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Ziai K, Azizzadeh B. Revision Rhytidectomy: Pearls and Pitfalls. Facial Plast Surg 2023. [PMID: 37827505 DOI: 10.1055/a-2190-8558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023] Open
Abstract
While rhytidectomy can yield remarkable results, some patients may subsequently require revision rhytidectomy due to either unsatisfactory outcomes from primary surgery or the natural aging process many years later. Like most other secondary plastic surgical procedures, revision rhytidectomy is a complex undertaking and fraught with potential pitfalls. This can be attributable to natural or postsurgical alterations that can occur with the facial skin, superficial musculoaponeurotic system/platysma muscle, and/or facial nerve landmarks. Additionally, complications such as cobra neck deformity, pixie ear deformity, and synkinesis can add an extra level of complexity to revisional surgery. Furthermore, as more surgeons are performing deep-plane facelifts and more aggressive neck procedures, the risks are further amplified in revisional surgery. In this article, we review the challenges that a facelift surgeon may face when performing revision rhytidectomy and the technical considerations to overcome these obstacles.
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Affiliation(s)
- Kasra Ziai
- Facial Plastic Surgery, The Center for Advanced Facial Plastic Surgery, Beverly Hills, California
- Department of Otolaryngology-Head and Neck Surgery, Cedars-Sinai Medical Center, Los Angeles, California
| | - Babak Azizzadeh
- Facial Plastic Surgery, The Center for Advanced Facial Plastic Surgery, Beverly Hills, California
- Department of Otolaryngology-Head and Neck Surgery, Cedars-Sinai Medical Center, Los Angeles, California
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Okumus A. Extended Superolateral Cheek Lift With a Short Preauricular Scar: A Local Anesthesia-based Practicable Technique for the Correction of Moderate-degree Facial Aging Signs. J Craniofac Surg 2023; 34:2384-2389. [PMID: 37417766 DOI: 10.1097/scs.0000000000009535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 05/20/2023] [Indexed: 07/08/2023] Open
Abstract
An ideal technique applicable to middle-aged individuals with a moderate degree of facial aging signs has not yet been established. This study aimed to evaluate the utility of an extended superolateral cheek lift with a short preauricular scar technique for the correction of facial aging signs. A total of 200 female patients (mean age: 43 y, range 27-56 y) who underwent a local anesthesia-based extended superolateral cheek lift for the correction of facial aging signs confined to the malar and nasolabial area, lower eyelid, jawline, and neck were included. Data on the Global Aesthetic Improvement Scale, patient-reported outcomes, and complications were recorded at 1, 6, 12, and 24 months postoperatively. The Global Aesthetic Improvement Scale scores revealed exceptional improvement in 90% of patients along with no complications at month 24. None of the patients developed a depressed scar, skin necrosis, breaking of the superficial musculoaponeurotic system plication sutures, asymmetry, or facial nerve problems. At postoperative month 24, the appearance was reported to be very much improved by 90% of patients, and 94% of patients reported that they were very satisfied with the treatment and that they would recommend this treatment to friends and acquaintances. Our findings revealed the potential utility of an extended superolateral cheek lift with a short preauricular scar as a local anesthesia-based practicable technique for the correction of facial aging signs in middle-aged patients, offering a favorable postoperative outcome, lack of complications and high patient satisfaction in addition to invisible scars and a short-term postoperative recovery.
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Affiliation(s)
- Ayhan Okumus
- Private Aesthetic Plastic and Reconstructive Surgery Office, Bursa, Turkey
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Brau-Javier CN, Caro-Muniz AP, Canizares O. Facial fat necrosis after autologous fat transfer possibly associated with SARS-CoV-2 vaccine. J Cosmet Dermatol 2023; 22:1477-1480. [PMID: 36891961 DOI: 10.1111/jocd.15635] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/03/2023] [Indexed: 03/10/2023]
Abstract
A 52-year-old female patient developed facial fat necrosis presenting with cutaneous induration three weeks after minimal access cranial suspension (MACS) lift with autologous fat grafting from the abdomen. Given that the patient received the Moderna SARS-CoV-2 vaccine one week after surgery, we hypothesize that the former predisposed her to tissue ischemia leading to fat necrosis. Histological findings after biopsy were consistent with fat necrosis, which included marked dermal fibrosis with areas of focal fat necrosis, lipophages, multinucleated giant cells, and siderophages. It is our hope that documenting this rare development in literature may serve as encouragement for adverse effect reporting after the SARS-CoV-2 vaccine administration and may boost inspection and monitoring of other health consequences by regulating agencies.
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Affiliation(s)
- Cristina N Brau-Javier
- Department of Dermatology, University of Puerto Rico School of Medicine, San Juan, Puerto Rico
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Truswell WH, Fox AJ. Reducing Surgical Risks in a Rhytidectomy. Facial Plast Surg Clin North Am 2023; 31:239-252. [PMID: 37001927 DOI: 10.1016/j.fsc.2023.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
Complications after rhytidectomy will occur even in the best of circumstances. Establishing a good rapport with the patient, taking a thorough history and physical exam to elicit potential risk factors such as hypertension or a bleeding diathesis, enlisting staff members to help understand a patient's goals, psychology, and supports, as well as setting realistic expectations help both the surgeon and the patient navigate the journey of surgery toward a successful outcome. Lastly, understanding how to manage potential complications when they arise, in a supportive and caring manner, is vital to the patient relationship and end result: a happy and satisfied patient.
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Nuances of Facelifting for the Male Patient. CURRENT OTORHINOLARYNGOLOGY REPORTS 2021. [DOI: 10.1007/s40136-021-00373-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Rhytidectomy techniques have evolved significantly since the procedure was first described in the early twentieth century. Techniques vary based on surgeon preference, patient characteristics, and the desired outcome. As facelifts are embraced by the general public and the frequency of rhytidectomy increases, attention to male patient-specific technique is critical. Male and female facelift techniques are fundamentally similar; however, there are nuances to patient selection and technique in males that guide the surgeon to improved postoperative outcomes. Attention to incision placement, trichophytic technique, and adjunct procedures will improve overall cosmesis in the male patient. Understanding of potential risks and their likelihood in the male patient will also minimize complications and allow for rapid recovery.
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Affiliation(s)
- Paul P Daraei
- Department of Facial Plastic Surgery, Rousso Facial Plastic Surgery, Mountain Brook, Alabama
| | - Ryan V Marshall
- Department of Otolaryngology -Head and Neck Surgery, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Austin S Adams
- Department of Facial Plastic Surgery, Rousso Facial Plastic Surgery, Mountain Brook, Alabama
| | - Daniel E Rousso
- Department of Facial Plastic Surgery, Rousso Facial Plastic Surgery, Mountain Brook, Alabama
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Truswell WH. Complications in Lower Face Rejuvenation: Avoiding, Minimizing, Recognizing, Dealing with Them, and Helping the Patient through the Process of Fixing the Problems. Facial Plast Surg 2020; 36:462-477. [PMID: 32866983 DOI: 10.1055/s-0040-1713823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
All surgical and minimally invasive procedures carry a risk of complications. It is imperative that the facial plastic surgeon and his/her staff are well educated in recognizing and managing all the possible problems that could arise. They must also be ready and able to deal with and correct any problem. The patient undergoing surgery or a procedure also needs to be informed of all possible sequelae and complications. Sequelae will happen after almost all procedures. These include soreness, swelling, bruising, and so on. If the patients understand that these are to be expected, they will be less likely to be overly concerned about them. They also must be educated about all the possible complications. They should be told that while complications are very rare, they could nevertheless happen. If a problem should arise, the surgeon and his/her staff should correct it and see that the patient receives the best care possible. This article examines the complications that could occur after rejuvenation surgery and minimally invasive procedures of the lower face and neck, what measures can be undertaken to reduce the risks, and how to recognize and manage them.
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Van Pham T, Truong KHTN. Short or Minimum Incision Deep Plane/Extended Deep Plane Facelift/Rhytidectomy. Facial Plast Surg 2020; 36:376-385. [PMID: 32866975 DOI: 10.1055/s-0040-1714118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
The mini facelift, often referred to as short scar or minimum incision facelift or rhytidectomy, is a facial rejuvenation procedure with limited incisions. It aims to lift and tighten the superficial musculo-aponeurotic system to restore the lower midface and the mandibular contour, thus eliminating undesirable jowls. By performing the deep plane or extended deep plane facelift with short incisions, the midface and upper neck can also be improved without the full face and neck incisions as in the typical rhytidectomy. With its decreased operative time and expense, rapid recovery, less complications, as well as more limited incisions with resultant less evidence of scars, mini facelift techniques have boomed over a decade for younger patients who seek facial rejuvenation. We describe our concept of the short or minimum incision deep plane/extended deep plane facelift or rhytidectomy and address what results can be expected.
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Affiliation(s)
- Tuan Van Pham
- Perth Facial Plastic and Cosmetic Surgery, Perth, Western Australia, Australia
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Revision and Secondary Facelift: Problems Frequently Encountered. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2947. [PMID: 32983758 PMCID: PMC7489740 DOI: 10.1097/gox.0000000000002947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 05/07/2020] [Indexed: 11/25/2022]
Abstract
Revision facelift is a very challenging operation. The goal of our study was to examine the most common problems that the facelift surgeon has to face in a revision case and to suggest ways of solving them. Methods A review of all patients from 2012 to 2017 in whom rhytidectomy was performed by the senior author was conducted. Results During the 5-year study period, the author performed 552 face lifts. After the review to confirm revision procedures, a total of 72 revision facelifts were found. On reviewing the most common problems encountered in our facelifts, we found that in addition to the stigmata of the primary facelift, which are thoroughly analyzed in our article, a new type of stigmata has been added nowadays to the revision facelift-that of the various noninvasive interventions that patients undergo after their first facelift, in their effort to postpone or avoid a second operation. In all the abovementioned cases, the surgeon has to modify his basic surgical plan accordingly, to be able to improve or solve all of those problems during the revision surgery. Conclusions The modern facelift surgeon often has to face much more than the stigmata of the primary facelift or the natural aging process. Thus, he/she should be appropriately trained to solve any problem we might encounter in a revision case.
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Rousso DE, Adams AS. Nuances in Superficial Musculoaponeurotic System Rhytidectomy. Facial Plast Surg Clin North Am 2020; 28:285-301. [PMID: 32503715 DOI: 10.1016/j.fsc.2020.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Rhytidectomy techniques have evolved since the early 1900s. As the understanding of facial anatomy and the aging process expanded, the superficial musculoaponeurotic system (SMAS) became a focal point in developing longer-lasting, natural results. Further evolution led to various approaches in repositioning the SMAS layer, including subperiosteal, composite, and deep plane rhytidectomies. This article describes the nuances of SMAS rhytidectomy, the biplanar SMAS imbrication technique, and adjuvant procedures used. This biplanar SMAS technique has been refined over more than 25 years and has proved to be a reliable and safe technique that leads to high patient satisfaction with minimal complications.
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Affiliation(s)
- Daniel E Rousso
- Facial Plastic Surgery, Otolaryngology, Rousso Facial Plastic Surgery Clinic, UAB, 2700 Highway 280, Suite 300 West, Birmingham, AL 35223, USA.
| | - Austin S Adams
- Surgery, Facial Plastic Surgery, Rousso Facial Plastic Surgery Clinic, 2700 Highway 280, Suite 300 West, Birmingham, AL 35223, USA
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Truswell WH. Approaches to Reducing Risk in Rhytidectomy Surgery. Facial Plast Surg Clin North Am 2020; 28:419-427. [PMID: 32503723 DOI: 10.1016/j.fsc.2020.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Please verify edit, "complications could". All operations have sequelae. These are to be expected and must be told to patients. With surgery, the risk of complications is ever-present albeit infrequent. Facelift surgeons have ethical and intellectual duties to fully inform patients of these risks. Surgeons also must have strategies to reduce the risks, knowledge in how to manage each potential risk, and ability to help patients understand how complications could have occurred and how to cope with them. This article discusses facelift complications, the causes thereof, and how to assess a problem, manage each complication, and comfort a distraught patient.
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Affiliation(s)
- William H Truswell
- Division of Otolaryngology-Head and Neck Surgery, University of Connecticut School of Medicine, Farmington, CT, USA; American Board of Facial Plastic and Reconstructive Surgery; American Academy of Facial Plastic and Reconstructive Surgery; Private Practice, Easthampton, MA, USA.
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Chien CY, Chang YH, Wu YJ, Lin PL, Chiou WR, Chi BC, Wu HP, Liao FC, Lee YH. Effectiveness of a Non-Taped Compression Dress in Patients Receiving Cardiac Implantable Electronic Devices. ACTA CARDIOLOGICA SINICA 2019; 35:320-324. [PMID: 31249462 DOI: 10.6515/acs.201905_35(3).20190107a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background Hematoma and skin damage are not uncommon after cardiac implantable electronic device (CIED) placement. The use of conventional hemostatic gauze and tape seems to be suboptimal in controlling these complications. This study aimed to evaluate the impact of a novel compression dress with a special pad and elastic bands for postoperative care. Methods A total of 175 CIED recipients were randomly divided into two groups: an experimental group with 85 patients who used a non-taped compression dress and a control group with 90 patients who used conventional gauze ball and elastic tapes. Skin integrity, hematoma, and oozing were compared between these two groups within 7 days after surgery. Results The mean age of the patients was 71.2 ± 13.3 years, and 83 (47.4%) were male. The results of the experimental vs. control group were as follows: skin integrity - 96.5% vs. 86.7% (p < 0.05); hematoma - 0% vs. 7.8% (p < 0.05); and oozing - 1.2% vs. 7.8% (p < 0.05). All observed endpoints were better in the experimental group. Conclusions The use of a non-taped compression dress was associated with less unfavorable outcomes in terms of skin integrity and hemostasis.
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Affiliation(s)
- Chih-Yin Chien
- Department of Nursing, Mackay Junior College of Medicine, Nursing, and Management; New Taipei City
| | | | - Yih-Jer Wu
- Cardiovascular Center, MacKay Memorial Hospital, Taipei.,Department of Medicine, Mackay Medical College, New Taipei City
| | - Po-Lin Lin
- Cardiovascular Center, MacKay Memorial Hospital, Taipei
| | - Wei-Ru Chiou
- Cardiovascular Center, MacKay Memorial Hospital, Taipei.,Department of Medicine, Mackay Medical College, New Taipei City
| | - Bo-Ching Chi
- Cardiovascular Center, MacKay Memorial Hospital, Taipei.,Department of Cardiology, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Hsu-Ping Wu
- Cardiovascular Center, MacKay Memorial Hospital, Taipei
| | | | - Ying-Hsiang Lee
- Cardiovascular Center, MacKay Memorial Hospital, Taipei.,Department of Medicine, Mackay Medical College, New Taipei City
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14
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The transverse facial artery anatomy: Implications for plastic surgery procedures. PLoS One 2019; 14:e0211974. [PMID: 30730953 PMCID: PMC6366864 DOI: 10.1371/journal.pone.0211974] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 01/23/2019] [Indexed: 11/30/2022] Open
Abstract
Background The transverse facial artery (TFA) perfuses the lateral face. Knowledge of topographical anatomy of the lateral face is crucial for safe procedural performance in aesthetic and plastic surgery, especially the face lift flap and face transplant. The aim of the present study was to assess detailed TFA morphometrical features. Patients and methods One-hundred computed tomography head angiographies were analyzed. TFA numbers and origins were recorded bilaterally (200 cases). TFA diameters and lengths in addition to their positions in relation to neighboring vessels and the zygomatic arches were measured. Results TFA was present in 96% of cases (192/200, left = 97, right = 95). A single TFA was present in 95.3% and double TFAs were present in 4.7% of cases. In 91.7%, the TFA originated from the superficial temporal artery, and in 3.1%, it originated from the external carotid artery. One left TFA originated from the maxillary artery. The TFA was significantly longer on the right than on the left side (56.6±26.0 versus 47.3±22.2 mm; p = 0.03). The TFA mean diameter was 1.0±0.4 mm (range: 0.4–2.2 mm) with no difference between face sides. TFA length correlated with its diameter (r = 0.46, p <0.05). The TFA always originated below the zygomatic arch, and it should be found in the 8.8 mm wide area beginning 17.0mm below the lower border of the zygomatic arch. Conclusions The TFA has a significant role in lateral face vascularization, and absence of this vessel is very uncommon.
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The Avoidance and Management of Complications, and Revision Surgery of the Lower Face and Neck. Clin Plast Surg 2018; 45:623-634. [PMID: 30268247 DOI: 10.1016/j.cps.2018.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Complications are an inherent occurrence in surgery. In rhytidectomy, many complications are avoidable with thorough preoperative assessment and optimal intraoperative and postoperative care. Nevertheless, complications do occur. In certain situations, avoidance of risks is the best way to decrease the occurrence. Once complications do occur, there is a large body of literature to aid in the correction.
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Hopping SB, Joshi AS, Tanna N, Janjanin S. Volumetric Facelift: Evaluation of Rhytidectomy with Alloplastic Augmentation. Ann Otol Rhinol Laryngol 2017; 119:174-80. [DOI: 10.1177/000348941011900305] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives Facial aging occurs as a result of soft tissue atrophy and resorption of the bony skeleton, which results in a loss of soft tissue volume and laxity of the overlying skin. Volumetric augmentation is a key component of facial rejuvenation surgery, and should be considered of equal importance to soft tissue lifting. Augmentation can be accomplished with synthetic fillers, autologous grafts, soft tissue repositioning techniques, and/or alloplastic implants. Only alloplastic implants, however, provide truly long-term volumetric correction. To date, there have been no large series dealing with the complications and results of implantation performed concurrently with rhytidectomy, which we have termed “volumetric rhytidectomy.” We present our experience with 100 patients treated with a combination of malar and chin implants and rhytidectomy, compared to 200 patients who underwent rhytidectomy alone. Methods The authors performed a retrospective review of patients treated with a combination of silicone malar and chin augmentation with rhytidectomy versus patients treated with rhytidectomy alone. Both groups of patients underwent close postoperative evaluation at 3 days, 1 week, 2 weeks, and 1 month. All patients were surveyed at 6 months to assess aesthetic satisfaction. Complication rates were noted and tabulated. Statistical analysis was performed to evaluate for any differences in the two groups. Results Between 2002 and 2006, 100 patients underwent malar and chin implantation along with rhytidectomy; 200 patients underwent rhytidectomy alone. In the first group, there were a total of 6 cases in which implant removal was necessary, and 2 cases in which revision was required. There were no statistically significant differences (p < 0.05) observed between the two groups with respect to major or minor hematoma, seroma, infection, sensory nerve injury, facial nerve injury, hypertrophic scarring, dehiscence, skin sloughing, or revision. Conclusions Volumetric rhytidectomy reliably augments the malar and mental areas, allows for subtle skeletal contouring, and results in successful rejuvenation. Rhytidectomy is relatively safe to perform concurrently with silicone augmentation, and does not result in an increased complication rate as compared to rhytidectomy alone.
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Affiliation(s)
- Steven B. Hopping
- Division of Otolaryngology–Head and Neck Surgery, George Washington University, Washington, DC
- Center for Cosmetic Surgery, George Washington University, Washington, DC
| | - Arjun S. Joshi
- Division of Otolaryngology–Head and Neck Surgery, George Washington University, Washington, DC
| | - Neil Tanna
- Division of Otolaryngology–Head and Neck Surgery, George Washington University, Washington, DC
- Division of Plastic Surgery, University of California, Los Angeles, Los Angeles, California
| | - Sasa Janjanin
- National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, Maryland
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Butz DR, Gill KK, Randle J, Kampf N, Few JW. Facial Aesthetic Surgery: The Safe Use of Oral Sedation in an Office-Based Facility. Aesthet Surg J 2016; 36:127-31. [PMID: 26446058 DOI: 10.1093/asj/sjv200] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The desire for efficient and safe office-based facial plastic surgery procedures has continued to rise. Oral sedation is a safe and effective method to provide anesthesia for facial aesthetic surgery. OBJECTIVES This study reviewed private practice anesthesia-related outcomes using oral sedation combined with local anesthesia for office-based facial aesthetic surgery procedures. METHODS A retrospective chart review was performed on all patients who underwent office-based facial plastic surgery procedures from July 2008 to July 2014. Patient demographic data including age, gender, body mass index (BMI), past medical history, social history, surgical history, allergies, and medications were collected. Anesthesia-related data were also collected including: American Society of Anesthesia (ASA) class, type of procedure, medications administered, and major complications related to sedation were assessed. RESULTS There were 199 patients (23 males and 176 females) who underwent 283 facial aesthetic surgical procedures. Mean age was 49.8 years (range, 29 to 80 years). There were 195 patients in ASA class I and 4 patients were in ASA class II. Patients underwent 44 upper blepharoplasty procedures, 35 lower blepharoplasty procedures, 5 browlifts, 43 upper blepharoplasty-browpexy, 46 facelifts, 38 neck lifts/lower facelifts, 54 fat grafting, 3 tip rhinoplasties, and 15 minor revision cases. During the study period, there were no major complications and no sedation issues. CONCLUSIONS Facial aesthetic surgical procedures can be performed safely and comfortably in the office-based setting under oral sedation in appropriately selected patients. LEVEL OF EVIDENCE 4: Therapeutic.
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Affiliation(s)
- Daniel R Butz
- Dr Butz is a Resident and Next Generation Editor of Aesthetic Surgery Journal and Dr Few is a Clinical Professor of Surgery, Section of Plastic and Reconstructive Surgery, University of Chicago Medicine, Chicago, Illinois; and Cosmetic Medicine Section Editor of Aesthetic Surgery Journal. Dr Gill is a plastic surgeon in private practice in Naples, Florida. Ms Randle and Ms Kampf are research assistants at a private plastic surgery practice in Chicago, Illinois
| | - Kiranjeet K Gill
- Dr Butz is a Resident and Next Generation Editor of Aesthetic Surgery Journal and Dr Few is a Clinical Professor of Surgery, Section of Plastic and Reconstructive Surgery, University of Chicago Medicine, Chicago, Illinois; and Cosmetic Medicine Section Editor of Aesthetic Surgery Journal. Dr Gill is a plastic surgeon in private practice in Naples, Florida. Ms Randle and Ms Kampf are research assistants at a private plastic surgery practice in Chicago, Illinois
| | - Jasmine Randle
- Dr Butz is a Resident and Next Generation Editor of Aesthetic Surgery Journal and Dr Few is a Clinical Professor of Surgery, Section of Plastic and Reconstructive Surgery, University of Chicago Medicine, Chicago, Illinois; and Cosmetic Medicine Section Editor of Aesthetic Surgery Journal. Dr Gill is a plastic surgeon in private practice in Naples, Florida. Ms Randle and Ms Kampf are research assistants at a private plastic surgery practice in Chicago, Illinois
| | - Natalie Kampf
- Dr Butz is a Resident and Next Generation Editor of Aesthetic Surgery Journal and Dr Few is a Clinical Professor of Surgery, Section of Plastic and Reconstructive Surgery, University of Chicago Medicine, Chicago, Illinois; and Cosmetic Medicine Section Editor of Aesthetic Surgery Journal. Dr Gill is a plastic surgeon in private practice in Naples, Florida. Ms Randle and Ms Kampf are research assistants at a private plastic surgery practice in Chicago, Illinois
| | - Julius W Few
- Dr Butz is a Resident and Next Generation Editor of Aesthetic Surgery Journal and Dr Few is a Clinical Professor of Surgery, Section of Plastic and Reconstructive Surgery, University of Chicago Medicine, Chicago, Illinois; and Cosmetic Medicine Section Editor of Aesthetic Surgery Journal. Dr Gill is a plastic surgeon in private practice in Naples, Florida. Ms Randle and Ms Kampf are research assistants at a private plastic surgery practice in Chicago, Illinois
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Gupta V, Winocour J, Shi H, Shack RB, Grotting JC, Higdon KK. Preoperative Risk Factors and Complication Rates in Facelift: Analysis of 11,300 Patients. Aesthet Surg J 2016; 36:1-13. [PMID: 26578747 DOI: 10.1093/asj/sjv162] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2015] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Facelift (rhytidectomy) is a prominent technique for facial rejuvenation with 126 713 performed in the United States in 2014. Current literature on facelift complications is inconclusive and derives from retrospective studies. OBJECTIVES This study reports the incidence and risk factors of major complications following facelift in a large, prospective, multi-center database. It compares complications of facelifts done alone or in combination with other cosmetic surgical procedures. METHODS A prospective cohort of patients undergoing facelift between 2008 and 2013 was identified from the CosmetAssure database. Primary outcome was occurrence of major complications, defined as complications requiring emergency room (ER) visit, hospital admission, or reoperation within 30 days of the procedure. Univariate and multivariate analysis evaluated risk factors including age, gender, BMI, smoking, diabetes, combined procedures, and type of surgical facility. RESULTS Of the 129 007 patients enrolled in CosmetAssure, 11 300 (8.8%) underwent facelifts. Facelift cohort had more males (8.8%), diabetics (2.7%), elderly (mean age 59.2 years) and obese (38.5%) induviduals, but fewer smokers (4.8%). Combined procedures accounted for 57.4% of facelifts. Facelifts had a 1.8% complication rate, similar to the rate of 2% associated to other cosmetic surgeries. Hematoma (1.1%) and infection (0.3%) were most common. Combined procedures had up to 3.7% complication rate compared to 1.5% in facelifts alone. Male gender (relative risk 3.9) and type of facility (relative risk 2.6) were independent predictors of hematoma. Combined procedures (relative risk 3.5) and BMI ≥ 25 (relative risk 2.8) increased infection risk. CONCLUSIONS Rhytidectomy is a very safe procedure in the hands of board-certified plastic surgeons. Hematoma and infection are the most common major complications. Male gender, BMI ≥ 25, and combined procedures are independent risk factors. LEVEL OF EVIDENCE 2: Risk.
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Affiliation(s)
- Varun Gupta
- Drs Gupta and Winocour are Plastic Surgery Fellows, Mr Shi is a Medical Student, Dr Shack is a Professor and Chairman, and Dr Higdon is an Assistant Professor, Department of Plastic Surgery, Vanderbilt University, Nashville, TN, USA. Dr Grotting is a Clinical Professor, Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA; and CME/MOC Section Editor for Aesthetic Surgery Journal
| | - Julian Winocour
- Drs Gupta and Winocour are Plastic Surgery Fellows, Mr Shi is a Medical Student, Dr Shack is a Professor and Chairman, and Dr Higdon is an Assistant Professor, Department of Plastic Surgery, Vanderbilt University, Nashville, TN, USA. Dr Grotting is a Clinical Professor, Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA; and CME/MOC Section Editor for Aesthetic Surgery Journal
| | - Hanyuan Shi
- Drs Gupta and Winocour are Plastic Surgery Fellows, Mr Shi is a Medical Student, Dr Shack is a Professor and Chairman, and Dr Higdon is an Assistant Professor, Department of Plastic Surgery, Vanderbilt University, Nashville, TN, USA. Dr Grotting is a Clinical Professor, Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA; and CME/MOC Section Editor for Aesthetic Surgery Journal
| | - R Bruce Shack
- Drs Gupta and Winocour are Plastic Surgery Fellows, Mr Shi is a Medical Student, Dr Shack is a Professor and Chairman, and Dr Higdon is an Assistant Professor, Department of Plastic Surgery, Vanderbilt University, Nashville, TN, USA. Dr Grotting is a Clinical Professor, Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA; and CME/MOC Section Editor for Aesthetic Surgery Journal
| | - James C Grotting
- Drs Gupta and Winocour are Plastic Surgery Fellows, Mr Shi is a Medical Student, Dr Shack is a Professor and Chairman, and Dr Higdon is an Assistant Professor, Department of Plastic Surgery, Vanderbilt University, Nashville, TN, USA. Dr Grotting is a Clinical Professor, Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA; and CME/MOC Section Editor for Aesthetic Surgery Journal
| | - K Kye Higdon
- Drs Gupta and Winocour are Plastic Surgery Fellows, Mr Shi is a Medical Student, Dr Shack is a Professor and Chairman, and Dr Higdon is an Assistant Professor, Department of Plastic Surgery, Vanderbilt University, Nashville, TN, USA. Dr Grotting is a Clinical Professor, Division of Plastic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA; and CME/MOC Section Editor for Aesthetic Surgery Journal
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Wudel JM, Novis S, Baker SR, Kim JC, Moyer JS. Cervicofacial Rhytidectomy After Radiotherapy for Head and Neck Tumors. JAMA FACIAL PLAST SU 2015; 18:9-14. [PMID: 26448162 DOI: 10.1001/jamafacial.2015.1316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Whether undergoing cervicofacial rhytidectomy after radiotherapy for tumors of the head and neck is associated with increased complication rates and therefore should be avoided remains unknown. OBJECTIVE To evaluate complication rates in patients who have undergone cervicofacial rhytidectomy after radiotherapy for head and neck tumors and compare these rates with those of patients who have not undergone radiotherapy. DESIGN, SETTING, AND PARTICIPANTS Retrospective review of the medical records of 16 patients who underwent cervicofacial rhytidectomy after completing radiotherapy for head and neck tumors and those of 16 age-matched control participants who did not undergo radiotherapy. Patients underwent treatment from July 1, 2006, through February 28, 2014, with final follow-up on February 28, 2014. Complications after surgery were reviewed and data for surgery type, technique, radiation dose and delivery method, and time to surgery after radiotherapy were analyzed. Data were collected from June 1 through December 31, 2013, and analyzed from January 1, 2014, through June 1, 2015. MAIN OUTCOMES AND MEASURES Rate of complications after surgery. RESULTS The radiotherapy and control group patients were a mean of 62 years old. In the radiotherapy group, 8 of 16 were women; 14 of 16 were women in the control group. Two major complications, 1 hematoma and 1 perioperative stroke, occurred in the 16 patients who composed the study cohort. In the control group, there was 1 case of transient facial nerve weakness and 1 case of cellulitis that was successfully treated with antibiotics. Two patients experienced wound dehiscence, and no incidents of motor or sensory nerve injury occurred. Subcutaneous face-lift (3 of 3 patients [100%] vs 1 of 13 patients [8%] who underwent superficial musculoaponeurotic system and deep-plane face-lifts; P = .02) and the addition of chemotherapy (4 of 9 patients [44%] vs 0 of 7 patients who did not receive chemotherapy; P = .04) were associated with increased complications. Being older and the time from completion of radiotherapy and surgery did not show any correlation to complications. CONCLUSIONS AND RELEVANCE Aesthetic facial surgery after radiotherapy has an increased risk for complication compared with facial surgery without radiotherapy. The incidence of wound dehiscence is elevated in the population undergoing radiotherapy but can be managed conservatively in most cases. Patients who undergo radiotherapy must be counseled on the increased risk for complications before proceeding with cervicofacial rhytidectomy. LEVEL OF EVIDENCE 3.
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Affiliation(s)
| | - Sarah Novis
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor
| | - Shan R Baker
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor
| | - Jennifer C Kim
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor
| | - Jeffrey S Moyer
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor
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Topographic Relationships Between the Transverse Facial Artery, Branches of the Facial Nerve, and the Parotid Duct in the Lateral Midface in a Korean Population. Ann Plast Surg 2014; 73:321-4. [DOI: 10.1097/sap.0b013e31827cd8d9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Mioton LM, Alghoul MS, Kim JYS. A comparative analysis of readmission rates after outpatient cosmetic surgery. Aesthet Surg J 2014; 34:317-23. [PMID: 24431346 DOI: 10.1177/1090820x13519796] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Despite the increasing scrutiny of surgical procedures, outpatient cosmetic surgery has an established record of safety and efficacy. A key measure in assessing surgical outcomes is the examination of readmission rates. However, there is a paucity of data on unplanned readmission following cosmetic surgery procedures. OBJECTIVES The authors studied readmission rates for outpatient cosmetic surgery and compared the data with readmission rates for other surgical procedures. METHODS The 2011 National Surgical Quality Improvement Program (NSQIP) data set was queried for all outpatient procedures. Readmission rates were calculated for the 5 surgical specialties with the greatest number of outpatient procedures and for the overall outpatient cosmetic surgery population. Subgroup analysis was performed on the 5 most common cosmetic surgery procedures. Multivariate regression models were used to determine predictors of readmission for cosmetic surgery patients. RESULTS The 2879 isolated outpatient cosmetic surgery cases had an associated 0.90% unplanned readmission rate. The 5 specialties with the highest number of outpatient surgical procedures were general, orthopedic, gynecologic, urologic, and otolaryngologic surgery; their unplanned readmission rates ranged from 1.21% to 3.73%. The 5 most common outpatient cosmetic surgery procedures and their associated readmission rates were as follows: reduction mammaplasty, 1.30%; mastopexy, 0.31%; liposuction, 1.13%; abdominoplasty, 1.78%; and breast augmentation, 1.20%. Multivariate regression analysis demonstrated that operating time (in hours) was an independent predictor of readmission (odds ratio, 1.40; 95% confidence interval, 1.08-1.81; P=.010). CONCLUSIONS Rates of unplanned readmission with outpatient cosmetic surgery are low and compare favorably to those of other outpatient surgeries.
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Affiliation(s)
- Lauren M Mioton
- Ms Mioton is a medical student at Vanderbilt University School of Medicine, Nashville, Tennessee
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New Perspectives on the Surgical Anatomy and Nomenclature of the Temporal Region. Plast Reconstr Surg 2013; 131:510-522. [DOI: 10.1097/prs.0b013e31827c6ed6] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Basile FV, Basile AR, Basile VV. Triple-anchoring sub-SMAS face-lift. Aesthetic Plast Surg 2012; 36:526-33. [PMID: 22350309 DOI: 10.1007/s00266-012-9872-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2011] [Accepted: 09/11/2011] [Indexed: 10/28/2022]
Abstract
BACKGROUND This article presents the senior author's (ARB) 10-year experience with a rhytidectomy technique that incorporates concepts of modern facial shaping and contour using a sub-SMAS repositioning of volumetric units with partial sub-SMAS elevation (tunnel dissection), periosteal anchoring of SMAS and volumetric units, and limited skin undermining. METHODS The cases of triple-anchoring sub-SMAS face-lift performed from January 2000 to January 2010 were analyzed retrospectively. Primary and secondary cases were included. All case data and photography were analyzed. Data regarding patient age, sex, and operative time were gathered. Complication rates were also calculated. RESULTS A total of 626 patients had a face-lift using the author's technique in this period. A total of 484 patients had a primary face-lift and 142 had secondary surgery. Experience with 626 rhytidectomies performed over a 10-year period indicates that this operation can be completed safely with satisfactory results and a low incidence of complications. To alter effectively the facial contour, a system that reliably elevates the facial volumetric units is needed. After adequate release of the retaining ligaments, the thick SMAS is used as a load-bearing layer. All the tension is transferred from the SMAS to a fixed periosteal anchor point. Each volumetric unit of the face (mala, lateral, and cervical) should be independently mobilized and fixed. CONCLUSION The author's technique was shown to be effective in repositioning facial volumes. It was a predictable and reliable technique with few complications over the years. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at http://www.springer.com/00266.
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Relationship of the Temporofrontal Rami of the Facial Nerve to the Fascial Layers of the Temporal Region. Ann Plast Surg 2012; 68:547-8. [DOI: 10.1097/sap.0b013e318221b563] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bilateral Parotid Duct Obstruction After Rhytidectomies: Case Report. J Oral Maxillofac Surg 2012; 70:449-52. [DOI: 10.1016/j.joms.2011.02.050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Accepted: 02/08/2011] [Indexed: 11/24/2022]
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Leve M, Rubin L, Pusic A. Cosmetic surgery and neoliberalisms: Managing risk and responsibility. FEMINISM & PSYCHOLOGY 2011. [DOI: 10.1177/0959353511424361] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The practice and culture of cosmetic surgery has proliferated in the past two decades. While much feminist scholarship has investigated women’s surgical stories, as well as the gendered sociocultural and sociopolitical contexts surrounding, and promoting, the ‘choice’ of surgery, very little research has examined material and symbolic risks associated with cosmetic surgery. This study employs a feminist interpretative phenomenological (IPA) approach to investigate cosmetic surgical risk experiences, as narrated by seven women who underwent aesthetic facial surgery. Our analysis focuses on how participants confront, and manage, medical, consumer and self-presentation risks associated with cosmetic surgery, under the political ethos of neoliberalism. The implications of these risk experiences are discussed in relation to the increasing normalization of cosmetic surgery and patriarchal/neoliberal obligations to construct a ‘feminine’ body through socially sanctioned practices.
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Lee SY, Koh YW, Kim BG, Hong HJ, Jeong JH, Choi EC. The Extended Indication of Parotidectomy Using the Modified Facelift Incision in Benign Lesions: Retrospective Analysis of a Single Institution. World J Surg 2011; 35:2228-37. [DOI: 10.1007/s00268-011-1209-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Herrero NA, Sherman EG, Adelson RT. Analysis of flap tension in surgical rejuvenation of the midface: a cadaver study. Otolaryngol Head Neck Surg 2011; 144:191-5. [PMID: 21493414 DOI: 10.1177/0194599810391847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To determine the flap tension present for 2 different surgical approaches for midface lifts and whether a gingivobuccal incision for release of the midface periosteum will diminish the resultant load on the midface flap. STUDY DESIGN Cadaver study. SETTING Anatomy laboratory at the University of Florida. SUBJECTS AND METHODS Twelve fresh-frozen cadaver heads are subjected to a transblepharoplasty (TB) approach on one side of the cadaver head while a transtemporal (TT) approach is performed on the contralateral side. The tension (grams) generated by moving the midface flap a distance of 1.03 cm is recorded by a digital load cell. A gingivobuccal incision is made on each side to allow transoral periosteal release (TOPR) of the midface flap, and the experiment is repeated. Three trials are performed for each operation, and the average load is calculated. A paired t test is applied. RESULTS The tension resulting from the TT approach (172 g) was not found to be significantly different from that of the TB approach (179 g; P = .75). Significant differences in the resultant tension were not appreciated when comparing standard techniques to TT with TOPR (141.5 g; P = .27) or for TB with TOPR (164.1 g; P = .45). DISCUSSION An experimental method is described for determining flap tension in facial rejuvenation surgery. No significant difference is found between flap tensions generated in the TB and TT approaches to the midface.
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Affiliation(s)
- Nicholas A Herrero
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology, University of Florida, Gainesville, Florida, USA
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Clevens RA. Avoiding Patient Dissatisfaction and Complications in Facelift Surgery. Facial Plast Surg Clin North Am 2009; 17:515-30, v. [DOI: 10.1016/j.fsc.2009.06.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Yoon YH, Park JY, Choi JW, Koo BS. Iatrogenic ear lobule ischemic injury from pressure dressing as an unusual complication of parotidectomy. Am J Otolaryngol 2008; 29:361-2. [PMID: 18722895 DOI: 10.1016/j.amjoto.2007.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2007] [Revised: 09/13/2007] [Accepted: 10/09/2007] [Indexed: 10/21/2022]
Abstract
The use of compressive dressing is usually spread to enhance neovascularization of the dissected facial flap by elimination of dead space between the flap and the dermis in parotid surgery through facelift incision. The author reports a clinical case of compressive dressing after parotidectomy that was inappropriately performed to folding of the ear lobule, leading to ischemic injury. This iatrogenic complication resulted in the development of contracture of ear lobule and deformity of auricle. Consequently, careful compressive dressing after parotidectomy through facelift incision must be applied; and the wound must be inspected daily for early detection and prompt treatment of local complications.
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Godeiro-Júnior CO, Oliveira ASB, Felício AC, Barros N, Gabbai AA. Peroneal nerve palsy due to compartment syndrome after facial plastic surgery. ARQUIVOS DE NEURO-PSIQUIATRIA 2007; 65:826-9. [DOI: 10.1590/s0004-282x2007000500018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2007] [Accepted: 05/23/2007] [Indexed: 05/25/2023]
Abstract
A 25-year-old white man, right after bilateral rhytidoplasty, presented with agitation, necessiting use of haloperidol. Some hours after, he developed severe pain in his legs and a diagnosis of neuroleptic malignant syndrome (NMS) was considered. Even with treatment for NMS he still complained of pain. A diagnosis of lower limb compartment syndrome (CS) was done only 12 hours after the initial event, being submitted to fasciotomy in both legs, disclosing very pale muscles, due to previous ischemia. This syndrome was not explained only by facial surgery, his position and duration of the procedure. It can be explained by a sequence of events. He had a history of pain in his legs during physical exercises, usually seen in chronic compartment syndrome. He used to take anabolizant and venlafaxine, not previously related, and the agitation could be related to serotoninergic syndrome caused by interaction between venlafaxine and haloperidol. Rhabdomyolisis could lead to oedema and ischmemia in both anterior leg compartment. This report highlights the importance of early diagnosis of compartment syndrome, otherwise, even after fasciotomy, a permanent disability secondary to peripheral nerve compression could occur.
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Abstract
PURPOSE OF REVIEW The demand for cosmetic procedures has increased dramatically over the past few years, in part fueled by the prevalence of cosmetic 'makeover shows', increased media coverage on television and easy accessibility to the Internet. This growing social acceptance of aesthetic surgery has caused an increasing number of women and men to undergo elective noninvasive and invasive procedures to enhance their appearance. As the number of patients interested in cosmetic surgery increases and the number of physicians performing these procedures increases, the risk of complications invariably also rises. An article focusing on the prevention of complications in facial plastic surgery, therefore, is clearly appropriate in the current era. RECENT FINDINGS One of the recurring themes in the literature is preventing complications before they occur. Proper patient selection, a thorough understanding of the anatomy and adhering to proper techniques are some of the methods mentioned to avoid unfavorable outcomes. SUMMARY The literature is replete with articles that focus on the newest techniques for facial rejuvenation. Only through careful analysis of the pitfalls of cosmetic procedures, however, can the facial plastic surgeon adopt principles to help prevent complications.
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Affiliation(s)
- Carlo P Honrado
- Division of Facial Plastic and Reconstructive Surgery, New York Medical College, Valhalla, New York, USA
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Bibliography. Current world literature. Head and neck reconstruction. Curr Opin Otolaryngol Head Neck Surg 2006; 14:289-91. [PMID: 16832188 DOI: 10.1097/01.moo.0000233602.37541.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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