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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_884_Библиотеки_им_академика_М_И_Перельмана
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4 Rhytidectomy (Cervicobuccal Plasty)
https://t.me/med1917
䊏
The excess flap is now resected from the tragus to the upper auricular
pole. (Fig. 4.36)
䊏
To make the second primary suture, the temporal hairline is rotated to
the upper auricular pole, where it is fixed with a suture. (Fig. 4.37)
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Fig. 4.36
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4 Rhytidectomy (Cervicobuccal Plasty)
Fig. 4.37
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4 Rhytidectomy (Cervicobuccal Plasty)
https://t.me/med1917
The following procedure is used to place the retroauricular primary
suture:
䊏
The dorsal lipocutaneous flap is grasped with the surgical tweezers and
pulled cranially. The excess portion of the flap is incised in the dorsal
ear fold and attached to the skin on the dorsal portion of the ear.
(Fig. 4.38)
䊏
The excess flap which is now stretched over the ear is incised up to the
upper pole of the auricular lobe and the ear lobe is unrolled toward the
outside with the surgical tweezers. (Fig. 4.39)
122
Fig. 4.38
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4 Rhytidectomy (Cervicobuccal Plasty)
Fig. 4.39
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4 Rhytidectomy (Cervicobuccal Plasty)
https://t.me/med1917
䊏
The assisting surgeon now rotates the preauricular lobe cranially with
the tweezers so that the surgeon can place the primary suture on the
lowerpoleoftheauricularlobe.(Fig.4.40)
䊏
This is followed by the preauricular resection of the flap.
Care should be taken that this resection is carried out without any tension and in the form of an arch in order to prevent ugly scar formation.
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Excess fatty and connective tissue is excised from the edges of the
incision.
(Fig. 4.41)
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Fig. 4.40
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4 Rhytidectomy (Cervicobuccal Plasty)
Fig. 4.41
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4 Rhytidectomy (Cervicobuccal Plasty)
https://t.me/med1917
䊏
This is followed by removal of the excess skin flap in the retroauricular
fold. The excess is usually not so pronounced at this location since rotation was strictly carried out cranially and not dorsally in accordance
with the ear line. This resection is also carried out with the number 15
blade. To permit a better view of the surgical area, the assisting surgeon
pulls the ear gently toward the front with the long two-pronged hook.
(Fig. 4.42)
䊏
All of the primary sutures have now been made for the periauricular
lobe resection. (Fig. 4.43)
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Fig. 4.42
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4 Rhytidectomy (Cervicobuccal Plasty)
Fig. 4.43
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4 Rhytidectomy (Cervicobuccal Plasty)
https://t.me/med1917
Subcutaneous W o und Closure (Fig. 4.44, 4.45)
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All areas under tension will be closed with subcutaneous sutures. These
will be made with 4/0 PDS or Monocryl™*
sutures both in front of and
behind the auricle.
128
* Ethicon GmbH, Ro bert-Koch-Str. 1, 22851 Norderstedt, Germany
Fig. 4.44
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4 Rhytidectomy (Cervicobuccal Plasty)
Fig. 4.45
129
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