Pearls and Pitfalls
in Cosmetic
Oculoplastic Surgery
Pearls and Pitfalls
in Cosmetic
Oculoplastic Surgery
Edited by
Morris E. Hartstein, MD, FACS
Clinical Associate Professor, Saint Louis University, Department of Ophthalmology and Division of Plastic and Reconstructive Surgery, St. Louis, Missouri
John B. Holds, MD, FACS
Clinical Professor, Saint Louis University, Departments of Ophthalmology and Otolaryngology-Head and Neck Surgery, St. Louis, Missouri
Guy G. Massry, MD
Director, Ophthalmic Plastic and Reconstructive Surgery. American Eye Institute, Cedars Sinai Medical Center, Los Angeles, CA, Spalding Dr. Cosmetic Surgery and Dermatology, Beverly Hills, California, Davidorf Eye Group, West Hills, California
Morris E. Hartstein, MD, FACS |
John B. Holds, MD, FACS |
Clinical Associate Professor |
Clinical Professor |
Saint Louis University |
Saint Louis University |
Department of Ophthalmology |
Departments of Ophthalmology |
and Division of Plastic |
and Otolaryngology-Head and |
and Reconstructive Surgery |
Neck Surgery |
St. Louis, MO |
St. Louis, MO |
USA |
USA |
Guy G. Massry, MD |
|
Director, Ophthalmic Pastic and |
|
Reconstructive Surgery |
|
American Eye Institute |
|
Cedars Sinai Medical Center |
|
Los Angeles, CA |
|
Spalding Dr. Cosmetic Surgery |
|
and Dermatology |
|
Beverly Hills, CA |
|
Davidorf Eye Group |
|
WestHills, CA |
|
USA |
|
Library of Congress Control Number: 2007937487
ISBN: 978-0-387-25389-3 |
e-ISBN: 978-0-387-25389-3 |
Printed on acid-free paper.
© 2008 Springer Science+Business Media, LLC.
All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden.
The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights.
While the advice and information in this book are believed to be true and accurate at the date of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
9 |
8 |
7 |
6 |
5 |
4 |
3 |
2 |
1 |
springer.com
Foreword
Learning oculofacial surgery is a lot like learning to dance. In the beginning, the dance student is consumed with where to put his or her feet. For these new students (or for the rhythmically challenged), dancing is characterized by the struggle to step their feet in imaginary numbered shoeprints, 1–2–3–4, and they barely hear the music. In surgery, the beginning surgeon is preoccupied with steps as well. Their focus is on the mechanical process. Proscribed steps create the paradigm for performing the surgery.
With time, the dance student moves on to the next stage. He does not have to think as much about where he is putting his feet, and can start to listen to the music and feel the rhythm. The advanced surgeon begins to internalize the steps of surgery so that instead of a preoccupation with the next maneuver, she can start to individualize the surgery to the patient and employ flexibilty in the face of unique problems.
The master dancer makes no conscious effort to move his feet; his feet move him. He does not concentrate on rhythm; the rhythm of the music becomes part of him. Freed from the intellectual exercise of dancing and from the technical requirements of keeping time, he is free to break from the restraints of the proscribed steps and invent a new dance as he goes along.
The master surgeon enjoys a similar freedom. The focus is not on maneuvers and, in fact, the surgeon might be temporarily taken aback if asked to explain the mechanical details of what he is doing. Instead, the thought process is conceptual. The surgeon is visualizing a result, is sensitive to the nuances of the patient’s individual anatomy, and is always making adjustments to address the unique requirements presented by the case at hand. By approaching the operation conceptually, and having effortless command of anatomy and technique, the master surgeon is freed from the constraints of proscribed operations, and is able to invent new surgeries.
In this book, a high octane collection of master surgeons provide a work that reflects the scope of ophthalmic plastic surgery. There is material here for every type of student. The beginner will appreciate step-by- step instructions and clear anatomic diagrams. The advanced surgeon
v
vi Foreword
will be drawn to the delightful tricks and peals that are sprinkled liberally throughout the text. The master surgeon (and the aspiring master) will recognize that they are seeking the same thing that the authors are seeking, and they will be stimulated to continue to search for better treatments and surgeries. The obvious hard work that went into the preparation of this book will pay off handsomely when its readers improve their ability to take care of their patients, and particularly when they are inspired to continue their own journey toward mastery of our discipline.
Robert Alan Goldberg, MD
Karen and Frank Daby Professor of Ophthalmology
David Geffen School of Medicine at UCLA
Chief, Orbital and Ophthalmic Plastic Surgery Division
Jules Stein Eye Institute
Preface
The goal of this book is to help surgeons perform more efficient, productive, and successful surgeries. By sharing our varied experiences, acquired through years of practice, we hope this book will provide insights that can enhance surgical outcomes. In compiling this text, we solicited contributions from experts in cosmetic oculoplastic surgery, as well as surgeons from other related fields, such as facial plastic surgery, plastic surgery, and dermatology. The book is divided into 12 parts, which cover the spectrum of oculofacial procedures. Each section is divided into concise chapters focusing on just one aspect of a given procedure. Within these short chapters, each contributor offers tips on how to achieve optimal results. For example, the section on upper lid blepharoplasty is subdivided as follows:
•Preoperative evaluation
•Incision planning
•Procedure pearls
•Adjunctive procedures
•Wound closure and postoperative care
There are also multiple presentations on the same aspect of a procedure to provide different points of view and approaches. We greatly appreciate the various experts, who have shared their experiences.
Acknowledgments
Roberta D. Sengelmann and Brent R. Moody served as section chiefs for Part IX, Skin Rejuvenation.
Tamara R. Fountain served as section chief for Part XII, Functional Lid Malpositions, Sections 1–2, Ptosis.
We would like to thank Jan Heizer and Chris Kleber, Saint Louis University Department of Ophthamology, for their assistance in preparing this book.
Morris E. Hartstein, MD, FACS
John B. Holds, MD, FACS
Guy G. Massry, MD
vii
Contents
Foreword by Robert Alan Goldberg . . . . . . . . . . . . . . . . . . . . . . . . |
v |
|
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
vii |
|
Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
xxiii |
|
Part I Preoperative Evaluation |
|
|
1 |
Preoperative Evaluation of the Cosmetic Patient . . . . . . . |
3 |
|
Jemshed A. Khan |
|
2 |
Evaluation of the Cosmetic Patient . . . . . . . . . . . . . . . . . . . |
6 |
|
Rona Z. Silkiss |
|
3Preoperative Patient Counseling for Cosmetic
|
Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
11 |
|
William P.D. Chen |
|
Part II Anesthesia |
|
|
4 |
Guide to Local Anesthetic Medications . . . . . . . . . . . . . . . |
15 |
|
Vivian Schiedler and Bryan S. Sires |
|
5 |
Motor Nerve Blocks in Oculofacial Surgery . . . . . . . . . . . . |
18 |
|
Vivian Schiedler and Bryan S. Sires |
|
6 |
Regional Nerve Blocks in Oculofacial Surgery . . . . . . . . . |
22 |
|
Vivian Schiedler and Bryan S. Sires |
|
7 |
Procedural Sedation in Oculofacial Surgery . . . . . . . . . . . . |
27 |
|
Vivian Schiedler and Bryan S. Sires |
|
8 |
Preoperative Preparation and Anesthesia . . . . . . . . . . . . . . |
30 |
|
William P.D. Chen |
|
9“Digital Diffusion” Technique for the Administration
of Local Anesthetic in Eyelid Surgery . . . . . . . . . . . . . . . . . |
32 |
Rona Z. Silkiss |
|
10 Anesthesia for In-Office Oculoplastic Surgery: |
|
How We Do It . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
33 |
Brent R. Moody and John B. Holds |
|
ix
xContents
Part III Upper Lid Blepharoplasty |
|
||
Section One |
Preoperative Evaluation |
|
|
11 |
Upper Eyelid Blepharoplasty: The Evaluation . . . . . . . . . . |
41 |
|
|
Evan H. Black, John D. Siddens, Frank A. Nesi, |
|
|
|
Shoib Myint, and Geoffrey J. Gladstone |
|
|
12 |
Preoperative Examination Checklist for |
|
|
|
Upper Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
44 |
|
|
Philip L. Custer |
|
|
13 |
Preoperative Evaluation and Documentation in |
|
|
|
Upper Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
46 |
|
|
Cat Nguyen Burkat |
|
|
Section Two |
Incision Planning |
|
|
14 |
Marking Strategies for Upper Blepharoplasty . . . . . . . . . . |
51 |
|
|
Guy G. Massry |
|
|
15 |
Orbit Size and Lid Marking in Upper Blepharoplasty . . . |
53 |
|
|
Philip L. Custer |
|
|
16 |
Incisional Guidelines When Marking the Skin in |
|
|
|
Upper Eyelid Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . |
56 |
|
|
Sheri L. DeMartelaere, Todd R. Shepler, Sean M. Blaydon, |
|
|
|
Russell W. Neuhaus, and John W. Shore |
|
|
17Marking the Proposed Upper Eyelid Crease: Determining the Safe Amount of Skin Removal—
|
The Pinch Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
58 |
|
Jemshed A. Khan |
|
18 |
Preoperative Measurements in Upper Blepharoplasty: |
|
|
Patient Selection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
61 |
|
Jemshed A. Khan |
|
19 |
Keys to Success When Marking the Skin in Upper |
|
|
Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
62 |
|
John R. Burroughs and Richard L. Anderson |
|
20 |
Skin Marking in Upper Blepharoplasty— |
|
|
Avoiding Pitfalls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
65 |
|
Cat Nguyen Burkat |
|
Section Three Upper Blepharoplasty Procedure Pearls |
|
|
21 |
Upper Blepharoplasty: Pearls for the Procedure . . . . . . . . |
71 |
|
Evan H. Black, John D. Siddens, Frank A. Nesi, |
|
|
Shoib Myint, and Geoffrey J. Gladstone |
|
22 |
Fat Excision in Upper Blepharoplasty . . . . . . . . . . . . . . . . . |
73 |
|
Sheri L. DeMartelaere, Todd R. Shepler, Sean M. Blaydon, |
|
|
Russell W. Neuhaus, and John W. Shore |
|
Contents xi
23 |
Mobilizing and Excising the Nasal Fat Pad in Upper |
|
|
|
Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
74 |
|
|
Jemshed A. Khan |
|
|
24 |
Tissue Removal Considerations in |
|
|
|
Blepharoplasty Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
75 |
|
|
Rona Z. Silkiss |
|
|
25 |
Fewer Hematomas in Upper Blepharoplasty . . . . . . . . . . . |
76 |
|
|
Martin H. Devoto |
|
|
26 |
Blepharoplasty Incisional Modalities: 4.0 Radiowave |
|
|
|
Surgery vs. CO2 Laser . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
81 |
|
|
Joseph Niamtu, III |
|
|
27 |
Fat Preservation and Other Tips for |
|
|
|
Upper Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
84 |
|
|
Cat Nguyen Burkat |
|
|
28 |
Asian Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
87 |
|
|
Samuel M. Lam |
|
|
Section Four |
Adjunctive Procedures in Upper Blepharoplasty |
|
|
29 |
Internal Brow Elevation with Corrugator Removal . . . . . |
95 |
|
|
John R. Burroughs and Richard L. Anderson |
|
|
30 |
Excision of ROOF During Upper Blepharoplasty . . . . . . . |
99 |
|
|
Jemshed A. Khan |
|
|
31 |
Addressing the Brow During Upper Blepharoplasty . . . . |
100 |
|
|
Philip L. Custer |
|
|
32 |
Transblepharoplasty Incision Lower Lid Canthopexy . . . . |
102 |
|
|
John R. Burroughs and Richard L. Anderson |
|
|
33 |
Lower Lid Canthopexy Through Upper Lid Incision . . . . |
104 |
|
|
Guy Ben Simon and John D. McCann |
|
|
Section Five |
Wound Closure and Postoperative Care |
|
|
34 |
Avoiding Dog Ears During Upper |
|
|
|
Blepharoplasty Closure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
107 |
|
|
Peter S. Levin |
|
|
35 |
Crease Formation in Upper Blepharoplasty . . . . . . . . . . . . |
109 |
|
|
Philip L. Custer |
|
|
36 |
Use of Tissue Adhesive for Oculoplastic |
|
|
|
Incision Closure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
111 |
|
|
Charles B. Slonim |
|
|
37 |
Avoiding or Minimizing Postoperative Swelling . . . . . . . . . |
112 |
|
|
John R. Burroughs and Richard L. Anderson |
|
|
38 |
Management of Postblepharoplasty Dry Eye . . . . . . . . . . . |
114 |
|
|
Morris E. Hartstein |
|
|
xii Contents
Part IV Lower Lid Blepharoplasty |
|
||
Section One |
Preoperative Considerations |
|
|
39 |
Lower Eyelid Blepharoplasty: The Evaluation . . . . . . . . . . |
121 |
|
|
John D. Siddens |
|
|
40 |
Lower Eyelid Blepharoplasty Evaluation: Avoid |
|
|
|
the Cookie Cutter Approach . . . . . . . . . . . . . . . . . . . . . . . . . |
125 |
|
|
Sheri L. DeMartelaere, Todd R. Shepler, Sean M. Blaydon, |
|
|
|
Russell W. Neuhaus, and John W. Shore |
|
|
Section Two |
Lower Blepharoplasty Procedure Pearls |
|
|
41 |
Three-Step Technique for Lower Lid Blepharoplasty . . . . |
129 |
|
|
Joseph A. Mauriello, Jr. |
|
|
42 |
Lower Eyelid Blepharoplasty: Procedure |
|
|
|
Pearls and Pitfalls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
137 |
|
|
John D. Siddens |
|
|
43 |
Lower Blepharoplasty: The Bilamelar Approach . . . . . . . . |
139 |
|
|
Guy G. Massry |
|
|
44 |
The Skin in Lower Lid Blepharoplasty: |
|
|
|
General Principles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
140 |
|
|
Guy Ben Simon and John D. McCann |
|
|
45 |
Incising the Septum over the Nasal, Central, |
|
|
|
and Lateral Fat Pads in Lower Blepharoplasty . . . . . . . . . |
141 |
|
|
Jemshed A. Khan |
|
|
46 |
Prolapsing the Inferior Fat Pads and Fornix in Lower |
|
|
|
Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
143 |
|
|
Jemshed A. Khan |
|
|
47 |
Identifying the Inferior Oblique in Transconjunctival |
|
|
|
Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
145 |
|
|
Jemshed A. Khan |
|
|
48 |
Achieving Symmetry in Lower Blepharoplasty |
|
|
|
Fat Removal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
147 |
|
|
Jemshed A. Khan |
|
|
49 |
Hemostasis in Lower Blepharoplasty . . . . . . . . . . . . . . . . . . |
150 |
|
|
Erin L. Holloman and Sterling S. Baker |
|
|
50 |
The Treatment of Festoons in Lower Blepharoplasty . . . . |
151 |
|
|
Sheri L. DeMartelaere, Todd R. Shepler, Sean M. Blaydon, |
|
|
|
Russell W. Neuhaus, and John W. Shore |
|
|
Section Three |
Fat Repositioning in Lower Blepharoplasty |
|
|
51 |
Fat Repositioning in Lower Blepharoplasty: |
|
|
|
Less Is More . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
157 |
|
|
Sheri L. DeMartelaere, Todd R. Shepler, Sean M. Blaydon, |
|
|
|
Russell W. Neuhaus, and John W. Shore |
|
|
Contents xiii
52 Fat Repositioning in Lower Lid Blepharoplasty: General Principles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158
Guy Ben Simon and John D. McCann
53 Transconjunctival Lower Lid Blepharoplasty with
and Without Fat Repositioning . . . . . . . . . . . . . . . . . . . . . . . 159
Guy G. Massry and Paul S. Nassif
54 Transconjunctival Lower Blepharoplasty with
Intra-SOOF Fat Repositioning . . . . . . . . . . . . . . . . . . . . . . . 167
Yasaman Mohadjer and John B. Holds
55 Lower Lid Blepharoplasty with Fat Repositioning
Using a Foam Bolster . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Eric A. Steele and Roger A. Dailey
56 Use of Tisseel in Lower Eyelid Blepharoplasty with Fat Repositioning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173
Asa D. Morton
57 Lower Blepharoplasty with Fat Repositioning
Without Sutures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176
John R. Burroughs and Richard L. Anderson
Section Four Management of Postblepharoplasty Lid Retraction
58 Managing Postblepharoplasty Lower
Eyelid Malposition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183
Michael T. Yen
59 Retroauricular Dermal Spacer Graft for Lower
Lid Retraction Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
Francesco P. Bernardini
60 Mid-Lower Eyelid Tarsoconjunctival Flap-Skin Graft:
Treatment of Cicatricial Lower Lid Retraction . . . . . . . . . 190
John Pak
61 Treatment of Postblepharoplasty Lower Eyelid
Retraction with Dermis Fat Spacer Grafting . . . . . . . . . . . 198
Bobby S. Korn and Don O. Kikkawa
Part V Forehead Rejuvenation |
|
|
Section One Preoperative Considerations |
|
|
62 |
Which Browlift to Do? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
205 |
|
Andrea N. Hass |
|
63 |
Browlifting: Patient Evaluation . . . . . . . . . . . . . . . . . . . . . . . |
206 |
|
Andrea N. Hass |
|
64 |
Preoperative Botox for Endoscopic Browlifting . . . . . . . . |
208 |
|
Andrea N. Hass |
|
xiv Contents
Section Two Endoscopic Forehead Rejuvenation |
|
|
65 |
Five Tips for Endoscopic Browlift . . . . . . . . . . . . . . . . . . . . |
211 |
|
Sheri L. DeMartelaere, Todd R. Shepler, Sean M. Blaydon, |
|
|
Russell W. Neuhaus, and John W. Shore |
|
66 |
Anesthesia Options in Endoscopic Forehead Lifting . . . . |
212 |
|
Andrew S. Eiseman |
|
67 |
Endoscopic Forehead Rejuvenation: How to Set Up |
|
|
the Operating Room and Trouble Shooting . . . . . . . . . . . . |
215 |
|
Asa D. Morton |
|
68 |
Endoscopic Forehead Rejuvenation: Equipment |
|
|
and Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
217 |
|
Asa D. Morton |
|
69 |
Incision Technique for Endoscopic Forehead |
|
|
Elevation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
220 |
|
Andrew S. Eiseman |
|
70 |
Endoscopic Forehead Elevation: Patient Marking |
|
|
and Preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
223 |
|
Geva Mannor |
|
71 |
Endoscopic Midforehead Techniques: Improved |
|
|
Outcomes with Decreased Operative Time and Cost . . . . |
224 |
|
Asa D. Morton |
|
72 |
Fifteen Principles of Enhanced Success in |
|
|
Endoscopic Browlift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
228 |
|
Guy G. Massry |
|
73 |
Dissection of Central Forehead and Temporal Pocket |
|
|
with Periosteal Release . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
231 |
|
Don O. Kikkawa |
|
74 |
Endoscopic Forehead Lifting: Dealing with the Central |
|
|
Brow Depressors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
234 |
|
Asa D. Morton |
|
75 |
Elevation and Fixation of the Lateral Brow and |
|
|
Canthus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
236 |
|
Robert G. Fante |
|
76 |
Fixation Methods in Endoscopic Browlifting . . . . . . . . . . . |
237 |
|
Andrea N. Hass |
|
77 |
Endosocopic Browlift with Deep Temporal |
|
|
Fixation Only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
238 |
|
Paul S. Nassif |
|
78Tridimensional Brow, Glabella, and Temple Enhancement with Micro Fat Injection During
Endoscopic Forehead Rejuvenation . . . . . . . . . . . . . . . . . . . |
247 |
Oscar M. Ramirez and Camilo O. Reyes |
|
Contents xv
79 |
Scalp Fixation in Endoscopic Browlift . . . . . . . . . . . . . . . . . |
254 |
|
|
Robert G. Fante |
|
|
80 |
Closing and Dressing the Wounds in Endoscopic |
|
|
|
Browlift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
257 |
|
|
Robert G. Fante |
|
|
81 |
Endoscopic Forehead Rejuvenation: Avoiding and |
|
|
|
Managing Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
259 |
|
|
Asa D. Morton |
|
|
Section Three Nonendoscopic Browlifting |
|
||
82 |
The Direct Browlift: Focus on the Tail . . . . . . . . . . . . . . . . . |
263 |
|
|
John B. Holds |
|
|
83 |
Soft Tissue Augmentation of the Temporal Brow in |
|
|
|
Browlifting Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
267 |
|
|
David E.E. Holck, Jill A. Foster, Manuel A. Lopez, |
|
|
|
and Kevin A. Kalwerisky |
|
|
Part VI |
Mid-Face Lift |
|
|
84 |
Mid-Face Lift: General Considerations and |
|
|
|
How I Do It . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
275 |
|
|
Guy G. Massry |
|
|
85 |
Ten Rules for Mid-Face Lifting for the Repair of |
|
|
|
Lid Retraction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
277 |
|
|
Morris E. Hartstein and Guy G. Massry |
|
|
86 |
The Subperiosteal Mid-Face Lift Using Bioabsorbable |
|
|
|
Implants for Fixation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
278 |
|
|
David E.E. Holck, Jill A. Foster, Kevin A. Kalwerisky, |
|
|
|
and Manuel A. Lopez |
|
|
87 |
Cheeklifting Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
285 |
|
|
Clinton D. McCord, Jr. |
|
|
88 |
Mid-Face Implants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
287 |
|
|
Joseph Niamtu, III |
|
|
Part VII |
Botox |
|
|
89 |
Introduction to Botox . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
293 |
|
|
John R. Burroughs and Richard L. Anderson |
|
|
90 |
Evaluating Potential Botox Patients . . . . . . . . . . . . . . . . . . . |
294 |
|
|
Samuel M. Lam |
|
|
91 |
Botox: General Principles of Treatment . . . . . . . . . . . . . . . |
296 |
|
|
Samuel M. Lam |
|
|
xvi Contents
92 |
Botox: Where It Works Best . . . . . . . . . . . . . . . . . . . . . . . . . |
298 |
|
Jemshed A. Khan |
|
93 |
Preparation of Botox . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
300 |
|
Jemshed A. Khan |
|
94 |
Documentation of Treatment: Botox . . . . . . . . . . . . . . . . . . |
301 |
|
Jemshed A. Khan |
|
95 |
Botox Injection Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . |
303 |
|
John R. Burroughs and Richard L. Anderson |
|
96 |
Cosmetic Botox Applications: General Considerations |
|
|
and Dosing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
305 |
|
John R. Burroughs and Richard L. Anderson |
|
97 |
Botox: Avoiding Pitfalls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
307 |
|
John R. Burroughs and Richard L. Anderson |
|
98 |
Botox Injection Techniques: Minimizing Bruising and |
|
|
Discomfort . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
309 |
|
Jemshed A. Khan |
|
99 |
Botulinum Toxin Injections Pearls . . . . . . . . . . . . . . . . . . . . |
311 |
|
Rona Z. Silkiss |
|
100 |
Botox Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
312 |
|
Jemshed A. Khan |
|
101 |
Glabella Treatment with Botox . . . . . . . . . . . . . . . . . . . . . . . |
314 |
|
Samuel M. Lam |
|
102 |
Corrugator and Procerus Rhytid Treatment with |
|
|
Botox . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
316 |
|
Jemshed A. Khan |
|
103 |
Frontalis Injection with Botox . . . . . . . . . . . . . . . . . . . . . . . . |
318 |
|
Jemshed A. Khan |
|
104 |
Frontalis Treatment with Botox . . . . . . . . . . . . . . . . . . . . . . |
320 |
|
Samuel M. Lam |
|
105 |
Shaping of the Eyebrows with Botox . . . . . . . . . . . . . . . . . . |
322 |
|
David F. Horne and Thomas E. Rohrer |
|
106 |
Botox Injection Techniques: Crow’s Feet . . . . . . . . . . . . . . |
326 |
|
Jemshed A. Khan |
|
107 |
Orbicularis Oculi Treatment with Botox . . . . . . . . . . . . . . . |
328 |
|
Samuel M. Lam |
|
108 |
Perioral Botox Injections . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
330 |
|
Jemshed A. Khan |
|
109 |
Botox Injection to the Lacrimal Gland for the |
|
|
Treatment of Epiphora . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
332 |
|
R. Jeffrey Hofmann |
|
Contents xvii
110 |
Botox Therapy for Hyperhydrosis: How I Do It . . . . . . . . |
335 |
|
Charles B. Slonim |
|
111 |
Other Uses of Botox . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
336 |
|
John R. Burroughs and Richard L. Anderson |
|
112 |
Botox for Axillary Hyperhydrosis . . . . . . . . . . . . . . . . . . . . |
338 |
|
R. Jeffrey Hofmann |
|
Part VIII Fillers |
|
|
113 |
Optimizing Outcome from Facial Cosmetic Injections |
|
|
and Promoting Realistic Expectations . . . . . . . . . . . . . . . . . |
341 |
|
Leslie Baumann |
|
114 |
Filler Pearls: General Considerations . . . . . . . . . . . . . . . . . . |
344 |
|
John R. Burroughs and Richard L. Anderson |
|
115 |
List of Fillers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
345 |
|
Bradley T. Kovach |
|
116 |
Dermal Filler Pearls: the Hyaluronic Acids . . . . . . . . . . . . |
352 |
|
John R. Burroughs and Richard L. Anderson |
|
117 |
Radiesse Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
354 |
|
John R. Burroughs and Richard L. Anderson |
|
118 |
Juvederm Pearls: Fine and Superficial Lines . . . . . . . . . . . . |
356 |
|
John R. Burroughs and Richard L. Anderson |
|
119 |
Achieving Beautiful Lip Augmentation . . . . . . . . . . . . . . . . |
357 |
|
Kimberly J. Butterwick |
|
120 |
Restylane Injection for the Lower Eyelid Tear |
|
|
Trough . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
362 |
|
R. Jeffrey Hofmann |
|
121 |
Liquid Injectable Silicone for the Upper Third of |
|
|
the Face . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
364 |
|
Derek H. Jones |
|
122 |
Periocular Injectables with Hyaluronic Acid and |
|
|
Calcium Hydroxyapatite . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
369 |
|
Robert A. Glasgold and Samuel M. Lam |
|
123 |
Pearls and Pitfalls of Botox and Filler Substances in |
|
|
the Upper Third of the Face . . . . . . . . . . . . . . . . . . . . . . . . . |
373 |
|
Seth L. Matarasso |
|
124 |
Periorbital-Facial Volume Rejuvenation for |
|
|
Focal Deficits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
379 |
|
John R. Burroughs and Richard L. Anderson |
|
125 |
Pearls for Periorbital Fat Transfer . . . . . . . . . . . . . . . . . . . . |
381 |
|
Lisa M. Donofrio |
|
xviii Contents
126 |
Complementary Fat Grafting in the Periorbital |
|
|
Region . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
384 |
|
Samuel M. Lam, Mark J. Glasgold, |
|
|
and Robert A. Glasgold |
|
127 |
Autogenous Orbicularis and Fat as a Filler . . . . . . . . . . . . . |
386 |
|
John R. Burroughs, Michael T. Yen, |
|
|
and Richard L. Anderson |
|
Part IX Skin Rejuvenation |
|
||
Section One |
Skin Care |
|
|
128 |
Skin Care 101: The Basics . . . . . . . . . . . . . . . . . . . . . . . . . . . |
391 |
|
|
Diane S. Berson |
|
|
129 |
Retinoids for the Cosmetic Patient . . . . . . . . . . . . . . . . . . . |
393 |
|
|
Kenneth R. Beer |
|
|
130 |
Evaluation of Skin Lesions in the Cosmetic Patient |
|
|
|
Made Simple: Actinic Keratosis . . . . . . . . . . . . . . . . . . . . . . |
396 |
|
|
Brent R. Moody |
|
|
Section Two |
Nonablative Therapy |
|
|
131 |
Chemical Peels for Facial Rejuvenation . . . . . . . . . . . . . . . |
401 |
|
|
Andrew J. Kaufman |
|
|
132 |
Nonablative Laser and Light Facial Rejuvenation . . . . . . . |
404 |
|
|
Jeffrey S. Dover |
|
|
133 |
Mesotherapy for Cosmetic Periocular Enhancement . . . . |
409 |
|
|
Samuel M. Lam and Gustavo H. Leibaschoff |
|
|
Section Three |
Ablative Therapy |
|
|
134 |
Skin Rejuvenation Techniques: |
|
|
|
General Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
413 |
|
|
Erin L. Holloman and Sterling S. Baker |
|
|
135 |
CO2 Laser Skin Resurfacing Prophylaxis . . . . . . . . . . . . . . |
416 |
|
|
Jemshed A. Khan |
|
|
136 |
CO2 Laser Resurfacing Immediate Postoperative |
|
|
|
Care Prior to Complete Epithelialization . . . . . . . . . . . . . . |
417 |
|
|
Jemshed A. Khan |
|
|
137 |
Products Used in CO2 Laser Resurfacing Wound Care: |
|
|
|
Late Postoperative Care After Complete |
|
|
|
Epithelialization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
418 |
|
|
Jemshed A. Khan |
|
|
138 |
Monopolar Radiofrequency Tissue Tightening . . . . . . . . . . |
419 |
|
|
Elizabeth F. Rostan |
|
|
Contents xix
139 |
Dual-Mode Erbium-YAG Laser Skin Resurfacing . . . . . . |
424 |
|
|
John B. Holds |
|
|
140 |
Fraxel Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
428 |
|
|
Howard Conn |
|
|
Part X |
Thread Lift |
|
|
141 |
Pros and Cons of Contour Threads for Upper Facial |
|
|
|
Rejuvenation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
433 |
|
|
Michael S. Kaminer |
|
|
142 |
Periocular Suture Lifts: Brow and |
|
|
|
Malar Repositioning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
435 |
|
|
Samuel M. Lam |
|
|
143 |
Contour Threads Technique Pearls . . . . . . . . . . . . . . . . . . . . |
438 |
|
|
Michael S. Kaminer |
|
|
144 |
Combined Modalities for the Correction of |
|
|
|
Asymmetric Brow Position . . . . . . . . . . . . . . . . . . . . . . . . . . |
440 |
|
|
William P. Mack |
|
|
Part XI Other Cosmetic Procedures |
|
||
145 |
Repair of the Torn Earlobe . . . . . . . . . . . . . . . . . . . . . . . . . . |
445 |
|
|
Yoash R. Enzer |
|
|
146 |
Upper Lip Lift as a Complementary Technique |
|
|
|
in Facial Rejuvenation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
452 |
|
|
Oscar M. Ramirez and Camilo O. Reyes |
|
|
147 |
SMAS Malar Fat Pad Lift with Short Scar Face Lift . . . . . |
457 |
|
|
Paul S. Nassif and Guy G. Massry |
|
|
148 |
Ten Tips for a Reliable and Predictable Deep Plane |
|
|
|
Facial Rhytidectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
460 |
|
|
David E.E. Holck, Jill A. Foster, Kevin A. Kalwerisky, |
|
|
|
and O. Bailey Robertson |
|
|
Part XII |
Functional Lid Malpositions |
|
|
Section One Ptosis: Anterior Approach |
|
||
149 |
Advantages of Sequential Versus Simultaneous |
|
|
|
Bilateral Levator Advancement Surgery . . . . . . . . . . . . . . . |
475 |
|
|
Herbert J. Glatt |
|
|
150 |
Considerations in Simultaneous vs. Sequential |
|
|
|
Bilateral Levator Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
476 |
|
|
Robert A. Mazzoli |
|
|
xx Contents
151 |
Unilateral Levator Resection for Jaw-Winking |
|
|
Ptosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
478 |
|
Stuart R. Seiff |
|
152 |
Ten Steps to Making Ptosis Surgery More Predictable . . . |
479 |
|
Russell S. Gonnering |
|
153 |
Adjustable Suture Technique for Levator Surgery . . . . . . |
481 |
|
Morris E. Hartstein and John J. Woog |
|
154 |
Tarsal Switch Levator Resection for the Treatment |
|
|
of Myopathic Blepharoptosis . . . . . . . . . . . . . . . . . . . . . . . . |
484 |
|
Sheri L. DeMartelaere, Todd R. Shepler, Sean M. Blaydon, |
|
|
Russell W. Neuhaus, and John W. Shore |
|
155 |
Modified Levator Advancement Ptosis Technique . . . . . . . |
490 |
|
Rona Z. Silkiss |
|
156 |
Minimally Invasive Ptosis Repair . . . . . . . . . . . . . . . . . . . . . |
491 |
|
Francesco P. Bernardini |
|
157 |
Small Incision External Levator Repair . . . . . . . . . . . . . . . |
494 |
|
Mark J. Lucarelli |
|
158 |
Ptosis Repair by a Single-Stitch Levator |
|
|
Advancement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
497 |
|
Don Liu |
|
159 |
Postoperative Care in Ptosis Surgery . . . . . . . . . . . . . . . . . . |
500 |
|
Edsel Ing |
|
Section Two Ptosis: Posterior Approach
160Pearls for Müller’s Muscle–Conjunctival Resection–Ptosis Procedure Combined with Upper
Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 503
Allen M. Putterman
161 |
Müller’s Muscle–Conjunctival Resection Pearls: |
|
|
Phenylephrine and Resection Considerations . . . . . . . . . . |
506 |
|
Melanie H. Erb and Steven C. Dresner |
|
162 |
Avoiding Lid Contour Abnormalities in Müller’s |
|
|
Muscle–Conjunctival Resection: Recognizing |
|
|
the Lateral Shift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
508 |
|
Michael E. Migliori |
|
163 |
Müller’s Muscle–Conjunctival Resection |
|
|
Procedure Tips . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
509 |
|
Melanie H. Erb and Steven C. Dresner |
|
Section Three Entropion |
|
|
164 |
Minimally Invasive, Three-Step, Transconjunctival |
|
|
Entropion Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
513 |
|
Francesco P. Bernardini |
|
Contents xxi
165 |
Simple Entropion Repair Using the Orbicularis Strip . . . |
515 |
|
Don Liu |
|
166 |
Simple “Bedside” Cautery Entropion Repair . . . . . . . . . . . |
517 |
|
David J. Singer |
|
Section Four Ectropion |
|
|
167 |
“Simple-Dimple” Lateral Tarsus Fixation . . . . . . . . . . . . . . |
521 |
|
William L. Walter |
|
168 |
Lower Lid Retractor Dissection . . . . . . . . . . . . . . . . . . . . . . |
524 |
|
Jeffrey P. Edelstein |
|
169 |
Simple Lower Lid Tightening Without Tarsal Strip . . . . . . |
525 |
|
Don Liu |
|
170 |
Technique for Medical Canthal Flap to Correct |
|
|
Lid Retraction/Medial Ectropion . . . . . . . . . . . . . . . . . . . . . |
526 |
|
Kathleen M. Duerksen |
|
171 |
Medial Canthorraphy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
528 |
|
Francesco P. Bernardini |
|
172 |
Myocutaneous Flaps and Canthopexy for Repair of |
|
|
Severe Cicatricial Ectropion . . . . . . . . . . . . . . . . . . . . . . . . . |
531 |
|
James Leong and Raf Ghabrial |
|
Index |
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
533 |