Index

534 Index

Autologous fat, 349

transconjunctival incision

Botox (BTX), 96, 341, 366, 377,

Avage (Tazarotene), 395

in, 137

413, 434

preoperative instructions for,

anesthesia for, 309

B

45

blepharoptosis and, 336

Bacitracin, 257, 447

radiowave surgery for, 81–83

brow and, 208, 211

Balance of power, 6–7

suborbital shadowing and,

arching/lifting, 323

Bedside cautery technique, 517

381

asymmetry and, 323, 441

Bell’s palsy, 41, 51, 114, 440,

tissue removal considerations

lowering/flattening, 323

484

for, 75

modifying position with,

Benzodiazepines

transconjunctival, 145, 150

322–323, 325

antagonists to, 29, 34

intra-SOOF fat

muscles in, 208, 211

oral, 28, 34

repositioning in,

ptosis, 307, 320

Benzyl alcohol, 17

168–169

browlift with, 305

Betacaine, 33, 309

patient selection for, 167

asymmetrical, 323, 441

Betadine, 51, 335, 447

postoperative care for,

charging for, 296

Bicarbonate, 17

168–169

chemical peel combined with,

Bilateral ptosis, 476

upper eyelid

401

Bioabsorbable implants

anatomic checklist for,

complications of, 307,

coronal browlift and, 278

44–45

312–313

Endotine Forehead, 254,

browlift and, 206

corrugator and, 316

278–280

crease formation in,

documentation for, 296,

Endotine Midface ST, 279,

107–108

301–302

281

evaluation for, 41–43, 206

dosage for, 298, 306, 378

subperiosteal midface lift

fat preservation in, 84–86

dry eye and, 307

with, 278–280

incision guidelines for,

ecchymosis and, 294

Bionix screws, 237

56–57

endoscopic browlift and, 208,

Blepharochalasis, 207

marking strategies for,

211

Blepharoplasty

51–57, 62–68

evaluation for, 294–295, 328

Asians and, 87–91

orbit size and, 53–55

expectation management for,

brow ptosis and, 41–42

partial incision method for,

342

CO2 laser surgery for, 81–83

87–88

eyelid retraction with, 336

cosmetic, 11

pinch technique for, 58–60

ller and, 344, 374

endoscopic browlift and,

preoperative evaluation

llers, 344, 374

229–230

for, 46–47

forehead and, 298, 305, 320–

eyelid margin and, 45

preoperative measurement

321, 378

fat grafting with, 385

for, 61

frontalis, 318–321

levator advancement and,

Blepharoptosis, 98, 293

glabella, 305, 314–315, 376,

475, 490

Botox for, 336

378

lower eyelid, 5

induced, 307

hyperlacrimation and, 336

bilamellar approach to, 139

myopathic, 484

indications for, 298–299

canthopexy in, 104

repairing, 506

informed consent for,

cheeklift and, 285

Blepharospasm, 293

301–302

evaluation for, 121–126

Blood thinners, 294, 296, 341

injecting, 303–304, 311

fat repositioning in, 157–

Body dysmorphic syndrome, 9

hematoma and, 307

158, 176–180

Bone xation

lacrimal glands and, 332–334,

hemostasis in, 150

endoscopic browlift and, 225,

336

malposition after, 183–184,

228, 237–238

lagophthalmos and, 336

190

endoscopic forehead

lip enhancement with, 360

postoperative care for, 161

rejuvenation and, 225

lower eyelid retraction with,

resuspension in, 131, 134

methods for, 237

307

retraction after, 198

Bone tunnel, 256

marking for, 296, 303

skin in, 140

Bony onlay implants, 267

perioral injection of, 330–331

three-step technique for,

Bony volume augmentation,

pinch technique for, 304

129–135

267–268

postoperative, 51

Index 535

prejudices about, 295

anesthesia for, 212–214, 228

C

preoperative counseling for,

bioabsorbable implants

Calcium hydroxyapatite (CH),

294–295

and, 278

349, 354

preoperative use of, 208

blepharoplasty with,

periocular rejuvenation with,

preparation of, 300, 307

229–230

369–371

procerus and, 316

bone fi xation for, 225, 228,

Canthopexy

ptosis and, 307, 320, 336

237–238

lateral, 102, 177

safety of, 307

central brow depressors

entropion repair and, 513

side effects of, 302

and, 234–235, 239

lower lid, 102, 104

thread lift and, 437

DFTO and, 229, 238–241

myocutaneous aps with,

upper face usage of, 373–376

equipment setup for,

531–532

Botulinum toxin type A (Botox),

217–219

Canthoplasty, 159

42, 239

flap xation techniques for,

Canthorrhaphy, medial,

action of, 293

224–225

528–530

Brow

hair confinement for,

Canthotomy, 525

asymmetry of, 323, 328

224–225

Canthus, elevation of, 236

correcting, 440–441

improving outcomes of,

Captique, 341, 347, 358

Botox and, 208, 211

228–230

Cell Friendly system, 247, 249

arching/lifting, 323

incision technique for,

Central fat pad, 141–142,

asymmetry and, 323, 441

220–221

145–146

lowering/flattening, 323

marking for, 223, 228

Central attening, 508

modifying position with,

muscle manipulation in,

Cephalosporin, 287

322–323, 325

229

Cerebrospinal fluid leak, 260

muscles in, 208, 211

preoperative Botox for,

Cetaphil, 391

ptosis, 307, 320

208, 211

CH. See Calcium

central depressors of, 234–235,

room setup for, 215–216

hydroxyapatite

239

wound closure for, 229, 257

Cheeklift

elevation of, 42, 236, 254

evaluation for

complications of, 285–286

DFTO and, 240

patient examination for,

facelift v., 285

fat sculpting in, 52, 100–101

206–207

implants for, 287–289

internal elevation of, 95–98,

procedure selection and,

lower eyelid blepharoplasty

100

205

and, 285

overaction of, 12

hairline and, 205

Chemical peeling, 140, 295, 393,

position of, 41

mid-forehead, 440

413

ptosis of, 41–44, 51, 61, 98,

pretrichial, 268, 269, 440

agents for, 402

207, 440

ptosis and, 207

AK and, 397

Botox and, 307, 320

scalp fixation in, 254–256

laser resurfacing combined

elevation for, 95

selecting, 205

with, 401

sulcus and, 44

soft tissue augmentation in,

retinoids and, 394

sulcus relation to, 44

269–271

skin care after, 392

usage of, 206

procedure for, 268

uses of, 401

Brow fat removal, 100–101

techniques for, 267

Chemosis, 132

Browlift, 51

trans-bleph, 205, 267, 440

Cicatricial ectropion, 191,

Botox for, 305, 322

tumescent injection for, 211

531

coronal, 205, 268, 440

upper lid blepharoplasty and,

Cicatrix excision, 190, 477

bioabsorbable implants

206

ectropion repair with, 531

and, 278

Browlift Bone Bridge System,

Cicatrix formation, 183

direct, 205, 440

256

correcting, 190–197

complications of, 264

Browpexy, 267

Cipro, 416, 417

marking for, 265

internal, 440

Ciprofloxacin hydrochloride

patient selection for, 263

BTX. See Botox

(Cipro), 416, 417

postoperative care for, 264

Bunny lines, 378

Cleft earlobe, 445

procedure for, 264

Bupivacaine, 15–16, 17, 21, 33,

Clobetasol propionate

endoscopic, 205, 247, 440, 469

35, 212–213, 229, 480

(Temovate-E), 418

536 Index

Closure

Cryosurgery, 397

postoperative care for, 264

crease formation and,

Cryosurgery hypopigmentation,

procedure for, 264

107–108

397

Dissociated vertical deviation

dog ear avoidance in, 107–108

Cyanoacrylate adhesive, 111

(DVD), 478

layered, 85

Cymetra, 350

Doctor-patient relationship

CO2 laser surgery, 81–83,

D

balance of power in, 6–7

424–426

procedure success and, 62

fractionated, 429

Dacryocystorhinostomy, 23

Documentation, 7

intra-SOOF fat repositioning

Deep temporal fascia (DTF)

Botox and, 296, 301–302

and, 168

implant fixation to, 279–280

photos for, 41, 45, 121–122

lower lid blepharoplasty with,

mid-face lift and, 275–276

preoperative evaluation and,

129–130, 137

Deep temporal fixation only

46, 121

resurfacing with, 140, 402,

(DFTO), 229, 238, 242,

Dog ear avoidance, 107–108

404, 414

244

Dove, 391

prophylaxis for, 416

results from, 241

Doxycycline, 115

skin thickness and, 132

surgical technique for,

Dry eye, 41, 46, 54, 312

CO2 Ultrapulse ablation, 428

239–241

Botox and, 307

Coban wrap, 254, 257

“Deer in the headlights” look,

lagophthalmos and, 114

Cod liver oil, 115

207

managing, 114–115

Co-enzyme Q10, 392

Dermabond, 111

Dry skin, 391

Cold sores. See Herpes simplex

Dermabrasion, 413. See also

DVD. See Dissociated vertical

Collagen, 267, 341, 342, 347,

Microdermabrasion

deviation

350, 358, 375

Dermal stimulators, 342

Dyschromia, 402

RF tightening and, 419

Dermatitis

Dyspigmentation, 404

Communication

earlobe tears and, 445

Dysport (Reloxin), 341

face and, 3–5

neomycin-associated, 112

Dyspraxia, 477

unintended, 3

Dermatochalasis, 41, 440

Compression wrap, 257–258

blepharoplasty methods and,

E

Condyloid process, 18, 21

87–88

Earlobe

Conjunctival anesthesia, 34

external levator repair and,

cleft, 445

Conjunctival fornix, prolapsing,

494

repairing, 445–450

143–144

festoon treatment and, 151

basic principles for, 446

Conjunctival muellerectomy

pseudo, 51

complete tears, 446–447,

(Putterman procedure),

sulcus, 44

449–450

476, 494

upper eyelid, 4, 5

partial tears, 447–448, 449

Contour lift, 436

visual field obstruction and,

rhytidectomy and, 463, 467

Contour ThreadLift, 431, 433–

46

slit, 445

434, 436, 438–440

Dermis fat spacer grafting,

split, 445

Corneal staining, 41

198–200

torn, classifi cations of, 445

Coronal browlift, 205, 268, 440

Dexamethasone, 131

Earlobe repair, preoperative

bioabsorbable implants and,

DFTO. See Deep temporal

counseling for, 446

278

xation only

Ear piercing, 445

Corrugator

Diazepam (Valium), 28, 30, 34

Ecchymosis, 32, 369, 374

Botox for, 316

Differin, 343

avoiding, 309, 328

removal of, 95, 97

Diflucan, 416

Botox and, 294

Corticosteroids, 131, 132, 401

Digital diffusion of anesthesia,

thread lift and, 437

Cosmeceuticals, 392, 393

32

Ectropion, 12, 33, 125, 151, 192

Cosmetic blepharoplasty, 11

Diode laser. See Intense pulsed

as blepharoplasty

Cosmoderm, 341, 347, 374–376

light

complication, 183, 184

Cosmoplast, 341, 347, 376

Diplopia, 162, 303, 307, 312

cicatricial, 191, 531

Coumadin, 343

Direct browlift, 205, 440

repairing, 526–527

Crease formation, 107–108

complications of, 264

Edema

Crow’s feet, 3, 298, 326–327,

marking for, 265

chemical peel and, 402

375, 378

patient selection for, 263

thread lift and, 437

Index 537

ElaMax, 17

flap xation techniques for,

intra-SOOF fat repositioning

ELA-Max cream, 362

224–225

and, 168

Elastin, 350

hair confi nement for, 224–225

resurfacing with, 140, 401,

Electrocautery

improving outcomes of,

402, 404

alopecia avoidance and, 259

228–230

Er:Glass laser, 407

levator repair and, 480

incision technique for,

Erythema, 342, 376, 402, 404

Elevess, 347

220–221

PDT for, 397

EMLA, 16, 309

central incision, 220

sun protection preventing,

Emollients, 392

paracentral incision,

392

retinoids and, 393, 395

220–221

Expectation risk, 9

Endoscopic blepharoplasty,

temporal, 221

Exposure keratitis, 312

229–230

marking for, 223, 228

Exposure keratopathy, 336, 484

Endoscopic browlift, 205, 247,

muscle manipulation in, 229

External levator repair, 494–496

440, 469

preoperative Botox for, 208,

Eyebag, 384

anesthesia for, 212–214, 228

211

Eye box photo, 122, 123

bioabsorbable implants and,

room setup for, 215–216

Eyelid margins, evaluating,

278

wound closure for, 229, 257

44–45

blepharoplasty with, 229–230

Endoscopic mid-face lift,

Eyelid position measurements,

bone fi xation for, 225, 228,

275–276

122

237–238

Endotine fixation system, 237,

Eyelid ptosis, 3, 46, 61, 312

central brow depressors and,

238

Eyelid retraction, 293

234–235, 239

Endotine Forehead

Botox for, 336

DFTO and, 229, 238–241

Bioabsorbable Implant,

levator repair and, 481

equipment setup for, 217–219

254, 278–280

Eyelid skin, evaluating, 44, 46

flap xation techniques for,

Endotine Midface ST

Eye medical history, 114

224–225

Bioabsorbable Implant,

hair con nement for, 224–225

279, 281

F

improving outcomes of,

Endotine ribbon, 431

Facelift, cheeklift v., 285

228–230

Enduragen, 379, 380

Facial akinesia, 18

incision technique for,

Enhancement. See

Facial features

220–221

Augmentation/

communication and, 3–5

marking for, 223, 228

enhancement

periocular, 3

muscle manipulation in, 229

Entropion, 12, 33, 525

rejuvenation of, 369–371

preoperative Botox for, 208,

causes of, 513

Facial nerve blocks, 18–21

211

repairing

Facial palsy, 293

room setup for, 215–216

bedside cautery technique

Facial paralysis, 336

wound closure for, 229, 257

for, 517

Facial ptosis, 312

Endoscopic forehead

lateral tarsus fixation for,

Facian, 348

rejuvenation, 205, 247,

521–523

Fasanella-Servat procedure,

469

orbicularis strap technique

506, 507

anesthesia for, 212–214, 228

for, 515–516

Fat capture techniques, 173–174

bioabsorbable implants and,

transconjunctival approach

Fat enhancement, 157

278

for, 513

periocular rejuvenation with,

blepharoplasty with, 229–230

spastic, 293

370

bone fi xation for, 225, 228,

Epicanthal fold, 46

Fat grafting, 89, 349

237–238

Epinephrine, 15–17, 21, 30, 32,

blepharoplasty and, 385

central brow depressors and,

34, 35, 71, 160, 168, 191,

dermal spacer, 198–200

234–235, 239

211–214, 354, 425, 429,

for ller, 173, 175

complication management

446, 480, 515, 517, 524, 525

glabella, 386

for, 259–260

toxicity from, 213–214

injected, 278

DFTO and, 229, 238

Epiphora, 332

lip enhancement with, 358

results from, 241

Epithelial suture cysts, 72

lip lift and, 453

technique for, 239–241

Erbium-YAG laser surgery,

to nasolabial folds, 386

equipment setup for, 217–219

424–425, 426

periorbital, 381–383, 384–385

538 Index

Fat harvesting, 248

endoscopic forehead

Glabellar frown lines, 3, 298,

Fat injection, 247–249

rejuvenation and, 225

352

Fat pad

methods for, 237

Glabellar furrows, 293, 305,

aging and, 381, 457

deep temporal only, 229, 238,

365

external levator repair and,

242, 244

Glogau wrinkle classification

494

results from, 241

scale, 298

herniation, lower eyelid, 3, 5

surgical technique for,

Glutaraldehyde, 376

prolapsing, 143–144

239–241

Glycerin, 391

Fat removal, 71, 73–74

DTF, 279–280

Glycolic acids, 393, 402

brow and, 100–101

Endotine system, 237, 238

Glycosaminoglycans, 350

de-emphasizing, 157

implant, 279–280

Gortex, 358

herniated, 137

lateral tarsus, 521–523

Grafting

limited, 84–86

scalp, 254–256

cicatricial lower lid retraction

retro-orbicularis oculi, 99,

skin flap

repair with, 190–197

100–101

endoscopic browlift, 224–225

dermis fat spacer, 198–200

transconjunctival, 129, 139

rhytidectomy, 462

fat, 89, 349

Fat repositioning, 363

SMAS ap, 461–462, 465–467

blepharoplasty and, 385

lower eyelid blepharoplasty

Flax seed oil, 115

dermal spacer, 198–200

and, 157–158

Fluconazole (Diflucan), 416, 417

for ller, 173, 175

sutureless, 176–180

Flumazenil, 28, 34

glabella, 386

orbital, 158

Focal volume defects, 379

injected, 278

postoperative care for, 161

Follicular shock, 222

lip enhancement with, 358

SOOF, 157, 167–168, 177,

Forehead. See also Endoscopic

lip lift and, 453

179–180

forehead rejuvenation

periorbital, 381–383,

nerve blocks for, 168

Botox and, 298, 305, 320–321

384–385

TCA and, 176–177

dosage for, 378

hard palate harvesting for,

technique for, 159–161,

brow overaction in, 12

184–185

162–165

dissection of, 231–232

lip lift and, 453

transconjunctival, 168–169

upper eyelid interaction with,

lower eyelid retraction

FDA Modernization Act of

11

correction with, 183–185

1997, 364

volumetric augmentation of,

retroauricular harvesting for,

Featherlift, 435

247–249

187–189

Fentanyl, 28

Forehead lift, 247

tarsoconjunctival flap-skin,

Festoons, 328

Fornix, prolapsing, 143–144

190–197

causes of, 151

Fractionated CO2 laser surgery,

Granuloma, 72

treatment of, 151–153

429

Green tea, 343, 393

Fibrin sealant. See Tisseel

Fraxel re:pair, 429

Growth factors, 393

Fillers, 413. See also Specific

Fraxel re:store, 428–429

llers

Frey’s syndrome, 338

H

Botox and, 344, 374

Frontalis, Botox for, 318–321

HA. See Hyaluronic acid

expectation management for,

Frontalis rhytids, 294–295

Hair confi nement, 224–225

342–343

Frontal nerve block, 22, 24

Hairline

fat pedicles as, 173, 175

browlift selection and, 205

lip enhancement and, 358

G

examining, 206

posttreatment for, 342

Gape test, 122

Hard palate, grafting from,

preparations for, 341

Garlic, 343

184–185

selecting, 374–375

Gentian violet, 296

Headache, 301

upper face usage of, 373–376

Ginger, 343

migraine, 293, 336

Fish oil, 343, 369

Gingko, 343, 369, 475

stress, 293

5-fluoricil, 397

Ginseng, 343

Hematoma

Fixation

Glabella

avoiding, 76, 211, 260, 287,

bone

Botox for, 305, 314–315, 376

480

endoscopic browlift and,

dosage for, 378

Botox injection and, 307

225, 228, 237–238

fat graft to, 386

levator repair and, 480

Index 539

Hemifacial spasm, 293

Hypopigmentation, 402

Keratoses, actinic, 396–398

Hemostasis, lower eyelid

cryosurgery causing, 397

Kerlix wrap, 254, 257

blepharoplasty and, 150

Kojic acid, 416, 418

Hepatitis, 379

I

KTP laser, 404–405, 406–407

Hering’s effect, 494

Ibuprofen, 343

K-wire suspension, 256

Herniated fat removal, 137

Idebenone, 392

Herpes simplex, 416, 429

Imiquimod, 397

L

chemical peel and, 402

Immunosuppression, 401

Lacrilube, 31

laser resurfacing and, 416,

Induced blepharoptosis, 307

Lacrimal glands

425

Infection control, 260

Botox injection to, 332–334,

HIV facial lipoatrophy, 365–

ller selection and, 379

336

367, 379

In ammatory dysthroid

prolapse of, 46–47, 61

HIV infection avoidance, filler

ophthalmopathy, 336

ptosis of, 44

selection and, 379

Informed consent, 3, 9–10

resuspending, 84, 86

HLLT. See Horizontal lower lid

anatomic evaluation and, 45

Lacrimal nerve block, 22, 23

tightening

Botox and, 301–302

Lactosorb screws, 237, 255–256

Horizontal lower lid tightening

Infraorbital nerve block, 23,

Lagophthalmos, 41, 46, 229, 312,

(HLLT), 151

25–26

484

Horner’s syndrome, 507

Infrared nonablative devices,

Botox for, 336

Hyaluronic acid (HA), 267, 341,

407

correcting, 114

347

pulsed dye laser v., 405

dry eye from, 114

ne line lling with, 356

Injected fat grafting, 278

examining for, 61

lip enhancement with, 358

Intense pulsed light (IPL)

levator repair and, 480

mesotherapy with, 409

indications for, 407

pinch technique and, 58–59

moisturizers containing, 391

number of sessions for, 414

postoperative, 52, 66–67, 500

patient expectations and, 342

retinoids and, 394, 395

preventing, 54, 56, 58, 65, 71,

periocular rejuvenation with,

spectrum of, 404–405

259

369–371

Internal brow elevation, 95–98,

Laser resurfacing, 5, 393, 413,

technique for, 370

100

415. See also Nonablative

residual line fi lling with, 375

Internal browlift, 100

laser treatments

reversing, 344

Inverse shoeshine sign, 161

AK and, 397

selection of, 352

Involutional ptosis, 65

alternatives to, 404

thread lift and, 437

Iopidine, 307

anesthesia for, 414, 425

Hyaluronidase, 32, 71, 344, 429,

IPL. See Intense pulsed light

chemical peel combined with,

446

401

Hydricidibe, 30

J

equipment for, 424–425

Hydrocortisone, 416, 417, 418

Jaw-winking ptosis, 478

fractional, 404, 407

Hydrodissection, 524

Jessner’s solution, 402

patient selection/preparation

Hydroeye, 115

Jones tube surgery, 332

for, 425

Hydroquinone, 402, 416, 418,

Juvederm, 341, 344, 352, 356,

postoperative care for, 426

425, 428

375, 379

preoperative counseling for,

Hylaform, 341, 348, 358

Juvederm Ultra, 349, 352–353,

425

Hylaform Plus, 341, 348

356

procedure for, 425

Hyperhidrosis, 293, 335, 338

Juvenal, 358

retinoids and, 394, 395

Hyperkeratosis, 396

skin care after, 392

Hyperkinetic wrinkles, 293

K

Lasers

Hyperlacrimation, 293

Keflex, 429

CO2, 81–83, 424–426

Botox for, 336

Kenalog, 211, 247

fractionated, 429

Hyperpigmentation

Keratinocyte organization, 393

intra-SOOF fat

nonablative device selection

Keratitis, exposure, 312

repositioning and, 168

and, 405

Keratopathy, 200

lower lid blepharoplasty

post-inflammatory, 391, 392,

exposure, 336, 484

with, 129–130, 137

417, 428

postoperative, 504

resurfacing with, 140, 402,

sun exposure and, 392

suture, 509

404, 414, 416

540 Index

Lasers (cont.)

direct, 205, 263, 264, 265,

Light emitting diodes, 404, 407

skin thickness and, 132

440

Light treatments, 404

erbium-YAG, 424–425, 426

endoscopic, 205, 208, 211–

Limited fat removal, 84–86

intra-SOOF fat repositioning

221, 223–225, 228–230,

Linear threading technique, 375

and, 168

234–235, 237–241, 247,

Lip enhancement, 352, 356

resurfacing with, 140, 401,

257, 278, 440, 469

anatomic guidelines for, 358

402, 404

hairline and, 205

anesthesia for, 357–358

Er:Glass, 407

internal, 100

Botox in, 360

KTP, 404–405, 406–407

mid-forehead, 440

consultation for, 357

Nd:YAG, 404, 406–407, 419

patient examination for,

ller for, 358

pulsed dye, 404, 405, 407

206–207

preoperative counseling for,

Sciton Contour Er:YAG,

pretrichial, 268, 269, 440

357

424–425

procedure selection for, 205

technique for, 359–360

LASIK, 114

ptosis and, 207

Lip lift, 455–456

Lateral canthal dehiscence, 12

scalp fixation in, 254–256

graft material for, 453

Lateral canthal syndrome, 137,

selecting, 205

markings for, 452, 454

138

soft tissue augmentation in,

procedure for, 452–453

Lateral canthal wrinkling, 42

267, 268, 269–271

Lipoatrophy, HIV-related, 365–

Lateral canthopexy, 102, 177,

trans-bleph, 205, 267, 440

367, 379

513

tumescent injection for, 211

Lipoaugmentation, 382

entropion repair and, 513

upper lid blepharoplasty

Lipostabil, 410

Lateral canthotomy, 525

and, 206

Liposuction, rhytidectomy and,

Lateral canthus repositioning,

cheek

468

236

complications of, 285–286

Liquid injectable silicone (LIS)

Lateral fat pad, incising,

facelift v., 285

biocompatibility of, 365

141–142

implants for, 287–289

indications for, 365

Layered closure, 85

lower eyelid blepharoplasty

technique for, 364–365

Levator complex ptosis, 71

and, 285

types of, 364

Levator repair surgery

Contour, 436

Local anesthesia, 15–17, 32–35

adjustable suture technique

Contour ThreadLift, 431,

Lorazepam (Ativan), 28

for, 481–483

433–434, 436, 438–440

Lower eyelid

aponeurosis and, 479–480

face v. cheek, 285

anatomic variation in, 125

blepharoplasty and, 475

featherlift, 435

blepharoplasty of, 5

external, 494–496

forehead, 247

bilamellar approach to,

jaw-winking ptosis and, 478

lip, 455–456

139

levator advancement

graft material for, 453

canthopexy in, 104

technique for, 490

markings for, 452, 454

cheeklift and, 285

MMCR v., 506

procedure for, 452–453

evaluation for, 121–126

predicability of, 479, 481

malar fat pads, 457–459

fat repositioning in, 157–

teaching, 479

midface, 190

158, 176–180

unilateral v. bilateral, 475

bioabsorbable implants in,

hemostasis in, 150

Lid-cheek junction, blending,

278–281

malposition after, 183–184,

173

cheek implants for, 287–289

190

Lid distraction test, 328

endoscopic, 275–276, 278–280

postoperative care for, 161

Lidocaine, 15–17, 33, 35, 71,

lid retraction and, 277

resuspension in, 131, 134

168, 191, 211, 212–214,

SMAS malar fat pad, 457–459

retraction after, 198

348, 354, 425, 429, 480,

suture

skin in, 140

515, 517, 524, 525

adjunctive techniques to,

three-step technique for,

toxicity from, 213–214

437

129–135

Lifts

closed, 435–436

transconjunctival incision

brow, 51

open, 435–437

in, 137

Botox for, 305, 322

types of, 435

canthopexy of, 102, 104

coronal, 205, 268, 278,

temporal, 238–239

fat pad herniation in, 3, 5

440

thread, 436

grafting to, 183–185

Index 541

hollowness of, 159

endoscopic, 223, 228

MRD. See Margin reflex

lateral dystopia of, 102

endoscopic browlift and, 228

distance

laxity of, 122, 125, 151

endoscopic forehead

MRD1. See Upper margin

causes of, 525

rejuvenation and, 223,

re ex distance

cicatricial lower lid

228

Mucomyst drops, 115

retraction repair and, 191

ethnic considerations in, 65

Müller’s muscle-conjunctival

entropion and, 513

gender considerations in, 65

resection (MMCR),

simple repair of, 525

importance of, 65, 71

503–504

malposition of, 183–184

lip lift and, 453, 454

contour abnormalities and,

retroauricular dermal

MMCR and, 509–510

508

spacer graft for, 187–189

orbit size and, 53–55

marking for, 509–510

tarsoconjunctival flap-skin

pupillary axis, 509–510

patient selection for, 506–507

graft for, 190–197

rhytidectomy and, 461–462,

phenylephrine test and, 504,

nerve block and, 19

464

506–507

retraction of, 183, 187, 525

SMFPL and, 457–459

resection nomogram for, 507

Botox and, 307

tear trough, 159

suture for, 509–510

cicatricial, 190–197

upper eyelid blepharoplasty,

tarsus and, 508

dehiscence of, 515

51–57, 62–68

Muscle strap, 159

dermis fat spacer grafting

Mark, inject and score (MIS),

Myectomy, 386

for, 198–200

52

Myobloc, 341

disinserted, 513, 515

Medial canthal fl ap, 526

Myocutaneous aps, 531–532

dissection of, 524

Medial canthal webbing, 58

Myopathic blepharoptosis, 484

medial canthal flap

Medial canthorrhaphy, 528–530

technique for, 526–527

Medial webbing, 62, 68

N

reinserting, 513–514

Medical history, 41, 121

Naloxone, 29

TCA peel for, 176–177

eye, 114

Naphcon, 307, 312

upper eyelid interaction with,

Medrol, 113

Narcissism, 9

11

Medtronix bone bridge system,

Nasal fat pad, 145–146

L-plasty, 445

237

incising, 141–142

Melatonin, 369

Nasal fat pocket, 73–74

M

Mesotherapy, 409

Nasal peaking, 508

Malar bags, 5, 151, 328. See also

Microdermabrasion, 413, 414

Nasal webbing, 61

Festoons

Microsponge technology, 393,

preventing, 51

Malar fat pads

395

Nasociliary nerve block, 23

aging of, 457

Midazolam (Versed), 28, 30

Nasolabial folds, 352, 362, 457

eyelid position correction

Midface lift, 190

fat graft to, 386

and, 183

bioabsorbable implants in,

Nd:YAG laser, 404, 406–407,

implants and, 280, 282

278–281

419

lifting, 457–459

cheek implants for, 287–289

Neomycin, 112

Malar implants, 279

endoscopic

Neosporin, 257

Mandible, 18

implants in, 278–280

Nerve blocks, 357

Marcaine (Bupivacaine), 32, 229

procedure for, 275–276

Atkinson, 18, 20

Margin fold distance, 41–42

lid retraction and, 277

facial, 18–21

Margin refl ex distance (MRD),

preoperative counseling for,

frontal, 22, 24

46, 61, 122. See also

277

infraorbital, 23, 25–26

Upper margin reflex

Midface rejuvenation, 285

intra-SOOF fat repositioning

distance

Mid-forehead browlift, 440

and, 168

external levator repair and,

Migraine, 293, 336

lacrimal, 22, 23

494

Milia, 72

MMCR and, 503

Marionette lines, 362

MIS. See Mark, inject and score

nasociliary, 23

Marking

Mitek anchors, 255

O’Brien, 18, 21

Botox and, 296, 303

MMCR. See Müller’s muscle-

peribulbar, 21

browlift

conjunctival resection

retrobulbar, 21

direct, 265

Motrin, 343

sensory, 22

542 Index

Nerve blocks (cont.)

P

Pixy-ear deformity, 463, 467

skin rejuvenation and, 414

Palsy

Platelet-inhibiting medications,

Van Lint, 18–19

Bell’s, 41, 51, 114, 440, 484

45

zygomaticofacial, 23

facial, 293

Polaris device, 419

Neutrogena, 391

Patients

Poly-L-lactic acid, 350

Nitropaste, 344, 370

communication with, 11

retinoids and, 394, 395

Nonablative laser treatments,

difficult, 8–9

Polymethylmethacrylate, 349

404, 413

doctor relationship to, 6–7, 62

Polytetrafl uoroethylene, 350

device selection for, 406

interviewing, 41

Post-inflammatory

hyperpigmentation and,

motivation of, 7

hyperpigmentation, 391,

405

preoperative counseling for,

392, 417, 428

infrared, 407

11–12, 34, 206–207

Postoperative care

infrared v. pulsed dye for,

Botox and, 294–295

blepharoplasty

405

earlobe repair, 446

lower eyelid, 161

patient selection for, 405

laser resurfacing and, 425

transconjunctival, 168–169

postoperative care for, 406

lip enhancement, 357

Botox in, 51

skin color and, 405

mid-face lift and, 277

browlift, direct, 264

Nonsteroidal anti-

self-perception of, 6

fat repositioning, 161

inflammatories

surgical goals/expectations of,

laser resurfacing, 426

(NSAIDs), 221, 294, 343,

7–8, 41–42, 51, 121, 374,

nonablative laser treatments,

369, 374, 402, 437, 475

402, 413, 421

406

NSAIDs. See Nonsteroidal

Patterns of aging

ptosis repair, 500

anti-inflammatories

fat pads, 381, 457

skin, 392

suborbital, 381

skin rejuvenation, 414

O

volumetric depletion in, 384

Postoperative keratopathy, 504

O’Brien block, 18, 21

PDT. See Photodynamic

Postoperative lagophthalmos,

Occipitalis suspension, 256

therapy

52, 66–67, 500

Ocular anesthesia, 15

Pentagonal resection, 525

Postoperative swelling,

Ocular evaluation, 45

Percutaneous screws, 254–255

112–113

Oculopharyngeal muscular

Peribulbar block, 21

Prednisone, 131

dystrophy, 485

Periocular facial features, 3

Preoperative counseling, 11–12,

Of ce environment, 10

Periocular rejuvenation

34

Olay, 391

CH for, 369–371

Preoperative evaluation

Omega-3 fatty acids, 115

fat enhancement in, 370

documentation and, 46, 121

Op-site, 500

HA for, 369–371

upper eyelid blepharoplasty

Oral benzodiazepines, 28, 34

Perioral rhytids, 352

and, 46–47

Oral incontinence, 336

Periorbital fat grafting, 381–385

Preoperative instructions, upper

Oral sedation, 28, 34, 35

Periosteum, releasing, 232–233

eyelid blepharoplasty

Orbicularis strap technique,

Perlane, 344, 352, 356, 358

and, 45

139

Petrolatum, 391, 392

Preparation H, 113

entropion repair with,

Petroleum jelly, 417

Preseptal orbicularis override,

515–516

Phenol peel, 295, 402

513

Orbiculectomy, 514

Phenylephrine, 17, 494, 504,

Pretrichial browlift, 268, 269,

Orbital rim, 18, 19

506–507

440

anesthesia for, 212–213

Phenylephrine test, 494

Prevention

Orbitomalar groove, 362

MMCR and, 504, 506–507

alopecia, 221–222, 259

Orbits

Phosphatidylcholine, 409, 410

erythema, 392

evaluating, 44

Photodynamic therapy (PDT),

lagophthalmos, 54, 56, 58, 65,

fat in, 44

397

71, 259

herniated, 125, 137

Photographs for documentation,

nasal webbing, 51

preservation of, 158

41, 45, 121–122

sun protection and, 391, 392,

removal of, 129

Pinch technique, 58–60, 66, 68,

402

repositioning of, 158

71, 139, 310

hyperpigmentation

Overcorrection, 10

Botox and, 304

avoidance and, 392

Index 543

laser resurfacing and, 416,

lacrimal gland, 44

agents for, 402

417, 418

levator complex and, 71

AK and, 397

Prilocaine, 17

levator repair and, 481

laser resurfacing combined

Procedures. See also Techniques

measuring, 41

with, 401

anesthesia, 34–35

progressive myopathic, 484

retinoids and, 394

browlift

repairing, 481

skin care after, 392

direct, 264

internal, 494

uses of, 401

selection of, 205

levator advancement

laser, 5, 393, 413, 415

soft tissue augmentation in,

technique for, 490

AK and, 397

268

minimally invasive

alternatives to, 404

conjunctival muellerectomy

technique for, 491–493

anesthesia for, 414, 425

(Putterman procedure),

postoperative care for, 500

chemical peel combined

476, 494

single-stitch levator

with, 401

doctor-patient relationship

advancement for,

equipment for, 424–425

and success of, 62

497–499

fractional, 404, 407

endoscopic midface lift,

upper eyelid, 3

patient selection/

275–276

Pulsed dye laser, 404, 407

preparation for, 425

Fasanella-Servat, 506, 507

infrared v., 405

postoperative care for, 426

laser resurfacing, 425

Punctal plugs, 115

procedure for, 425

lip lifts, 452–453

Punctum, 66

retinoids and, 394, 395

RF tightening, 421–422

atresia of, 126

skin care after, 392

skin rejuvenation, 414

everted, 126

nonablative laser treatments,

tarsal strip, 190, 199, 525

Putterman procedure, 476. See

404, 413

transconjunctival

also Conjunctival

device selection for, 406

blepharoplasty, 167–168

muellerectomy

hyperpigmentation and,

Procerus, Botox for, 316

405

Progressive myopathic ptosis,

R

infrared v. pulsed dye for,

484

Radiesse, 344, 348, 352, 354–

405

Prolapsing fat pads, 143–144

355, 358, 372, 379

patient selection for, 405

Proparacaine, 15, 30, 33, 34

Radiofrequency skin tightening

postoperative care for, 406

Pruritus, 402

(RF tightening), 413, 414

skin color and, 405

Pseudodermatochalasis, 51

background of, 419

Retin-A, 343, 394, 416

Psychiatric history, 121

patient selection for, 420–421

Retinaldehyde, 394

Psychiatric syndromes

procedure for, 421–422

Retinoids, 392, 425

difficult patients and, 9

technology for, 419–420

acne treatment with, 393

medication for, 121

Radiowave surgery, 81–83, 84

as adjunctive therapy,

Ptosis, 12

Rejuvenation, understanding of,

394–395

acquired, 62

9

development of, 393

bilateral, 476

Reloxin, 341

Retinol, 342, 392, 393

blepharo, 98, 293

expectation management for,

Retroauricular area, grafting

Botox for, 336

342

from, 187–189

induced, 307

Renova, 393

Retrobulbar block, 21

myopathic, 484

Residual lines, 375

Retro-orbicularis oculi fat

repairing, 506

Reston self-adhering foam, 254,

(ROOF), 61, 76

brow, 41–44, 51, 61, 98, 207,

257–258

browlift and, 267–268

440

Restylane, 341, 344, 348, 352–

excising, 99, 100–101

Botox and, 307, 320

353, 356, 358, 371, 375,

Revision surgery, 88

elevation for, 95

377, 379

RF tightening. See

sulcus and, 44

lower eyelid injection of, 362,

Radiofrequency skin

browlift and, 207

363

tightening

eyelid, 46, 61, 312

thread lift and, 437

Rheumatoid arthritis, 114

facial, 312

Resurfacing

Rhytidectomy, 278, 402, 469

involutional, 65

chemical peeling, 140, 295,

earlobes and, 463, 467

jaw-winking, 478

393, 413

liposuction in, 468

544 Index

Rhytidectomy (cont.)

RF tightening, 420–421

SOOF. See Suborbicularis oculi

marking for, 460–461, 464

transconjunctival

fat

neck and, 463–464

blepharoplasty, 167

Soy, 392

skin excision in, 463, 468

sedation, 34

Spastic entropion, 293

skin flap dissection for, 461,

Sensory nerve block, 22

Split earlobe, 445

464

Serial puncture technique, 364,

StarluxIR device, 419

skin flap fixation for, 462

375

Steatoblepharon, 151, 384–385

SMAS ap creation/fixation

Silhouette Midface suture, 431

STF. See Super cial temporalis

for, 461–462, 465–467

Silicone injection, 349, 350, 358

fascia

Rhytides, 402

Silikon-1000, 350, 364

Strabismus, 293

Rhytids, 305, 311, 317

Single-stitch levator

Stress headache, 293

crow’s feet, 326–327

advancement, 497–499

Stryker SILVERGlide, 112

frontalis, 294–295

Sjögren’s syndrome, 114

Suborbicularis oculi fat

perioral, 352

Skin cancer, 391

(SOOF), 102, 126, 151

ROOF. See Retro-orbicularis

Skin care

dermis fat spacer grafting

oculi fat

basic, 391

and, 198–199

Rosacea, 12

postoperative, 392

elevation of, 177, 179–180,

PDT for, 397

preoperative, 391–392

386

Russian threads, 435

Skin disease, 121

eyelid position correction

Skin evaluation, 122

and, 183

S

Skin pinch, 159

fat repositioning and, 157,

St. John’s wort, 343, 369

Skin rejuvenation

167–168, 177, 179–180

Salicylic acid, 402

anesthetic for, 414

implants and, 280

Scalp fixation, endoscopic

patient evaluation for, 413

Sulcus

browlift and, 254–256

postoperative care for, 414

anesthetic block of, 357–358

Scanlan, 62–63

procedure for, 414

brow ptosis and, 44

Schirmer testing, 114, 121

surgical planning for, 413–414

fat removal and, 84

Sciton Contour Er:YAG laser,

Skin types

prominent, 12

424–425

laser resurfacing and, 425

Sulcus dermatochalasis, 44

Sculptra, 342, 350, 358

retinoids and, 394

Sun protection, 391, 392, 402

Sedation

Slit earlobe, 445

hyperpigmentation avoidance

antagonist/reversal agents for,

Slit lamp examination, 46

and, 392

28–29

SMAS. See Superficial

laser resurfacing and, 416,

intraoperative, 30–31

musculoaponeurotic

417, 418

minimal, 28

system

Super cial musculoaponeurotic

moderate, 28

SMAS malar fat pad lift

system (SMAS), 183

monitoring of, 27–28

(SMFPL), 457–459

rhytidectomy and, 461–462,

oral, 28, 34, 35

SMFPL. See SMAS malar fat

465–467

preoperative, 30

pad lift

Super cial temporalis fascia

risk factors for, 27

Snap back test, 122, 124, 125, 328

(STF), 231–232

selecting, 34

Socket reconstruction, 21

Supratarsal crease, 88–89

staff for, 27

Sodium bicarbonate, 16–17, 33,

Surgical goals, 7–8

Selection

168, 429

Surgical integrity, 7

of anesthesia, 32–33

Softform, 351

Suture keratopathy, 509

browlift procedures, 205

Soft tissue augmentation, 341

Suture lifts

of llers, 374–375, 379

browlift and, 267–271

adjunctive techniques to,

HA, 352

procedure for, 268

437

nonablative devices, 405

techniques for, 267

closed, 435–436

patient

expectation management for,

open, 435–437

direct browlift, 263

342–343

types of, 435

laser resurfacing, 425

periocular

MMCR, 506–507

CH for, 369–371

T

nonablative laser

complications of, 369–370

Tarsal strip procedure, 190, 199,

treatments, 405

HA for, 369–371

525

Index 545

Tarsal switch levator resection,

Tegaderm, 500

U

484–485

Telangiectasia, 404

Ultrasoft, 351

Tarsoconjunctival flap-skin

Telfa, 191

Ultraviolet light, 392

graft, 190–197

Telogen effluvium. See

Unintended communication, 3

Tarsorrhaphy, 114, 301

Follicular shock

Upper eyelid

Tazarotene, 391, 393, 395

Temovate-E, 418

blepharoplasty of

Tazorac, 343

Temporal fascia (TF), 232

anatomic checklist for,

TCA. See Trichloroacetic acid

Temporal lift, 238–239

44–45

Tear production, 51, 114

Temporal space, dissection of,

browlift and, 206

Tear supplements, 114–115

231–232

crease formation in,

Tear trough, 352–353

Tetracaine, 15, 17, 31, 33, 160,

107–108

correcting, 362, 363

167

evaluation for, 41–43, 206

deformity of, 157–158

TF. See Temporal fascia

fat preservation in, 84–86

marking, 159

ThermaCool device, 419

incision guidelines for,

Techniques

Thermage, 434

56–57

adjunctive to suture lifts, 437

Threadlift, 436

marking strategies for, 51–

bedside cautery, 517

Thyroid eye disease, 113, 187

57, 62–68

blepharoplasty

Tisseel (fibrin sealant), 173–175

orbit size and, 53–55

three-step lower eyelid,

Titan device, 419

partial incision method for,

129–135

Topicaine, 17

87–88

upper eyelid pinch, 58–60

Topical anesthesia, 15, 33, 34

pinch technique for, 58–60

browlift, soft tissue

Torn earlobe, 445

preoperative evaluation

augmentation, 267

Torticollis, 293

for, 46–47

DFTO, 239–241

Toxicity

preoperative measurement

endoscopic browlift

anesthesia, 213–214

for, 61

flap fixation, 224–225

epinephrine, 213–214

crease of, 71

incision, 220–221

tumescent technique and, 214

dermatochalasis of, 4, 5

fat capture, 173–174

Transblepharoplasty internal

forehead interaction with, 11

fat repositioning, 159–161,

browpexy, 267, 440

hooding of, 11, 46

162–165

Trans-bleph browlift, 205, 267,

lower eyelids interaction with,

levator repair surgery

440

11

adjustable suture, 481–483

Transconjunctival

nerve block and, 19

levator advancement, 490

blepharoplasty, 145

ptosis of, 3

linear threading, 375

hemostasis in, 150

Upper margin reflex distance

lip enhancement, 359–360

intra-SOOF fat repositioning

(MRD1), 41, 122

LIS, 364–365

in

MMCR and, 504, 507

orbicularis strap, 139

patient selection for, 167

entropion repair with,

postoperative care for, 168

V

515–516

procedure for, 167–168

Valcyclovir (Valtrex), 425

periocular HA rejuvenation,

Transconjunctival fat removal,

Valium, 28, 160, 402, 433

370

129, 139

Valtrex, 425, 429

pinch, 58–60, 66, 68, 71, 139,

Transepidermal water loss

Van Lint block, 18–19

310

(TEWL), 391

Versed, 28

Botox and, 304

Tretinoin, 391, 393, 394, 401,

Vicodin, 402, 429

lagophthalmos, 58–59

402, 425

Visual elds, 45, 46

upper eyelid

Tretinsin (Retin A), 416

Vitamin A, 392, 393, 409

blepharoplasty, 58–60

Triamcinolone acetonide

Vitamin B, 409

ptosis repair

(Kenalog), 247

Vitamin C, 113, 392, 393, 409

levator advancement, 490

Trichloroacetic acid (TCA),

Vitamin E, 343, 392, 409

minimally invasive, 491–493

295, 402

Vitamin K, 342, 409

serial puncture, 364, 375

fat repositioning and, 176–177

Volumetric aging depletion, 384

v suture, 129–130, 132–133

Tumescent technique, 211, 213

Volumetric enhancement, 369

tumescent, 211, 213

toxicity issues in, 214

forehead, 247–249

toxicity issues in, 214

Tylenol, 341

restorative, 393

546 Index

V-plasty, 445

endoscopic forehead

Zone Quick Phenol Red test,

V suture technique, 129–130,

rejuvenation and,

114

132–133

224–225

Zovirax, 416, 417

layered, 85

Z-plasty, 445, 446, 447

W

W-plasty, 448

Zyderm, 341, 347, 374–377

Warfarin, 343

Zygomatic arch, 18, 20, 212,

Web test, 58

X

375

Wound closure

Xanax, 429

cheek implants and, 287

crease formation and,

Xylocaine, 30, 32, 160, 429, 446

mid-face lift and, 275

107–108

rhytidectomy and, 461

dog ear avoidance in, 107–108

Z

Zygomaticofacial nerve block,

endoscopic browlift and, 229,

Zimmer Cryo 5, 428

23, 26

257

Zolpidem, 34

Zyplast, 341, 348, 376