Archives of Facial Plastic Surgery (ARCH FACIAL PLAST S)

Publications in this journal

• Article: A 6-year experience in flat helixcorrection with a simple procedure.

  Lykoudis EG, Seretis K, Spyropoulou GA
  Archives of Facial Plastic Surgery 05/2011;
• Article: Computed tomography use and repair of orbitozygomatic fractures.

  P N Manson
  Archives of Facial Plastic Surgery 1(1):25-6.
• Article: Current status of "soft" implant materials for the face.

  R L Goode
  Archives of Facial Plastic Surgery 1(1):60-1.
• Article: Perspective: committed to excellence.

  R L Simons
  Archives of Facial Plastic Surgery 1(1):63-4.
• Article: The lip-cheek groove: a new analysis with treatment options.

  Naznin Karsan, David A F Ellis
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  ABSTRACT: To present a clinical classification of the lip-cheek groove. The clinical classification, which is based on years of analysis, will provide optimal management options for achieving the greatest degree of correction and rejuvenation of the lip-cheek groove. The use of the clinical classification of the lip-cheek groove will guide the surgeon to the management option(s) that will attain the best aesthetic outcome. The classification of the lip-cheek groove enables the surgeon to choose the optimal approach for improvement of the groove.
  Archives of Facial Plastic Surgery 8(5):324-8.
• Article: Lateral crus pull-up: a method for collapse of the external nasal valve.

  Dirk J Menger
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  ABSTRACT: Collapse of the nasal vestibule during inspiration is a frequently encountered symptom, often caused by weak or medially displaced lateral crura in the lower lateral cartilages. Numerous techniques are available for lateralizing and strengthening the lateral crura using cartilage grafts or suture techniques. In most cases, they involve an external rhinoplasty approach or additional incisions. An elegant endonasal method for widening and strengthening the lateral component of the nasal valve area is described herein. The basis of the procedure is a permanent submucosal spanning suture between the piriform aperture and the distal part of the lower lateral cartilage. The effect of this technique is 2-fold. First, it provides superolateral rotation of the lateral crura, increasing the cross-sectional area, and second, the spanning suture provides additional support for the lateral wall of the nasal vestibule.
  Archives of Facial Plastic Surgery 8(5):333-7.
• Article: Subcutaneous superficial musculoaponeurotic system grafting of the aging melolabial furrow.

  Thomas A Lamperti, Jeffrey S Carithers
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  ABSTRACT: To describe a technique of subcutaneous superficial musculoaponeurotic system grafting during rhytidectomy to treat the aging melolabial furrow. Two hundred seventeen patients received bilateral superficial musculoaponeurotic system grafts from December 1, 1996, through June 30, 2003 (a 78-month period). The patients' charts were reviewed for demographic data, follow-up dates, and complications. Selected preoperative and postoperative photographs were viewed. In the 217 patients, 434 grafts were performed, with a mean follow-up of 23.2 months. Follow-up postoperative photographs showed effective long-term effacement of the melolabial furrow. There was a 0.9% complication rate involving 4 cases of unilateral graft infection that resolved with oral antibiotic therapy. Subcutaneous superficial musculoaponeurotic system grafting of the melolabial furrow is a safe, effective technique of treating the prominent melolabial furrow. It adds very little time to the rhytidectomy procedure, is well tolerated by patients, and shows durable results.
  Archives of Facial Plastic Surgery 6(6):384-8.
• Source

  Available from: metroatlantaotolaryngology.org

  Article: Nonablative laser and light therapies for skin rejuvenation.

  Karen H Kim, Roy G Geronemus
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  ABSTRACT: Multiple modalities have been described for skin rejuvenation, including ablative and nonablative therapies. Because of the prolonged recovery period associated with ablative procedures that injure the epidermis, nonablative skin treatments have grown increasingly popular. Various laser- and light-based systems have been designed or applied for promoting skin remodeling without damage to the epidermis. Studies investigating the use of nonablative procedures for facial rhytids or acne scarring with clinical, histological, and objective quantitative measurements are systematically reviewed. Nonablative treatments are associated with clinical and objective improvements for the treatment of facial rhytids and acne scarring. Dermal remodeling seems to occur as a result of thermal injury, leading to dermal fibrosis without epidermal disruption. Although results are not as impressive as those of ablative treatments, nonablative procedures are effective in the treatment of photoaging and acne scarring. As technology in nonablative therapies continues to evolve, future laser and light sources may yield even more favorable results.
  Archives of Facial Plastic Surgery 6(6):398-409.
• Article: In pursuit of an optimal wound closure technique.

  W Thomas Lawrence
  Archives of Facial Plastic Surgery 8(2):139-40.
• Article: The double transposition flap for closure of the extremely wide hard palate cleft.

  Sivi Bakthavachalam, Yadranko Ducic
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  ABSTRACT: Repair of the extremely wide hard palate cleft can be done effectively with a double transposition flap. All cases referred for closure of cleft palates from 1997 to 2005 were considered for this study. Of these, 6 were classified as extremely wide cleft palates thought not to be treatable with standard closure techniques. A double transposition flap was used in each case. All patients tolerated the procedure well; no flap failure or dehiscence was noted; and none has required secondary repair. All patients tolerated an appropriate diet following flap repair. Two patients who were gastrostomy tube dependent preoperatively no longer required gastrosotomy tubes postoperatively.
  Archives of Facial Plastic Surgery 8(2):123-7.
• Article: Initial management of total nasal septectomy defects using resorbable plating.

  Charles C Della Santina, Patrick J Byrne
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  ABSTRACT: Temporary reconstruction of the nasal skeleton using resorbable plating offers several advantages in management of carefully selected patients undergoing septectomy. These include protection against early soft tissue contracture, lack of interference with postoperative radiation and surveillance imaging, ease of use, and reversibility. This strategy can yield a good functional result and acceptable cosmesis during radiotherapy and a period of surveillance prior to definitive reconstruction. Herein, we describe the use of resorbable plating material for temporary nasal support in staged reconstruction of complex nasal skeletal defects. We managed near-total defects of the nasal cartilaginous and bony skeleton after cancer resection by staged reconstruction, initially using resorbable plating material to provide temporary structural support for nasal soft tissue during a 1-year period of postresection surveillance. The resorbable reconstruction provided adequate support to maintain nasal patency and external contour for a year or more, allowing early return to normal activities. Partial extrusion occurred in a patient who continued heavy smoking.
  Archives of Facial Plastic Surgery 8(2):128-38.
• Article: Objective assessment of facial asymmetry in rhinoplasty patients.

  Paul Chatrath, Jose De Cordova, S A Reza Nouraei, Jahangir Ahmed, Hesham A Saleh
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  ABSTRACT: To determine the incidence and nature of facial asymmetry in patients referred for consideration of aesthetic rhinoplasty and to assess whether objective anthropometric facial measurements correlate with subjective perceptions of asymmetry. Two independent observers measured facial features, including midline to medial and lateral canthi, tragus, ala, and oral commissure distances, in 234 prerhinoplasty surgical photographs. The photographs were rated by 10 independent observers for a global "first impression" of facial symmetry, and the relationship between anthropometric measurement and subjective perception of facial symmetry was explored with logistic regression. Objectively, 97% of patients had significant degrees of facial asymmetry, with the midline to ala distances showing the most variations and the midline to oral commissures showing the least variations. Subjectively, 38% of results were perceived as asymmetrical, with the degree of midline to lateral alar margin asymmetry being an independent predictor of the perception of facial asymmetry on binary logistic regression (P<.003). A significant correlation was found between the degree of objective facial asymmetry, particularly in anthropometric nasal measurements, and the subjective perception of a face as asymmetrical in patients requesting aesthetic rhinoplasty. This relationship may be a factor in patients who request rhinoplasty and should be explored in this patient group.
  Archives of Facial Plastic Surgery 9(3):184-7.
• Article: Placement of a lateral nasal suspension suture via an external rhinoplasty approach.

  Scott B Roofe, Sam P Most
  Archives of Facial Plastic Surgery 9(3):214-6.
• Article: Two-flap palatoplasty over 2 decades of experience.

  Jason J Miller
  Archives of Facial Plastic Surgery 9(2):144-5.
• Source

  Available from: drmatthewwhite.com

  Article: Clinical pilot study of intense ultrasound therapy to deep dermal facial skin and subcutaneous tissues.

  Richard E Gliklich, W Matthew White, Michael H Slayton, Peter G Barthe, Inder Raj S Makin
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  ABSTRACT: To evaluate the clinical safety of intense ultrasound in the treatment of the dermis and subcutaneous tissues of the face and neck in terms of skin inflammation, pain, adverse events, and histologic features. In an open-label, phase 1 study, patients scheduled to undergo a rhytidectomy were enrolled into immediate (face-lift surgery within 24 hours of intense ultrasound treatment) and delayed (face-lift surgery 4-12 weeks after treatment) treatment groups. Intense ultrasound treatments were performed as a series of several linear exposures delivered 1.5 to 2.0 mm apart with the use of 1 of 3 available handpieces with different focal depths. Subject pain ratings and standardized digital photographs were obtained at uniform points. Photographs were blindly rated for inflammation. Histologic evaluation of treated tissues was performed with nitroblue tetrazolium chloride viability stain. Fifteen subjects with a mean +/- SD age of 53 +/- 7 years were enrolled. Seven subjects were nonrandomly assigned to the immediate group and 8 were in the delayed group. On histologic examination, thermal injury zones were consistently identified in the dermis at exposure levels greater than 0.5 J as focal areas of denatured collagen. At this threshold level or above, most patient exposures were associated with transient superficial skin erythema and slight to mild discomfort on a standardized pain scale. No other adverse effects were noted in any case. Thermal injury zones were produced in the expected linear pattern and were consistent in size and depth from zone to zone. Increasing source power did not increase the depth of the epicenter of the thermal injury zone. Epidermis was spared in all cases. In this first clinical study of intense ultrasound therapy to facial tissues, the intense ultrasound system allowed for the safe and well-tolerated placement of targeted, precise, and consistent thermal injury zones in the dermis and subcutaneous tissues with sparing of the epidermis.
  Archives of Facial Plastic Surgery 9(2):88-95.
• Article: Efficacy and safety of endotine fixation device in endoscopic brow-lift.

  Patrick J Byrne
  Archives of Facial Plastic Surgery 9(3):212-4.
• Source

  Available from: drfarrior.com

  Article: Retrospective analysis of the Farrior technique for otoplasty.

  Scott A Scharer, Edward H Farrior, Richard T Farrior
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  ABSTRACT: To evaluate clinical outcomes and patient satisfaction following otoplasty for surgical correction of protruding or prominent ears using the Farrior technique. This was a retrospective study of patients undergoing cosmetic otoplasty with the Farrior method at a private facial plastic surgery practice in Tampa, Fla. The study population comprised 75 subjects desiring operative correction of auricular deformities by one of the authors (E.H.F.) over the past 15 years. The subjects (40 male and 35 female) ranged in age from 5 to 68 years, with a mean age of 23.9 years. Clinical follow-up ranged from 1 day to 7 years 2 months, with a mean duration of 1 year 5 days. The Farrior otoplasty is a graduated technique that combines elements of cartilage sculpting, suturing, and conchal setback procedures, and stresses a patient-specific, anatomy-directed approach. This method was first introduced in the literature in 1959 by the senior author (R.T.F.) and is continued to the present day by his son (E.H.F.). Main outcome measures included satisfactory correction of auricular deformity, incidence of postoperative complications, and degree of patient satisfaction with the procedure. These outcomes were compared with that of other otoplasty techniques and long-term studies in the literature. Of the 75 patients who underwent otoplasty via the Farrior technique over the last 15 years, bilateral otoplasties were performed in 69 (92%). Of the cases, 69 (92%) were primary procedures, with revision otoplasties constituting 6 (8%) of the total. A combination of conchal cartilage reduction, cartilage scoring, and mattress suturing was the most frequently used maneuver (47 cases [63%]). Most cases were performed using local anesthesia (n = 62 [83%]), with 18 (24%) of all cases having adjunctive procedures at the time of the otoplasty. No major complications (large hematoma, tissue necrosis, gross deformity, or significant wound infection) were documented. A total of 40 minor complications was observed in 29 patients, with suture extrusion and persistent auricular protrusion being the most common (occurring in 14 [19%] and 17 [23%] cases, respectively). Overall, 11 patients required revision surgery (9 for protrusion, 1 for hypertrophic scar, and 1 for cartilaginous callus). A majority of positive responses on an anonymous patient survey reflects a high degree of patient satisfaction with the procedure and results. The Farrior otoplasty is a graduated technique that has met with clinical success over the years. It combines elements of cartilage shaping and suturing procedures and as such is susceptible to complications such as suture extrusion and auricular protrusion that are ascribed to similar otoplasty methods described in the literature. It allows for a directed approach to correct the causative anatomic defects, while maintaining a natural appearance. While further research and long-term analyses are encouraged, this technique remains a valuable component of a facial plastic surgeon's armamentarium.
  Archives of Facial Plastic Surgery 9(3):167-73.
• Source

  Available from: thomaschicagoplasticsurgery.com

  Article: Brow-lift: subgaleal vs subperiosteal flap adherence in the rabbit model.

  J Regan Thomas, Arnold S Lee, Amit B Patel
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  ABSTRACT: To analyze and compare the postoperative adherence qualities between the subperiosteal layer approach and the subgaleal layer approach for brow elevation using a rabbit model. Twelve New Zealand white rabbits (weight, 3.1-3.5 kg) were evenly divided into 2 groups and underwent forehead flap elevation via subperiosteal or subgaleal dissection, depending on the group assignment. Two rabbits were not operated on and served as controls. Histologic and biomechanical testing (tensiometer) was performed at 2, 4, 6, 8, and 10 weeks to assess adherence and wound strength. The subgaleal flap strength was greater than that of the subperiosteal flap at each time point. The mean flap strength for the subgaleal and subperiosteal control subjects were 208 g and 706 g, respectively. These values approximately correspond with the postelevation subgaleal flap strength regained at 2 weeks and the postelevation subperiosteal flap strength regained at 8 weeks. On histologic analysis, the subgaleal specimen showed less intervening space and a greater degree of connective tissue proliferation than the subperiosteal specimen at as early as 4 weeks. This study supports our hypothesis that rapid healing and early fixation occurs when the subgaleal approach is used for surgical brow elevation.
  Archives of Facial Plastic Surgery 9(2):101-5.
• Source

  Available from: drbensimon.co.il

  Article: Modified conjunctivodacryocystorhinostomy for upper lacrimal system obstruction.

  Robert M Schwarcz, Seongmu Lee, Robert A Goldberg, Guy J Ben Simon
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  ABSTRACT: To describe a modified technique for conjunctivodacryocystorhinostomy (CDCR) and to compare this technique with the standard transcaruncular placement of the glass tube. Patients with upper lacrimal system obstruction underwent CDCR at the Jules Stein Eye Institute during a 3-year period. Thirteen patients underwent modified CDCR leaving the caruncle intact, while 7 patients underwent Jones glass tubes placement through a caruncular incision (conventional CDCR). Data regarding ocular and tearing history were recorded and analyzed. Success rates, defined as complete improvement in tearing, were compared between patients who underwent standard CDCR and those who underwent modified CDCR. Main outcome measures included symptom relief, patients' tolerance of the Jones tube, and surgical complications. Nineteen patients (12 men and 7 women; mean age, 66 years) underwent 20 CDCR surgical procedures with Jones tube placement. Previous lacrimal history included malignancy of the ocular adnexa, trauma, chemotherapy, and previous failed dacryocystorhinostomy. Success was found in 13 surgical cases (65%) and partial improvement was found in 4, giving a qualified success rate of 85%. Patients who underwent modified CDCR were more likely to undergo a successful surgery compared with patients who underwent conventional CDCR, with 11 (85%) of 13 cases achieving complete improvement vs 2 (29%) of 7 cases in the conventional CDCR group (P = .03, Fisher exact test). Complications included 1 case of migration and loss of the Jones tube. Modified CDCR results in partial or complete resolution of tearing in nearly 92% of cases, allowing for an improved outcome both functionally and cosmetically compared with conventional CDCR.
  Archives of Facial Plastic Surgery 9(2):96-100.
• Article: Effect of celecoxib on fasciocutaneous flap survival and revascularization.

  Mark K Wax, Douglas D Reh, Melissa M Levack
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  ABSTRACT: To study the effect of celecoxib (Celebrex; Pfizer, Cambridge, Mass) on (1) primary ischemic time and (2) revascularization of fasciocutaneous free flaps in a rat model. In the ischemia study, 50 male Sprague-Dawley rats were divided into 2 groups of 25 rats each, a control group and a celecoxib group. Five rats in each treatment group were exposed to ischemic times of 4, 6, 8, 10, and 12 hours. Survival of the flap was assessed 7 days after reversal of the ischemia. Probit curves and the critical ischemic time were calculated. In the revascularization study, 30 male Sprague-Dawley rats were divided into 2 groups of 15 rats each. One group was fed celecoxib, while the other was fed a normal diet. All rats had a 3 x 6-cm fasciocutaneous flap based on the inferior epigastric artery elevated and exposed to 2 hours of primary ischemia. The flap was then sutured back into the wound bed. Each of these groups was then divided into 3 groups of 5 rats whose pedicles were divided on postoperative day 5, 6, or 7. Percentage survival of the flap was measured 7 days later. In both parts of the study, the experimental group was fed celecoxib, 1500 ppm, throughout the interoperative period. In each animal, a 3 x 6-cm ventral fasciocutaneous groin flap based on the left superficial epigastric artery was elevated. In the ischemia study, respective flap survival rates from the control and celecoxib groups at the various ischemic times were as follows: 4 hours, 100% and 100%; 6 hours, 80% and 100%; 8 hours, 80% and 80%; 10 hours, 60% and 60%; and 12 hours, 20% and 10%. The median lethal ischemic times were 9.7 and 9.6 hours, respectively. There was no statistical difference in flap survival between the celecoxib and control groups. In the revascularization study, ligation of the flap pedicle on day 5, 6, or 7 did not result in any difference in the percentage of flap survival among the 3 groups. Celecoxib appears to have no deleterious effect on free tissue transfer survival or healing, as evidenced by revascularization in a fasciocutaneous free flap model.
  Archives of Facial Plastic Surgery 9(2):120-4.