- •Foreword
- •Foreword
- •Preface
- •Contents
- •Contributors
- •1.1 Introduction
- •1.2 Blepharoplasty
- •1.3 Forehead Lift
- •1.4 Midface
- •1.5 Conclusion
- •References
- •2.1 Introduction
- •2.2 Facial Proportions
- •2.3 Forehead
- •2.4 Eyebrows
- •2.5 Eyelid
- •2.5.1 Topography
- •2.5.2 Lamellae
- •2.5.3 Upper Eyelid Retractors
- •2.5.4 Tarsus
- •2.5.5 Lower Eyelid
- •2.6 Midface
- •2.6.1 Topography
- •2.6.2 Soft Tissue Lamellae
- •2.6.3 Nasojugal Groove
- •2.6.4 Malar Region
- •2.6.5 Nasolabial Region
- •2.7 Facial Vasculature, Innervation, and Lymphatic Drainage
- •2.8 Conclusion
- •References
- •3.1 Introduction
- •3.2 Specific Anatomic Subunits
- •3.3 Conclusion
- •References
- •4.1 Introduction
- •4.3 Examination of the Brow and Upper Eyelid Continuum
- •4.4 Examination of the Lower Eyelid and Cheek Continuum
- •4.5 Conclusion
- •References
- •5: Oculofacial Anesthesia
- •5.1 Introduction
- •5.2 Topical Anesthesia
- •5.2.1 Eye Drops
- •5.2.2 Topical Skin Creams
- •5.3 Local Injectable Anesthesia
- •5.4 Tumescent Anesthesia
- •5.5 Oral Sedation
- •5.6 Monitored Anesthesia Care
- •5.7 General Anesthesia
- •5.8 Issues for Consideration
- •5.9 Postoperative Care
- •5.10 Regional Nerve Blocks
- •5.11 Sensory Blocks
- •5.12 Conclusion
- •References
- •6: The Open Approach to Forehead Lifting
- •6.1 Introduction
- •6.2 Background
- •6.3 Anatomy
- •6.4 Preoperative Assessment
- •6.5 Technique
- •6.6 Postoperative Care
- •6.7 Complications
- •6.8 Conclusion
- •References
- •7.1 Introduction
- •7.2 Forehead and Temporal Anatomy
- •7.3 Aesthetics and Aging
- •7.4 Patient Selection
- •7.5 Instrumentation
- •7.5.1 Technique
- •7.5.2 Complications
- •7.6 Conclusion
- •References
- •8: Direct Brow Lift: An Aesthetic Approach
- •8.1 Introduction
- •8.2 Direct Eyebrow Lift
- •8.3 The Limited Lateral Supraciliary Eyebrow Lift Procedure
- •8.5 Scar Management
- •8.6 Conclusion
- •References
- •9: Upper Eyelid Blepharoplasty
- •9.1 Introduction
- •9.2 Anatomic Eyelid and Periorbital Considerations
- •9.3 Assessing Patients’ Concerns
- •9.4 Patient History
- •9.5 Patient Examination
- •9.6 Preparation for Surgery
- •9.7 Anesthesia
- •9.8 The Surgical Prep
- •9.9 The Surgery
- •9.10 Postoperative Management
- •9.11 Complications
- •9.12 Conclusion
- •References
- •10.1 Introduction
- •10.2 Anatomical Considerations and Preoperative Evaluation
- •10.3 Internal Brow Fat Sculpting and Elevation
- •10.3.1 Surgical Technique
- •10.4 Glabellar Myectomy
- •10.4.1 Surgical Technique
- •10.5 Lacrimal Gland Prolapse
- •10.5.1 Surgical Technique
- •10.6 Conclusion
- •References
- •11.1 Introduction
- •11.2 Complications
- •11.2.1 Hemorrhage
- •11.2.1.1 Eyelid Hematoma
- •Medical Management
- •Surgical Management
- •11.2.1.2 Retrobulbar/Intraorbital Hemorrhage
- •Medical Management
- •Surgical Management
- •11.2.2 Vision Loss
- •11.2.2.1 Orbital Compartment Syndrome
- •11.2.2.2 Globe Rupture/Perforation
- •Medical Management
- •Surgical Management
- •11.2.2.3 Corneal Abrasion
- •Medical Management
- •Surgical Management
- •11.2.3 Infection
- •11.2.3.1 Medical Management
- •11.2.3.2 Surgical Management
- •11.3 Surgical Complications
- •11.3.1 Lagophthalmos
- •11.3.1.1 Medical Management
- •11.3.1.2 Surgical Management
- •11.3.2 Dry Eye Syndrome
- •11.3.2.1 Medical Management
- •11.3.2.2 Surgical Management
- •11.3.3 Lacrimal Gland Injury
- •11.3.3.1 Medical Management
- •11.3.3.2 Surgical Management
- •11.3.4 Ptosis
- •11.3.4.1 Medical Management
- •11.3.4.2 Surgical Management
- •11.3.5 Diplopia
- •11.3.5.1 Medical Management
- •11.3.5.2 Surgical Management
- •11.3.6 Sulcus Deformity
- •11.3.6.1 Medical Management
- •11.3.6.2 Surgical Management
- •11.4 Incision Irregularities
- •11.4.1 Canthal Webbing
- •11.4.1.1 Medical Management
- •11.4.1.2 Surgical Management
- •11.4.2 Scarring
- •11.4.2.1 Medical Management
- •11.4.2.2 Surgical Management
- •11.4.3 Suture Milia
- •11.4.3.1 Medical Management
- •11.4.3.2 Surgical Management
- •11.5 Asymmetry
- •11.5.1 Lid Crease and Fold
- •11.5.1.1 Medical Management
- •11.5.1.2 Surgical Management
- •11.5.2 Skin
- •11.5.2.1 Medical Management
- •11.5.2.2 Surgical Correction
- •11.5.3.1 Medical Management
- •11.5.3.2 Surgical Management
- •11.5.4 Brow Position
- •11.5.4.1 Medical Management
- •11.5.4.2 Surgical Treatment
- •11.5.5 Undercorrection/Overcorrection
- •11.5.5.1 Medical Management
- •11.5.5.2 Surgical Management
- •11.6 Unrealized Patient Expectations
- •11.7 Conclusion
- •References
- •12.1 Introduction
- •12.2 Ptosis Repair: Which Approach?
- •12.3 Patient Evaluation
- •12.4 Anatomy
- •12.5 Procedure
- •12.6 Complications
- •12.7 Conclusion
- •References
- •13.1 Introduction
- •13.2 Preoperative Evaluation
- •13.2.1 Degree of Eyelid Ptosis
- •13.2.2 Levator Muscle Function
- •13.2.3 Phenylephrine Test
- •13.3 Anesthesia
- •13.4 Surgical Technique
- •13.4.1 Step 1: Eyelid Marking for Upper Blepharoplasty
- •13.4.2 Step 2: Instilling Local Anesthetic for Upper Blepharoplasty
- •13.4.3 Step 3: Performing the Frontal Block
- •13.4.4 Step 4: Placement of the Traction Suture
- •13.4.5 Step 5: Measuring Amount of Resection
- •13.4.6 Step 6: Separation of Conjunctiva and Müller’s Muscle
- •13.4.7 Step 7: Placement of the Ptosis Clamp
- •13.4.8 Step 8: Preventing Inappropriate Ptosis Clamp Placement
- •13.4.9 Step 9: Passage of Suture
- •13.4.10 Step 10: Excision of Conjunctiva and Müller’s Muscle
- •13.4.11 Step 11: Closure of Conjunctival Wound
- •13.4.12 Step 12: Burying the Suture Knot
- •13.4.13 Step 13: Completion of Upper Blepharoplasty
- •13.5 Postoperative Management
- •13.6 Complications
- •13.7 Conclusion
- •References
- •14.1 Introduction
- •14.2 Anatomic Considerations of the Asian Upper Eyelid
- •14.2.1 Musculature
- •14.2.2 Orbital Septum
- •14.2.3 Orbital Fat
- •14.2.4 Levator Palpebrae Superioris
- •14.3 Modern Management of the Upper Eyelid
- •14.5 Strategies for the Aging Asian Eyelid
- •14.5.1 Asians with a Natural Crease
- •14.5.2 Asians Without a Crease
- •14.5.3 Asians with Prior Surgery for Supratarsal Crease Formation
- •14.6 Eyelid Crease Formation
- •14.6.1 Preoperative Eye Evaluation and Crease Positioning
- •14.6.2 Surgical Marking
- •14.6.3 Anesthesia
- •14.6.4 Surgical Technique
- •14.6.4.1 Levator-to-Skin Fixation
- •14.6.5 Postoperative Care
- •14.7 Conclusion
- •References
- •15.1 Introduction
- •15.2 Patient Selection
- •15.3 Patient Examination
- •15.4 Eyelid Position and Laxity
- •15.5 Revision Patients
- •15.6 Festoons and Malar Edema
- •15.7 Patient Expectations and Psychology
- •15.8 Important Surgical Anatomy
- •15.9 Operative Technique
- •15.10 Fat Transposition
- •15.11 Lower Eyelid Tightening
- •15.12 Skin Resurfacing
- •15.13 Postoperative Care
- •15.14 Complications and Management
- •15.14.1 Milia
- •15.14.2 Dry Eye/Chemosis
- •15.14.3 Hematoma
- •15.14.4 Eyelid Malposition/Ectropion
- •15.15 Conclusion
- •References
- •16.1 Introduction
- •16.2 Lower Eyelid Anatomy
- •16.3 Eyelid Analysis/Preoperative Evaluation
- •16.5 Postoperative Care
- •16.6 Complications
- •16.7 Conclusion
- •References
- •17.1 Introduction
- •17.2 Canthal Anatomy
- •17.3 Patient Evaluation for Canthal Surgery
- •17.4 Surgical Techniques
- •17.4.1 Canthoplasty (Lateral Tarsal Strip)
- •17.4.2 Modified Canthoplasty
- •17.4.3 Canthopexy (Muscle suspension)
- •17.4.4 The Prominent Globe
- •17.5 Postoperative Care
- •17.6 Complications
- •17.7 Conclusion
- •References
- •18.1 Introduction
- •18.2 Anatomy of the Eyelid and Cheek
- •18.4 Presentation
- •18.5 Preoperative Evaluation
- •18.6 Surgical Procedures
- •18.7 Surgical Technique
- •18.7.1 Scar Lysis and Mobilization
- •18.7.2 Midface Elevation
- •18.7.3 Graft Placement
- •18.7.4 Lateral Canthal Resuspension
- •18.7.5 Eyelid Splinting and Casting
- •18.8 Conclusion
- •References
- •19: Laser Management of Festoons
- •19.1 Introduction
- •19.2 Laser Tissue Interactions
- •19.4 Treatment Protocols
- •19.5 Complications
- •19.6 Conclusion
- •References
- •20: Midface and Lower Eyelid Rejuvenation
- •20.1 Introduction
- •20.2 The Midface
- •20.3 Why I Prefer the Subperiosteal Face Lift
- •20.4 Patient Selection
- •20.5 Indications
- •20.6 Preoperative Preparation
- •20.7 Aesthetic Considerations
- •20.8 Technique
- •20.9 Lower Eyelid Blepharoplasty
- •20.10 Fat Grafting
- •20.12 Summary
- •References
- •21: Face Implants in Aesthetic Surgery
- •21.1 Introduction
- •21.2 Midface Treatment Options
- •21.3 Diagnosis and Implant Selection
- •21.4 Surgical Procedure
- •21.5 Postoperative Care and Healing
- •21.6 Implant Complications
- •21.7 Conclusion
- •21.8 Case Presentations
- •References
- •22: Periorbital Fat Grafting
- •22.1 Introduction
- •22.2 Analysis
- •22.2.1 Lower Eyelid
- •22.2.2 Upper Eyelid
- •22.3 Volume Source: Fat Versus Filler
- •22.4 Surgical Technique
- •22.4.1 General Considerations
- •22.4.2 Fat Harvest
- •22.4.3 Fat Processing
- •22.4.4 Fat Injection
- •22.5 Postoperative Considerations
- •22.6 Complications
- •22.7 Conclusion
- •References
- •23: Periorbital Laser Resurfacing
- •23.1 Introduction
- •23.2 History
- •23.3 Use of Resurfacing Lasers for Periorbital Resurfacing
- •23.4 Traditional Ablative Laser Resurfacing
- •23.7 Fractionated Laser Resurfacing
- •23.8 Technical Considerations: Nonablative Fractionated Laser
- •23.9 Posttreatment Care for Nonablative Fractionated Laser
- •23.10 Conclusion
- •24: Laser Incisional Eyelid Surgery
- •24.1 Introduction
- •24.2 History
- •24.3 Laser Incisions
- •24.4 Laser Safety
- •24.5 Upper Blepharoplasty
- •24.6 Lower Lid Transconjunctival Blepharoplasty
- •24.7 Ptosis Repair
- •24.8 Direct Brow Lift
- •24.10 Conclusion
- •References
- •25.1 Introduction
- •25.2 Review of Neuromodulators and Fillers: The Products
- •25.3 Treatments
- •25.3.1 Lateral Orbital Rhytids (Crow’s Feet)
- •25.3.2 Glabellar Complex
- •25.3.3 Frontalis Muscle
- •25.3.4 Nasojugal Groove/Tear Trough
- •25.4 Avoiding and Managing Complications
- •25.5 Conclusion
- •References
- •26: Management of the Prominent Eye
- •26.1 Introduction
- •26.2 Anatomic Associations of the Prominent Eye
- •26.3 Surgical Treatment of the Prominent Eye
- •26.3.1 Orbital Decompression Surgery
- •26.3.2 Cheek/Orbital Rim Implants
- •26.3.3 Repair of Eyelid Retraction
- •26.3.4 Upper Lid Retraction
- •26.3.5 Lower Lid Retraction
- •26.4 Cosmetic Treatment of the Tear Trough in the Prominent Eye
- •26.7 Conclusion
- •References
- •27.1 Introduction
- •27.2 Anti-metabolites
- •27.3 5-Fluorouracil
- •27.3.1 Mechanism of Action
- •27.3.2 Management
- •27.3.3 Safety
- •27.4 Corticosteroids
- •27.4.1 Mechanism of Action
- •27.4.2 Management
- •27.4.3 Safety
- •27.5 Fillers
- •27.5.1 Safety
- •27.6 Conclusions
- •References
- •28.1 History
- •28.3 Key Anatomic Features
- •28.4 Preoperative Assessment
- •28.5 Preoperative Care
- •28.6 Surgical Preparation and Technique
- •28.7 Postoperative Care
- •28.8 Potential Complications
- •28.9 Future Considerations
- •References
- •Index
Contributors
Richard L. Anderson, MD, FACS Medical Director, Center for Facial Appearances, Salt Lake City, UT, USA
Babak Azizzadeh, MD Center for Advanced Facial Plastic Surgery, Assistant Clinical Professor of Surgery, Department of Facial Plastic and Reconstructive Surgery,
David Geffen School of Medicine at UCLA, Beverly Hills, CA, USA
Sterling S. Baker, MD Assistant Clinical Professor, Department of Ophthalmology
and Dermatology, University of Oklahoma College of Medicine, Oklahoma City, OK, USA
Adjunct Clinical Professor, Department of Dermatology, University of Oklahoma College of Medicine, Oklahoma City, OK, USA
Geeta Belsare, MD Instructor, Department of Ophthalmology, Loyola University Medical Center, Stritch School of Medicine, Maywood, IL, USA
Adam G. Buchanan, MD Assistant Chief, Department of Ophthalmology, Madigan Army Medical Center, Tacoma, WA, USA
Craig N. Czyz, DO, FACOS Chair, Section Head, and Clinical Faculty,
Department of Ophthalmology, Section of Oculofacial Plastic and Reconstructive Surgery, Ohio University, OhioHealth Doctors Hospital, Columbus, OH, USA
Raymond S. Douglas, MD, PhD Associate Professor, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
Jill A. Foster, MD, FACS Associate Clinical Professor, Director,
Division of Oculofacial Plastic and Reconstructive Surgery, Department of Ophthalmology, Ohio State University, Columbus, OH, USA
Dan Georgescu, MD, PhD Clinical Assistant Professor, Wilmer Eye Institute, Johns Hopkins Medical Center, Baltimore, MD, USA
Mark J. Glasgold, MD Clinical Associate Professor of Surgery, Department of Surgery, UMDNJ-Robert Wood Johnson Medical School, Highland Park, NJ, USA
Robert A. Glasgold, MD Clinical Assistant Professor of Surgery, Department of Surgery, UMDNJ-Robert Wood Johnson Medical School, Highland Park, NJ, USA
Robert A. Goldberg, MD Professor, Department of Ophthalmology and Oribitofacial Surgery, Jules Stein Eye Institute at UCLA, Los Angeles, CA, USA
Gregory J. Griepentrog, MD Clinical Instructor, Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, USA
xv
xvi |
Contributors |
|
|
Douglas G. Hamilton, MD Private Practice, Dermatologist and Assistant Clinical
Professor, David Geffen School of Medicine at UCLA, Beverly Hills, CA, USA
Morris E. Hartstein, MD, FACS Clinical Associate Professor, Department
of Ophthalmology and Division of Plastic Surgery,
St. Louis University School of Medicine, St. Louis, MO, USA
Director, Oculoplastic Surgery, Department of Ophthalmology,
Assaf Harofeh Medical Center, Beer Yaacov, Israel
Jonathan A. Hoenig, MD Assistant Professor, Jules Stein Eye Institute,
UCLA Medical Center, Private Practice, Beverly Hills, California, USA
Paul K. Holden, MD, MS Holden Facial Plastic Surgery, Scottsdale, AZ, USA
John B. Holds, MD, FACS Clinical Professor, Departments of Ophthalmology
and Otolaryngology Head and Neck Surgery, St. Louis University School of Medicine, Director, Ophthalmic Plastic and Cosmetic Surgery, Inc., Des Peres, MO, USA
Amina Husain, MD Oculoplastic Fellow, Department of Ophthalmology, Duke Eye Center, Durham, NC, USA
Amir M. Karam, MD Director of Facial Plastic Surgery, Carmel Valley Facial Plastic
Surgery, San Diego, CA, USA
Don O. Kikkawa, MD Professor of Clinical Ophthalmology and Chief of Division of Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology, Shiley Eye Center, University of California, La Jolla, San Diego, CA, USA
Bobby S. Korn, MD Assistant Professor of Clinical Ophthalmology,
Department of Ophthalmology, Shiley Eye Center, University of California,
La Jolla, San Diego, CA, USA
Jonathan S. Kulbersh, MD Fellow in Facial Plastic Surgery, Spaulding Drive
Cosmetic Surgery and Dermatology, Beverly Hills, CA, USA
Samuel M. Lam, MD, FACS Director, Willow Bend Wellness Center, Plano, TX, USA
Vincent B. Lam, MD Department of Ophthalmology, Drexel University College
of Medicine, Columbus, OH, USA
Kimberly J. Lee, MD Assistant Clinical Professor, Department of Surgery,
Division of Head and Neck Surgery, University of California, Los Angeles, CA, USA
Attending Surgery, Department of Facial Plastic and Reconstructive Surgery,
Cedars-Sinai Medical Center, Los Angeles, CA, USA
Seongmu Lee, MD Department of Ophthalmology, David Geffen School
of Medicine at UCLA, Los Angeles, CA, USA
Mark J. Lucarelli, MD, FACS Professor, Director, Oculofacial and Orbital Surgery,
Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison,
Madison, WI, USA
Ronald Mancini, MD Assistant Professor, Department of Ophthalmology,
UT Southwestern Medical Center, Dallas, TX, USA
Corey S. Maas, MD, FACS The Maas Clinic, Associate Clinical Professor,
University of California-San Francisco, San Francisco, CA, USA
Guy G. Massry, MD Director, Ophthalmic Plastic Surgery, Spaulding Drive Cosmetic
Surgery and Dermatology, Beverly Hills, CA, USA
Contributors |
xvii |
|
|
John D. McCann, MD, PhD Medical Director, Center for Facial Appearances,
Salt Lake City, UT, USA
Asa D. Morton, MD, BA Director of Oculoplastic and Facial Reconstruction,
Eye Care of San Diego, San Diego, CA, USA
Mark R. Murphy, MD Director, Palm Beach Facial Plastic Surgery,
Palm Beach Gardens, FL, USA
Paul S. Nassif, MD Spaulding Drive Cosmetic Surgery and Dermatology,
Assistant Clinical Professor, Department of Otolarlaryngology–Head and Neck Surgery,
University of Southern California School of Medicine, Beverly Hills, California, USA
Kartik D. Nettar, MD The Maas Clinic, San Francisco, CA, USA
Joe Niamtu III, DMD Cosmetic Facial Surgeon, Private Practice, Midlothian, VA, USA
Sang-Rog Oh, MD Clinical Fellow in Oculofacial and Reconstructive Surgery,
Department of Ophthalmology, Shiley Eye Center, University of California,
La Jolla, San Diego, CA, USA
Stephen W. Perkins, MD Meridian Plastic Surgeons, Indianapolis, IN, USA
Ayelet Priel, MD Clinical Fellow in Oculofacial and Reconstructive Surgery,
Department of Ophthalmology, Shiley Eye Center, University of California, San Diego,
La Jolla, CA, USA
Allen M. Putterman, MD Professor, Department of Ophthalmology and Visual Sciences,
Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, USA
Nicholas A. Ramey, MD Resident, Department of Ophthalmology, Duke Eye Center,
Durham, NC, USA
Oscar M. Ramirez, MD, FACS Director, Sanctuary Plastic Surgery, Boca Raton, FL, USA
Usha P. Reddy, MD Fellow in Oculoplastic and Reconstructive Surgery,
Department of Ophthalmology, Duke University Medical Center, Durham, NC, USA
Kiran Sajja, MD Clinical Assistant Professor, Department of Ophthalmology
and Visual Sciences, Havener Eye Institute, The Ohio State University, Columbus, OH, USA
Adam J. Scheiner, MD Oculoplastic Surgeon, Tampa Eye Clinic, Tampa, FL, USA
Christian L. Stallworth, MD Assistant Professor, Department of Otolaryngology– Head and Neck Surgery, University of Texas Health Science Center
at San Antonio, San Antonia, TX, USA
Mehryar Taban, MD Associate Diplomate, Department of Ophthalmology
and Orbitofacial Surgery, Jules Stein Eye Institute, David Geffen School
of Medicine at UCLA, Los Angeles, CA, USA
Kevin S. Tan, MD Resident Physician, Department of Ophthalmology, Shiley Eye Center,
University of California, La Jolla, San Diego, CA, USA
Jeremiah P. Tao, MD, FACS Assitant Professor, Director, Oculoplastic Surgery,
Department of Ophthalmology, University of California, Irvine, CA, USA
Betina Wachter, MD Clinical Instructor, Oculoplastic Surgery,
Department of Ophthalmology, University of California, Irvine, CA, USA
Tom D. Wang, MD Professor and Chief, Division of Facial Plastic
and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, Oregon Health and Science University, Portland, OR, USA
xviii |
Contributors |
|
|
Daniel J. Woodward, MD Pediatric Cardiac Anesthesiologist, |
|
Department of Anesthesiology, Oregon Health and Sciences University, Portland, OR, USA |
|
Julie A. Woodward, MD Associate Professor, Chief Division of Oculofacial Surgery, |
|
Department of Ophthalmology, Duke University, Durham, NC, USA |
|
Steven Yoon, MD Clinical Instructor, Oculoplastic Surgery, Department of Ophthalmology, |
|
University of California, Irvine, CA, USA |
|
Kenneth C.Y. Yu, MD Department of Otolaryngology-Head and Neck Surgery, |
|
Wilford Hall Medical Center, Lackland Air Force Base, TX, USA |
|
Part I
General Considerations
