- •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
606 |
M. Salgarello |
Fig. 54.20 (a1, a2) Preoperative 15-year-old boy with mildly asymmetrical prominent ears. (b1, b2) One year postoperative.
a1
b1
a2
b2
54.5 Conclusions
Otoplasty techniques include a large number of different methods, over 200 techniques, today restricted to the different combination of the elements of few basic techniques. The sunset of full-thickness methods is evident, as well as the current trend of the use of a graduated approach of combining the elements of various techniques.
The author utilizes a combination of techniques that are adapted to the anatomical needs of each deformity which gives natural and pleasant results and few complications. Their basic principles are presented as a graduated approach which is suitable to standardization, thus making this a simple, reliable, versatile, and reproducible method.
54 Combined Technique in Otoplasty |
607 |
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