
- •3.2.2 Zone 2
- •3.2.3 Zone 3
- •3.2.4 Zone 4
- •3.2.5 Zone 5
- •3.2.6 Zone 6
- •3.2.7 Zone 7
- •3.3 Conclusions
- •References
- •4: Muscles Used in Facial Expression
- •4.1 Introduction
- •4.2 Discussion
- •References
- •5.1 Introduction
- •5.2 Studies and Technique
- •5.3 Results
- •5.4 Discussion
- •5.4.1 SMAS and SMAFS: Concept and Variations
- •5.4.1.1 Sleep Lines
- •5.4.1.2 Membranous SMAFS
- •5.4.1.3 Fatty SMAFS
- •5.4.1.4 Flaccid SMAFS
- •5.4.1.5 Mixed SMAFS
- •5.4.1.7 Fleshy SMAFS
- •5.4.1.8 Fibrous SMAFS
- •5.4.1.9 SMAFS Sleep Lines Correction
- •5.5 Conclusions
- •References
- •6.1 Introduction
- •6.2 Surgical Facility
- •6.3 Ancillary Personnel
- •6.4 Preoperative Evaluation
- •6.4.1 Preoperative Risk Assessment
- •6.4.3 Cardiac Disease
- •6.4.4 Obesity
- •6.4.5 Hypertension
- •6.4.6 Diabetes Mellitus
- •6.4.7 Pulmonary Disease
- •6.4.8 Obstructive Sleep Apnea
- •6.4.9 Malignant Hyperthermia Susceptibility
- •6.5 Selections and Delivery of Anesthesia
- •6.5.1 Local Anesthesia
- •6.5.3 Regional Anesthesia
- •6.5.4 General Anesthesia
- •6.5.5 Preoperative Preparation
- •6.5.6 Perioperative Monitoring
- •6.5.7 Fluid Replacement
- •6.5.8 Recovery and Discharge
- •References
- •Recommended Reading
- •7.1 Introduction
- •7.3 Other Considerations
- •7.4 Assessing Level of Sedation
- •7.5 Agents Used in Sedation
- •7.5.1 Propofol
- •7.5.2 Benzodiazepines
- •7.5.3 Clonidine and Dexmedetomidine
- •7.5.4 Ketamine
- •7.5.5 Opioids
- •7.5.6 Acetaminophen
- •7.5.8 Other Agents
- •7.6 Devices Used in the Delivery of Sedation
- •7.7 Postoperative Nausea and Vomiting (PONV)
- •7.7.1 Risk Factors
- •7.8 Techniques of Sedation
- •7.9 Conclusions
- •References
- •8: Preoperative and Postoperative Plan
- •8.1 Plan for Facelift Surgery
- •8.2 Facelift Preoperative Instructions
- •References
- •9: Facial Imaging
- •9.1 Introduction
- •9.2 The Camera
- •Practical Tips
- •9.3 Resolution
- •Practical Tips on Resolution
- •9.4 Lighting
- •Practical Tips
- •9.5 Background
- •Practical Tips
- •9.6 Advertising and Ethics
- •9.7 Before and After Photos
- •9.8 Consent
- •Practical Tips for Consent for Photography
- •9.9 Special Problems with Consent
- •9.10 Radiology
- •9.10.1 Computed Tomography (CT)
- •9.10.2 Magnetic Resonance Imaging (MRI)
- •10.1 Introduction
- •10.2 Skin Aging
- •10.3 Techniques
- •10.3.1 Skin Care Program
- •10.3.1.1 Tretinoin
- •10.3.1.2 Skin Cleansers
- •10.3.1.3 Sun Protection
- •10.3.1.4 Light Chemical Peel or “Friendly Peel”
- •10.3.1.5 Microdermabrasion
- •10.3.1.6 Carboxytherapy
- •10.4 Complications
- •10.5 Discussion
- •10.6 Conclusions
- •References
- •11: What Is Human Beauty?
- •11.1 Introduction
- •11.2 Beauty
- •11.2.1 What Is Human Beauty? What Do the Books Say? Dictionaries? Philosophers?
- •11.2.2 Konrad Lorenz’s Theory
- •11.3 Conclusion
- •11.4 Summary
- •12: Body Dysmorphic Disorder
- •12.2 Symptoms
- •12.3 Consequences of BDD
- •12.4 Associated Disorders
- •12.5 Treatment
- •12.6 Discussion
- •12.7 Conclusions
- •References
- •13: Hair Transplantation
- •13.1 Introduction
- •13.3 Modern Hair Transplantation and Terminology
- •13.4 Nonsurgical Treatment Options
- •13.4.1 Medications
- •13.5 Nonmedical Treatments
- •13.6 Preoperative Consultation
- •13.7 Female Considerations
- •13.8 Preoperative Instructions
- •13.9 Surgical Planning
- •13.9.1 Men with MPB
- •13.9.2 The Crown
- •13.9.3 Females
- •13.9.4 Selection of Donor Area Site and Size
- •13.9.5 Estimating Size of Donor Strip
- •13.10 Anesthesia
- •13.11 Removal of Donor Strip
- •13.12 Follicular Unit Extraction
- •13.12.1 Indications for FUE
- •13.12.2 Advantages of FUE
- •13.12.3 Disadvantages of FUE
- •13.13 Graft Preparation
- •13.14 Recipient Site Creation
- •13.15 Graft Orientation: CAG or SAG
- •13.16 Instruments (Table 13.3)
- •13.17 Re-creating a Natural Hairline
- •13.18 Planting Recipient Grafts
- •13.19 The Vertex Region
- •13.20 Postoperative Care
- •13.21 Complications
- •13.21.1 Surgical Complications/Side Effects
- •13.21.2 Cosmetic/Esthetic Complications
- •13.22 Examples of Applications for Hair Transplants
- •13.22.1 Male Pattern Baldness
- •13.22.2 Female Pattern Hair Loss
- •13.22.3 Transplants After Rhytidectomy
- •13.22.4 Transplants After Burns
- •13.23 Non-scalp Areas
- •13.24 Transgendered Patients
- •13.25 Conclusions
- •References
- •14: Ablative Laser Facial Resurfacing
- •14.1 Introduction
- •14.2 Technique
- •14.2.1 Preoperative Preparation
- •14.2.2 Carbon Dioxide Laser
- •14.2.3 Erbium Laser
- •14.2.4 Postoperative Care
- •14.3 Complications
- •14.4 Discussion
- •14.5 Conclusions
- •References
- •15: Photorejuvenation
- •15.1 Introduction
- •15.2 Technique
- •15.3 Complications
- •15.4 Discussion
- •15.5 Conclusions
- •References
- •16.1 Introduction
- •16.2 Skin Anatomy
- •16.3 Technique
- •16.3.1 Patient Selection
- •16.3.2 Pretreatment
- •16.3.3 Technique
- •16.4 Alpha Hydroxy Acids
- •16.5 Salicylic Acid
- •16.6 Jessner’s Peel
- •16.6.1 Medium Depth Peels
- •16.7 Trichloroacetic Acid
- •16.8 Adjunctive Measures
- •16.9 Postoperative Care
- •16.10 Complications
- •16.11 Discussion
- •16.12 Conclusions
- •References
- •17: Deep Phenol Chemical Peels
- •17.1 Introduction
- •17.2 Patient Selection
- •17.3 Technique
- •17.4 Complications
- •17.5 Conclusions
- •References
- •18: Chemical Blepharoplasty
- •18.1 Introduction
- •18.2 Skin Preparation
- •18.3 Skin Evaluation and Chemical Agent Selection
- •18.4 Anesthesia and Sedation
- •18.5 Details of the Procedure
- •18.6 The Postoperative Period
- •18.7 Complications
- •18.7.1 Ectropion
- •18.7.4 Web Formation
- •18.7.5 Eyelid Skin Infection
- •18.8 Discussion
- •18.9 Conclusion
- •References
- •19: Facial Implants
- •19.1 Introduction
- •19.2 Technique
- •19.2.1 Midface Implants
- •19.2.2 Mandibular Implants
- •19.3 Complications
- •19.4 Discussion
- •19.5 Conclusions
- •References
- •20: Injectable Facial Fillers
- •20.1 Introduction
- •20.2 Historical Background
- •20.3 Available Facial Fillers
- •20.3.1 Autologous Fat
- •20.3.2 Collagen
- •20.3.3 Hyaluronic Acids (HAs)
- •20.3.4 Synthetic Polymers
- •20.4 Technical Considerations
- •20.5 Injection Techniques
- •20.6 Post-procedural Considerations
- •20.7 Facial Filler Complications
- •20.8 Conclusions
- •References
- •Recommended Reading
- •21: Botulinum Toxin for Facial Rejuvenation
- •21.1 Introduction
- •21.2 History
- •21.3 Chemical Overview
- •21.5 Onset and Duration of Paralysis
- •21.10 Locations of Treatment
- •21.10.1 Upper Face
- •21.10.2 Midface
- •21.10.3 Lower Face
- •21.11 New Frontiers for Botulinum Toxin in Facial Rejuvenation
- •21.12 Contraindications
- •21.13 Avoidance of Potential Pitfalls
- •21.15 Conclusions
- •References
- •22: History of Fat Transfer
- •22.1 Introduction
- •22.2 History
- •References
- •23.1 Introduction
- •23.2 Relevant Anatomy and Pathophysiology
- •23.3 Clinical Applications
- •23.3.1 Harvesting the Fat
- •23.3.2 Preparation
- •23.4 Applications and Injection Techniques
- •23.4.1 Injection Methods
- •23.5 Complications
- •References
- •24.1 Introduction
- •24.2 Patient Assessment
- •24.4 Anatomy
- •24.5 Liposuction
- •24.6 Tumescent Anesthesia
- •24.7 Liposuction Technique
- •24.8 Summary of Critical Points for Successful Liposuction
- •24.9 Chin Implantation
- •24.10 Submentoplasty
- •24.10.1 Submentoplasty Technique
- •24.11 Dealing with the Visible Submandibular Gland
- •24.12 Complications
- •24.12.1 Over-resection of Fat
- •24.12.2 Sialocele
- •24.12.3 Nerve Injury
- •24.12.4 Seroma
- •24.12.5 Skin Redundancy
- •24.12.6 Chronic Pain
- •24.12.8 Infection
- •24.12.9 Bleeding and Hematomas
- •24.12.10 Skin Slough
- •24.13 Conclusions
- •References
- •Submental Liposuction
- •26: Vaser UAL for the Heavy Face
- •26.1 Introduction
- •26.2 Technologies
- •26.3 Technique
- •26.4 Complications
- •27: Suture Facelift Techniques
- •27.1 Introduction
- •27.2 Concept
- •27.3 Patient Selection
- •27.4 Suture Types and Materials
- •27.4.1 Barbed Sutures
- •27.4.1.2 Anchored Bidirectional Barbed Sutures
- •27.4.1.3 Unidirectional Barbed Sutures
- •27.4.2 Non-barbed Sutures
- •27.4.2.1 Nonabsorbable Non-barbed Sutures
- •27.4.2.2 Absorbable Non-barbed Sutures
- •Upper Face
- •Midface
- •Lower Face
- •Neck
- •27.4.3 Coned Sutures
- •27.4.3.1 Midface
- •27.4.3.2 Neck
- •27.5 Postoperative Care
- •27.6 Complications
- •27.7 Conclusions
- •References
- •28: Bio-Lifting and Bio-Resurfacing
- •28.1 Introduction
- •28.2 Patient Desires
- •28.3 Aging of the Face
- •28.4 T3 Bioresurfacing
- •28.4.2 Young-Peel Method
- •28.4.2.2 Transdermal Introduction of Substances (Trans Peel)
- •28.4.3 Photodynamic Treatment
- •28.6 Biolifting
- •28.6.1 Method
- •28.6.1.2 Middle Layer
- •28.6.1.3 Deep Layer
- •28.6.1.4 Threads of Support
- •28.7 Endo Light Lift
- •28.8 Biodermogenesi™
- •28.9 Bio-Lifting: Protocol of Treatment
- •28.10 Conclusions
- •References
- •29: Standard Facelifting
- •29.1 Introduction
- •29.2 Technique
- •29.3 Postoperative Care
- •29.4 Complications
- •29.4.1 Hematoma
- •29.4.2 Nerve Injury
- •29.4.3 Infection
- •29.4.4 Skin Flap Necrosis
- •29.4.5 Hypertrophic Scarring
- •29.4.7 Parotid Gland Pseudocyst
- •29.5 Discussion
- •29.6 Conclusions
- •References
- •30.1 Introduction
- •30.4 Role of the Retaining Ligaments in Aging Face
- •30.5 Role of the Retaining Ligaments on Facelift
- •30.7 Presurgical Planning of Facelift
- •30.8 Facelift Procedure with Release and Suspension of the Retaining Ligaments and SMAS
- •30.8.1 Design of Skin Incision
- •30.8.2 Dissection
- •30.8.3 Liposuction
- •30.8.4 Treatment of Crow’s Feet and Sagging Lower Eyelid
- •30.8.5 Suspension
- •30.9 Clinical Cases
- •30.9.1 Case 1
- •30.9.2 Case 2
- •References
- •31.1 Introduction
- •31.2 Consultation
- •31.3.2 Photography
- •31.3.4 Preoperative Preparation on the Operating Table
- •31.3.5 Anesthesia: Intravenous Sedation
- •31.3.6 Nerve Mapping
- •31.3.8 Instrumentation
- •31.4 Procedure
- •31.5 The SMAS
- •31.6 Dressings
- •31.7 Results
- •References
- •32.1 Introduction
- •32.2 Technique
- •32.3 Complications
- •32.4 Discussion
- •32.5 Conclusions
- •References
- •33.1 Introduction
- •33.3.1 Marking
- •33.3.2 Anesthesia
- •33.4.1 Dressings
- •33.6 Disadvantages
- •References
- •34.1 Introduction
- •34.2 Strategy and Selection of SMAS Flap
- •34.3 SMAS Flap Study
- •34.4 Discussion
- •34.5 Conclusions
- •References
- •35.1 Introduction
- •35.2 Anatomic Considerations
- •35.2.1 The Facial Nerve
- •35.2.2 The SMAS Layer
- •35.3 Indications
- •35.4 Technique
- •35.5 Discussion
- •35.6 Complications
- •35.6.1 Hematoma
- •35.6.2 Nerve Injury
- •35.7 Conclusions
- •References
- •Recommended Reading
- •36.1 Introduction
- •36.2 Surgical and Functional Anatomy of the Face
- •36.2.1 Parotidomasseteric Fascia
- •36.2.2 Temporal Fascia
- •36.2.3 Deep Cervical Fascia
- •36.2.4 Malar: Buccal Fat Pad
- •36.2.5 Facial Mimetic Muscles
- •36.2.6 Facial Nerve
- •36.2.7 Retaining Ligaments
- •36.3 Anatomicohistologic Study of the Retaining Ligaments of the Face
- •36.3.1 Zygomatic Cutaneous Ligament (McGregor’s Patch)
- •36.3.2 Preauricular Parotid Cutaneous Ligament
- •36.3.3 Parotidomasseteric Cutaneous Ligament
- •36.3.4 Platysma Cutaneous Ligament
- •36.3.5 Mandibular Ligament
- •36.4 Aging Changes in the Face
- •36.5 Facelift and Historical Development of Retaining Ligaments of the Face
- •36.6 Retaining Ligament Correction and SMAS Plication in Facelift
- •36.6.1 Preparations for Surgery and Skin Marking
- •36.6.2 Surgical Technique
- •36.7 Postoperative Care and Complications
- •References
- •37.1 Introduction
- •37.2 Technique
- •37.3 Conclusions
- •References
- •38.1 Introduction
- •38.2 Preoperative Evaluation
- •38.3 Preoperative Markings
- •38.4 Anesthesia
- •38.5 Deep Plane Technique
- •38.6 Postoperative Care
- •38.7 Complications
- •38.8 Discussion
- •Recommended Reading
- •39: Subperiosteal Face-Lift
- •39.1 Introduction
- •39.2 Technique
- •39.2.1 Preoperative Evaluation
- •39.2.2 Surgical Technique
- •39.3 Complications
- •39.4 Discussion
- •39.5 Conclusions
- •References
- •40.1 Introduction
- •40.2 Limited Flap Rhytidectomy Procedures
- •40.3 Extended Flap Rhytidectomy Procedures
- •40.4 Deep-Plane Rhytidectomy
- •40.5 Adjuvant Procedures
- •References
- •41.1 Introduction
- •41.2 Pathomechanics
- •41.3 Preoperative Evaluation
- •41.3.1 Rhytidectomy in the Postbariatric Patient
- •41.4 Postoperative Care and Complications
- •41.5 Conclusions
- •References
- •42: Complications of Facelift Surgery
- •42.1 Introduction
- •42.2 Complications
- •42.2.1 Asymmetry
- •42.2.2 Bleeding
- •42.2.3 Dehiscence
- •42.2.5 Ear Deformities
- •42.2.6 Edema
- •42.2.7 Hair Loss
- •42.2.8 Hematoma
- •42.2.9 Infection
- •42.2.10 Irregularities
- •42.2.11 Necrosis
- •42.2.12 Neurological
- •42.2.13 Pain
- •42.2.14 Pigmentation Changes
- •42.2.15 Salivary Fistula
- •42.2.16 Scar
- •42.2.17 Seroma
- •References
- •43.1 Introduction
- •43.2 Historical Review
- •43.3 Anatomic Guidelines
- •43.4 The Eyebrow and Forehead as an Aesthetic Unit
- •43.5 Position of the Eyebrows
- •43.6 General Indications
- •43.7.1 Frontal Ptosis Degree
- •43.7.2 Depth of the Skin Furrows
- •43.7.3 Asymmetries
- •43.7.4 Frontal Redundant Skin
- •43.8 What Fixing Approaches and Techniques Do We Use?
- •43.8.1 Coronal
- •43.8.2 Pretrichial/Trichial
- •43.8.3 “Half Frontal”
- •43.8.4 Direct Eyebrow Lift
- •43.8.5 Endoscopic
- •43.9 Complications
- •43.10 Discussion
- •43.11 Conclusions
- •References
- •44: Endoscopic Forehead Lift
- •44.1 Forehead Aging Process
- •44.2 Indications
- •44.3 Alternative Methods
- •44.4 Anatomy
- •44.5 Endoscopic Forehead Lift Surgery: Rationale
- •44.6 Technique
- •44.6.1 Instruments
- •44.6.2 Anesthesia
- •44.6.3 Delimitation of the Working Areas
- •44.6.4 Skin Incisions
- •44.6.5 Subaponeurotic Supraperiosteal Dissection
- •44.6.6 Subperiosteal Dissection
- •44.6.7 Interfascial Dissection
- •44.6.8 Communication Between the Two Pockets
- •44.6.9 Endoscope Placement and Use
- •44.6.10 Periosteal and Muscular Sectioning
- •44.6.11 Fixation Suture Placement
- •44.6.12 Closure
- •44.6.13 Postoperative Follow-Up
- •44.7 Complications
- •44.8 Discussion
- •References
- •45.1 Introduction
- •45.2 History
- •45.3 Forehead Anatomy
- •45.5 Nonsurgical Techniques in Forehead Rejuvenation
- •45.6.1 Autogenous Fat Injection
- •45.6.2 Moisturizing Graft
- •45.6.3 Open Frontal Lift
- •45.6.4 Periorbital Approach
- •45.6.6 Forehead Endoscopic Rejuvenation
- •45.7 Complications
- •45.8 Conclusions
- •References
- •46.1 Introduction
- •46.2 Patient Marking
- •46.3 Surgical Procedure
- •46.4 Complications
- •46.5 Discussion
- •46.6 Conclusions
- •References
- •47: Endobrow Lift
- •47.1 Introduction
- •47.2 Anatomy
- •47.3 Endobrow Lift
- •47.3.1 Objectives of a Brow Lift
- •47.3.2 Preoperative Counseling
- •47.3.3 Learning Curve
- •47.3.5 Surgical and Nonsurgical Treatments of Forehead Rejuvenation
- •47.3.6 Direct Operations to the Brow
- •47.3.7 Endoscopic Brow Lift
- •47.3.8 Risks
- •47.4 Variations of Forehead and Brow Lift
- •47.5 Transpalpebral Corrugator Resection
- •47.6 Coronal Incision
- •47.7 Fat Grafting
- •47.8 Suspension and Suture Techniques
- •47.8.1 Thread Lift Guide
- •47.8.2 Thread Lift Risks
- •47.9 Botox (Chemodenervation with Botulinum Toxin)
- •47.10 Endobrow
- •47.10.1 Screw Placement
- •47.10.2 Possible Complications
- •References
- •48: Minimally Invasive Midface Lift
- •48.1 Introduction
- •48.2 Surgical Goals
- •48.3 Indications and Contraindications
- •48.4 Surgical Technique
- •48.4.1 Preoperative Markings
- •48.4.2 Anesthesia
- •48.4.5 Anchoring the Suture to the Deep Temporalis Fascia
- •48.5 Complications
- •48.6 Conclusions
- •Recommended Reading
- •49: Upper Eyelid Blepharoplasty
- •49.1 Introduction
- •49.2 Periorbital Aging
- •49.3 Anatomic Considerations
- •49.4 Musculature
- •49.5 Orbital Septum
- •49.6 Levator Palpebrae Superioris
- •49.7 Orbital Fat
- •49.8 Preoperative Evaluation
- •49.9 Ocular Assessment
- •49.10 Operative Procedure
- •49.11 Upper Eyelid Blepharoplasty Approach
- •49.12 Preparation
- •49.13 Postoperative Care
- •49.14 Complementary Treatments
- •49.14.1 Restoration of Infrabrow and Lateral Brow Volume
- •49.14.2 Injectable Fillers
- •49.14.3 Structural Fat Grafting of the Infrabrow Region
- •49.15 Complications
- •49.15.1 Hematomas
- •49.15.2 Blindness
- •49.15.3 Epiphora
- •49.15.4 Suture Line Complications
- •49.15.5 Wound Healing Complications
- •49.15.6 Ocular Injury
- •49.15.7 Contour Irregularities
- •References
- •50: Lower Eyelid Blepharoplasty
- •50.1 Introduction
- •50.2 Periorbital Aging
- •50.3 Anatomic Considerations
- •50.3.1 Lamellae
- •50.3.2 Musculature
- •50.3.3 Orbital Fat
- •50.3.4 Infraorbital and Midface Anatomy
- •50.4 Preoperative Evaluation
- •50.4.1 Ocular Assessment
- •50.4.3 Assessment of Tear Trough or Nasojugal Deformity
- •50.5 Operative Procedure
- •50.5.1 Technique
- •50.5.1.1 Transconjunctival Approach
- •Preparation
- •Postoperative Care
- •50.5.1.2 Skin–Muscle Flap Approach
- •Preparation
- •Incision
- •Fat Removal
- •Closure
- •Postoperative Care
- •50.6 Complementary Treatments with Restoration of Infraorbital Volume
- •50.6.1 Injectable Fillers
- •50.6.2 Orbital Fat Repositioning
- •50.6.3 Suborbicularis Oculi Fat Lift
- •50.7 Structural Fat Grafting of the Infraorbital Region
- •50.8 Complications
- •50.8.1 Ectropion
- •50.8.2 Hematomas
- •50.8.3 Blindness
- •50.8.4 Epiphora
- •50.8.5 Suture Line Complications
- •50.8.6 Wound Healing Complications
- •50.8.7 Skin Discoloration
- •50.8.8 Ocular Injury
- •50.8.9 Contour Irregularities
- •References
- •51: Upper Blepharoplasty of the Asian Eyelid
- •51.1 Introduction
- •51.2 Instrument List
- •51.3 Operative Technique
- •51.4 Postoperative Care
- •Reference
- •52: Medial and Lateral Epicanthoplasty
- •52.1 Introduction
- •52.3 Technique
- •52.3.1 Medial Epicanthoplasty
- •52.3.1.1 Elliptical excision: Von Ammon, Arlt, Hiraga, and Watanabe methods
- •52.3.1.2 Z-Plasty Method
- •52.3.2 Lateral Epicanthoplasty
- •52.4 Complications
- •52.5 Conclusions
- •References
- •53.1 Introduction
- •53.2 Hyaluronic Acid Gel Filler
- •53.3 Patient Marking and Preparation
- •53.4 The Injection
- •53.5 Complications
- •53.6 Discussion
- •53.7 Conclusions
- •References
- •54: Combined Technique in Otoplasty
- •54.1 Introduction
- •54.2 Technique
- •54.3 Complications
- •54.4 Discussion
- •54.5 Conclusions
- •References
- •55: Rhinoplasty
- •55.1 Introduction
- •55.2 Types of Nasal Deformity
- •55.3 Preoperative Analysis
- •55.4 Surgical Techniques
- •55.4.1 Incisions in Rhinoplasty
- •55.4.2 Osteotomies in Rhinoplasty
- •55.5 Complications
- •55.5.1 Intrasurgical Complications
- •55.5.2 Immediate Postoperative Complications
- •55.5.3 Early Postoperative Complications
- •55.5.4 Late Postoperative Complications
- •55.6 Conclusions
- •References
- •56.1 Introduction
- •56.2 Biochemistry
- •56.3 Storage
- •56.4 Mechanism of Action
- •56.5 Duration of Action
- •56.6 Clinical Uses
- •56.6.1 FDA-Approved Uses
- •56.6.2 Aesthetic Off-Label Uses
- •56.8 Nonsurgical Rhinoplasty
- •56.8.1 Initial Consult
- •56.8.2 Physical Examination
- •56.8.3 Nasal Anatomy
- •56.8.4 Anesthesia and Prophylaxis
- •56.8.5 Needles
- •56.8.6 Injection Technique
- •56.8.7 Dosage
- •56.8.8 Postinjection Care
- •56.8.9 Patient Satisfaction
- •56.9.1 Asian
- •56.9.2 African-American
- •56.9.3 Hispanic
- •56.9.4 Arabic (Middle Eastern)
- •56.9.5 Aging
- •56.9.6 Revision Rhinoplasty
- •56.10 Discussion
- •56.11 Conclusions
- •References
- •57: Lip Enhancement: Personal Technique
- •57.1 Introduction
- •57.2 Anatomical Basics of the Human Lip
- •57.3 Injectable Materials
- •57.4 Technique
- •57.5 Postoperative Instructions
- •57.6 Complications
- •57.7 Discussion
- •References
- •58.1 Introduction
- •58.2 Advantages
- •58.3 Mechanism of Action
- •58.4 The Tumescent Technique
- •58.5 Indications
- •58.6 Contraindications
- •58.7 Technique
- •58.8 Complications
- •58.9 Special Considerations
- •58.9.1 Submandibular Gland Exposure
- •58.9.2 Platysmal Band Exposure
- •58.9.3 Thyroid Thickness or Band
- •58.9.4 Receding Chin
- •References
- •59: Neck Lifting Variations
- •59.1 Introduction
- •59.2 Pathophysiology of the Aging Neck
- •59.2.1 Aging Skin
- •59.2.2 Aging Soft Tissue
- •59.2.3 Aging Facial Skeleton
- •59.3 Other Factors
- •59.4 Evaluation of the Aging Neck
- •59.4.2 Physical Findings
- •59.5 Jowl/Mandibular Evaluation
- •59.6 Submental/Neck Evaluation
- •59.7 Surgical Technique Selection
- •59.7.1 Nonsurgical Intervention
- •59.7.2 Botulinum Toxin A
- •59.7.3 Skin Tightening Procedures
- •59.7.4 Intradermal Fillers
- •59.7.5 Laser Resurfacing
- •59.8 Surgical Treatment
- •59.8.1 Liposculpting
- •59.8.2 Platysmaplasty
- •59.8.3 Rhytidoplasty
- •59.9 Special Neck Lifting
- •59.9.1 Vertical Neck Lift
- •59.9.2 Horizontal Neck Lift
- •59.10 Clinical Pearls and Pitfalls
- •References
- •60.1 Introduction
- •60.2 Technique
- •60.3 Instructions
- •60.3.1 Day of Treatment
- •60.3.2 Second Day: Micropore Tape Mask Removal and Application of Subgalatic Mask
- •60.3.3 Eighth Day: Bismuth Subgalatic Mask Removal
- •60.4 Patient Instructions
- •60.4.1 Shopping List
- •60.4.2 Night Before Procedure
- •60.4.3 The Procedure (Day 1)
- •60.4.6 Days Four (4) to Seven (7)
- •60.4.7 Mask Removal on Day Eight (8)
- •60.5 Remember
- •60.6 Complications
- •60.7 Discussion
- •60.8 Conclusions
- •61.1 Applications of Permanent Cosmetics
- •61.2 Preprocedure Preparation
- •61.3 Pigment Blends
- •61.4 Eyebrows
- •61.5 Lips
- •61.6 Postprocedure Considerations
- •61.6.1 Longevity
- •61.6.2 Risks
- •61.7 Conclusions
- •Recommended Reading
- •62.1 Introduction
- •62.4 Mechanism of Action/Histology
- •62.5 Technique
- •62.6 Longevity
- •62.7 Complications
- •62.8 Conclusions
- •References
- •63.2 Prevalence
- •63.3 Clinical Features
- •63.3.1 Morphological Changes
- •63.3.2 Metabolic Changes
- •63.3.3 Pathogenesis
- •63.3.4 Protease Inhibitors
- •63.4 HIV Infection
- •63.5 Nutritional Status, Age, and Adiposity
- •63.6 Female Sex
- •63.7 Cytokines
- •63.8 Management
- •63.8.1 Nonsurgical Treatment of HIV Facial Lipoatrophy
- •63.9 Autologous Fat Transfer
- •63.9.1 History of Autologous Fat Transfer
- •63.10 Theories of Fat Graft Survival
- •63.11 Histological Evaluation of Transplanted Fat
- •63.12 Technique
- •63.13 Surgical Technique
- •63.13.1 Anaesthesia of the Donor Site
- •63.13.2 Choice of Donor Site
- •63.13.3 Harvesting Method
- •63.15 Placement
- •63.16 Post-operative Care
- •63.17 Complications
- •63.18 Discussion
- •63.19 Conclusions
- •References
- •64.1 Introduction
- •64.2 Comparative Studies
- •References
- •65.1 Introduction
- •65.2.1 Duty
- •65.2.2 Breach of Duty (Negligence)
- •65.2.3 Causation
- •65.2.4 Damages
- •65.3 Avoiding Lawsuits
- •65.4 What to Do When a Lawsuit Is Threatened or Filed
- •Index
Advanced Surgical Facial Rejuvenation
Anthony Erian xMelvin A. Shiffman
(Editors)
Advanced Surgical
Facial Rejuvenation
Art and Clinical Practice
Editors |
|
Anthony Erian, MD |
Melvin A. Shiffman, MD |
Pear Tree Cottage |
17501 Chatham Drive |
Cambridge Road |
Tustin, California 92780-2302 |
Wimpole 43 |
USA |
SG8 5QD Cambridge |
shiffmanmdjd@yahoo.com |
United Kingdom |
|
plasticsurgeon@anthonyerian.com |
|
ISBN 978-3-642-17837-5 e-ISBN 978-3-642-17838-2
DOI 10.1007/978-3-642-17838-2
Springer Heidelberg Dordrecht London New York
Library of Congress Control Number: 2011937179
© Springer-Verlag Berlin Heidelberg 2012
This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilm or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer. Violations are liable to prosecution under the German Copyright Law.
The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.
Product liability: The publishers cannot guarantee the accuracy of any information about dosage and application contained in this book. In every individual case the user must check such information by consulting the relevant literature.
Cover design: eStudioCalamar, Figueres/Berlin
Printed on acid-free paper
Springer is part of Springer Science+Business Media (www.springer.com)
Foreword
The trend of this last century is undoubtedly to look young and youthful for the longest time possible. I believe this is due to many factors. Certainly progress in medicine, precocious diagnosis of many diseases and new therapeutic protocols have contributed in increasing longevity but most of all never like in these last decades has the image of a person been so important. We have surely become a society of appearances.
This book will certainly help the young cosmetic surgeon to choose the best techniques in order to achieve excellent results. Another important aspect that comes out of this well-described book is that invasive surgery is not necessary all the times as we once used to believe. Today, traditional lifting is usually proposed in fewer patients than before. It is possible to achieve ameliorations with other, less-invasive techniques such as fat transfer and others. In this way the patient can have short postoperative recovery periods. We should learn to satisfy our patients with the less aggressive techniques possible. Theses combined techniques is the answer that this book can give to its readers. I think that we should really be grateful to Anthony Erian, Melvin Shiffman, and to the other authors for lending us their knowledge.
I would like to add a simple thought of mine to the reader of this book. Besides the technique chosen, the cosmetic surgeon should always keep in mind that he or she is not infallible. In no way does he or she have divine power, so humbleness should be his or her main character trait. Personal hypertrophic ego can lead to major mistakes! We should make our patients happy and try to help them find a better way of living with themselves. My advice is always not to promise your patients what they will not receive.
I would like to quote a beautiful thought of the author of the book The Face by Charles H. Willi, published in 1926: “The plastic surgeon is undoubtedly the greatest of all contemporary artists, he paints on living canvas and sculpts on human flesh contributing to the health and happiness and success of his patient.”
Rome, Italy |
Giorgio Fischer, M.D. |
v
Preface
This book is the result of the hard work of many surgeons who wish to share with you their passion of facial aesthetic surgery. They are experts in their field and have agreed to share their knowledge and experience. The book covers comprehensive and “state- of-the-art” techniques in facial aesthetic surgery, and specific accounts and special techniques, both general and personal, are included.
The aim of this book is to give an up-to-date account of the latest in cosmetic facial surgery, as the trends and techniques seems to change with the times. We surgeons spend our lives learning and improving our techniques, honing and refining them. Both a beginner and an experienced surgeon will learn something from this text book.
A new trend of nonsurgical solutions has been added, as now facial rejuvenation encompasses both surgical and nonsurgical. It is acknowledged that anatomy is 90% of surgery, hence the inclusion of a detailed account relevant to facial rejuvenation.
This book has also stressed preand postoperative preparation to reduce complications and avoid litigation which is essential to our society nowadays.
Also, assessments and concepts of beauty have been added as it is difficult to have a basic parameter in this subjective industry.
I am very grateful to all the doctors who contributed with their time, knowledge, and dedication to make this book a special one.
I would like to refer to a facelift as surgical facial rejuvenation, as I feel the word “facelift” is confusing to both the patient and surgeon. It is also a misnomer. It is very difficult to divide the face into zones as all the anatomy is interlinked and interdependent.
In modern surgery today, one tends to combine more than one procedure, both surgical and nonsurgical, so it is more appropriate to name it Surgical Facial Rejuvenation.
I hope and believe that this book will be extremely useful to colleagues and students who want to know more about Facial Rejuvenation.
Cambridge, UK |
Anthony Erian, M.D. |
vii
