Faculty Bibliography

Flaps of the lateral orbital portion of the orbicularis oculi muscle splayed out and sutured under tension help smooth skin folds and reduce wrinkles in the lateral canthal area

Surgical alteration of the platysma muscle improves the results of cervicofacial rhytidoplasty. The operative technique indicated for an individual patient is determined, in part, by the anatomy of the platysma deformity. Many questions regarding the late results of platysma muscle surgery can only be answered by long-term follow-up. This paper presents the results in 75 patients who had platysma muscle flap cervicofacial rhytidoplasty. The 8 most common platysma deformities are discussed. Undesirable results and pitfalls in technique are noted

Enophthalmos, flattening of the maxilla that may progress to inferior orbital rim and floor defects, eyelid atrophy, and slight relative hypotony occurred in patients with hemifacial atrophy. Less common manifestations included pupillary and iris abnormalities, vertical muscle imbalances, and retinal changes. The prognosis for vision was good. Fluid silicone injection was the major modality in treatment and the results were generally excellent

The usual complications associated with blepharoplasty are well known. This report presents a case of second-degree burns of the face which occurred while oxygen was being administered to a patient undergoing blepharoplasty and a heat-producing cautery was being used for hemostasis. A possible cause for the complication is suggested. Surgeons are warned of the potential problem that may occur when this combination of factors are present.

A review of the more common and/or more serious complications which may follow rhytidectomy has been presented. The surgeon who performs face lift surgery must be aware of these complications, their incidence, their management, and, in many instances, how they can be prevented, as prevention is the best treatment for postrhytidectomy problems

In 25 random patients undergoing rhytidectomy, we did unilateral subplatysmal-fascial dissections of the superficial musculoaponeurotic system (SMAS) of the face and neck--with redistribution of the tension of this system and fixation by suturing. Late evaluation of these patients by 3 observers showed no detectable difference in the results, as compared to the other side on which the standard technique of skin flap elevation alone was done. Our investigation did not study the usefulness of more extensive dissections of the muscle with complete transection excision of segments of it, or the formation of long muscle flaps

More men are undergoing rhytidectomy now. This operation is specifically different in the preoperative planning, the surgical procedure, the postoperative complications, and the final results (compared to rhytidectomy in females). Large hematomas occurred in our male patients more than twice as often as in females

Although not a frequent occurence, when present a prominent nasal spine contributes to unpleasing septolabial and columella-alar angles which detract from the overall aesthetic quality of the face. It is important to recognize and correct this deformity. In some patients the necessity for spine resection may be subtle. Resection of the nasal spine must be conservative

The tuberous breast deformity cannot usually be corrected satisfactorily by standard augmentation mammaplasty or mastopexy. The two operative techniques described have been most helpful in dealing with this difficult problem. Anatomic differences in patients may permit or require modification of the techniques to correct a specific deformity. Although our experience to date with these techniques has been limited in number, we have been pleased with the postoperative results