{"title":"Update in wound healing in facial plastic surgery.","authors":"Meir D Hershcovitch, David B Hom","doi":"10.1001/2013.jamafacial.33","DOIUrl":"https://doi.org/10.1001/2013.jamafacial.33","url":null,"abstract":"<p><p>Many advances in wound healing have relevance to facial plastic surgery. We briefly highlight some of these advances, including new biological and synthetic products and other potential technologies to improve wound healing, as well as the literature describing them.</p>","PeriodicalId":55470,"journal":{"name":"Archives of Facial Plastic Surgery","volume":"14 6","pages":"387-93"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/2013.jamafacial.33","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31059851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yves Saban, Chiara Andretto Amodeo, David Bouaziz, Roberto Polselli
{"title":"Nasal arterial vasculature: medical and surgical applications.","authors":"Yves Saban, Chiara Andretto Amodeo, David Bouaziz, Roberto Polselli","doi":"10.1001/archfacial.2012.202","DOIUrl":"https://doi.org/10.1001/archfacial.2012.202","url":null,"abstract":"<p><strong>Objectives: </strong>To analyze the nasal superficial arterial vasculature and to compare these anatomic findings with the results of ultrasonography Doppler investigations to evaluate nasal blood flow in physiological and pathologic conditions.</p><p><strong>Methods: </strong>We performed 40 ultrasonography Doppler investigations in patient volunteers, 20 facial anatomic dissections in fresh cadavers, and a review of the literature on nasal blood supply. In cadavers, facial arteries were dissected to analyze nasal arterial supply.</p><p><strong>Results: </strong>When the facial artery, the ophthalmic artery, or both were compressed on 1 side in volunteers, blood flow inversion was proved by ultrasonography Doppler investigation at the level of the nasal area. These results confirm anatomic findings that demonstrate a polygonal system.</p><p><strong>Conclusions: </strong>A schema of nasal blood supply as a polygonal system connecting the external and internal carotid systems is proposed. This facilitates our understanding of anatomic variations, physiological and pathologic modifications of blood flow, and nasal reconstructions with local flaps and medical rhinoplasties using filler injections.</p>","PeriodicalId":55470,"journal":{"name":"Archives of Facial Plastic Surgery","volume":"14 6","pages":"429-36"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archfacial.2012.202","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30700198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Diced cartilage augmentation: early experience with the Tasman technique.","authors":"Shan R Baker","doi":"10.1001/archfacial.2012.494","DOIUrl":"https://doi.org/10.1001/archfacial.2012.494","url":null,"abstract":"<p><p>Numerous methods have been used for dorsal augmentation in reconstructive and aesthetic rhinoplasty. The Tasman technique is a method for dorsal augmentation using diced cartilage solidified by tissue sealant. This article describes the author's early experience using the Tasman technique and offers some helpful suggestions to surgeons who might wish to use this unique method of preparing a cartilaginous graft.</p>","PeriodicalId":55470,"journal":{"name":"Archives of Facial Plastic Surgery","volume":"14 6","pages":"451-5"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archfacial.2012.494","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30701935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Craniomaxillofacial buttresses: anatomy and repair.","authors":"Amit Dave Bhrany","doi":"10.1001/archfacial.2012.906","DOIUrl":"https://doi.org/10.1001/archfacial.2012.906","url":null,"abstract":"","PeriodicalId":55470,"journal":{"name":"Archives of Facial Plastic Surgery","volume":"14 6","pages":"469"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archfacial.2012.906","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31588325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Subjective and objective improvement in breathing after rhinoplasty.","authors":"Richard A Zoumalan, Minas Constantinides","doi":"10.1001/archfacial.2012.665","DOIUrl":"https://doi.org/10.1001/archfacial.2012.665","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether rhinoplasty improves subjective and objective nasal patency.</p><p><strong>Design: </strong>Retrospective study including subjective breathing scores and acoustic rhinometry before and 6 to 9 months after septorhinoplasty among a cohort of 31 patients. We used a paired t test to analyze the difference between preoperative and postoperative values.</p><p><strong>Setting: </strong>Academic medical center.</p><p><strong>Patients: </strong>Patients undergoing septorhinoplasty with potassium titanyl phosphate laser turbinate reduction at a single institution.</p><p><strong>Results: </strong>The mean subjective breathing scores improved significantly, with an overall improvement of 38%. The overall mean volume increased and the overall resistance decreased, but the changes were significant only on the right side. The minimal cross-sectional area (MCA) did not change, but the distance of the MCA of the nasal cavity moved anteriorly by 0.23 cm on the left side. The patients were stratified into subsets based on other procedures undergone, including spreader grafts and alar batten grafts, and on the absence of osteotomies. These groups had similar results. In patients with severe obstruction, all measured values improved more than any other subgroup, including the MCA, which improved significantly by an average of 55%. Patients with normal preoperative MCA values did not experience any significant changes except for an anterior shift in MCA.</p><p><strong>Conclusions: </strong>Septorhinoplasty increases nasal volume, decreases nasal resistance, and advances the MCA anteriorly. These changes coexist with subjective improvements in nasal patency, which suggests that this new anatomic configuration creates a positive outcome on nasal airflow. Spreader grafts do not increase the MCA significantly. Patients with preoperative severe obstruction have the best overall improvement, whether measured subjectively or objectively.</p>","PeriodicalId":55470,"journal":{"name":"Archives of Facial Plastic Surgery","volume":"14 6","pages":"423-8"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archfacial.2012.665","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30895694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Standardized suture placement for mini-invasive ptosis surgery.","authors":"Audrey E Ahuero, Bryan J Winn, Bryan S Sires","doi":"10.1001/archfacial.2012.388","DOIUrl":"https://doi.org/10.1001/archfacial.2012.388","url":null,"abstract":"<p><strong>Objective: </strong>To report a refinement of small-incision external levator advancement with a standardized method for suture placement for correction of acquired blepharoptosis and 1 surgeon's results with this technique.</p><p><strong>Methods: </strong>Retrospective medical record review of data from all patients with unilateral or bilateral acquired blepharoptosis who underwent small-incision external levator advancement from October 1, 2007, through January 31, 2011.</p><p><strong>Results: </strong>Ninety-two eyelids from 66 patients with acquired blepharoptosis were treated with small-incision external levator advancement with uniform suture placement. Forty patients underwent unilateral surgery and 26 underwent bilateral surgery. The mean preoperative margin-to-reflex distance was 0.70 mm. The mean postoperative margin-to-reflex distance was 2.95 mm. Symmetry was achieved in 49 patients (74%) on the basis of a less than 1-mm difference in margin-to-reflex distance. When stratified by unilateral ptosis repair vs bilateral ptosis repair, bilateral ptosis repair achieved greater symmetry on average (81% vs 70%). Nine patients underwent revision. There were only 2 postoperative complications: one was postoperative upper eyelid bleeding and the other was exposure keratopathy.</p><p><strong>Conclusion: </strong>The simplified method of suture placement for small-incision external levator advancement is an effective, safe, and efficient option for acquired ptosis correction.</p>","PeriodicalId":55470,"journal":{"name":"Archives of Facial Plastic Surgery","volume":"14 6","pages":"408-12"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archfacial.2012.388","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30833954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sami P Moubayed, Frederick Duong, Christian Ahmarani, Akram Rahal
{"title":"A novel technique for malar eminence evaluation using 3-dimensional computed tomography.","authors":"Sami P Moubayed, Frederick Duong, Christian Ahmarani, Akram Rahal","doi":"10.1001/archfacial.2012.510","DOIUrl":"https://doi.org/10.1001/archfacial.2012.510","url":null,"abstract":"<p><strong>Objective: </strong>To describe a novel method to locate the malar eminence using 3-dimensional computed tomography (3D-CT), and a new axis system for evaluation of malar eminence symmetry.</p><p><strong>Methods: </strong>A retrospective case series was carried out in 42 disease-free white adult patients. The 3D-CT reconstructions of the face were obtained, and the soft-tissue maxillozygion was used to locate the malar eminence. Other skeletal and soft-tissue landmarks (frontozygomatic suture, zygion, and orbitale) were evaluated. A patient-oriented axis system was constructed using 3 sagittal midline landmarks (nasion, subspinale, and basion). Coordinates were obtained for each landmark, and symmetry was evaluated.</p><p><strong>Results: </strong>Twenty-one men and 21 women with mean ages of 41.1 and 41.3 years, respectively, were included. The malar eminence was easily localized using the 3D-CT technique for soft-tissue maxillozygion identification. Clinical asymmetry at the level of the soft-tissue maxillozygion was 40.5% (95% CI, 25.0%-56.0%). Other landmarks showed a prevalence of clinical asymmetry ranging from 24.0% to 50.0%.</p><p><strong>Conclusions: </strong>The malar eminence can be easily and precisely located using the 3D-CT soft-tissue maxillozygion landmark. A reliable patient-oriented axis system can be defined using nasion, subspinale, and basion. The prevalence of malar eminence asymmetry in our study was 40.5%.</p>","PeriodicalId":55470,"journal":{"name":"Archives of Facial Plastic Surgery","volume":"14 6","pages":"403-7"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archfacial.2012.510","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30847803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Levi G Ledgerwood, Steven Tinling, Craig Senders, Annjoe Wong-Foy, Harsha Prahlad, Travis T Tollefson
{"title":"Artificial muscle for reanimation of the paralyzed face: durability and biocompatibility in a gerbil model.","authors":"Levi G Ledgerwood, Steven Tinling, Craig Senders, Annjoe Wong-Foy, Harsha Prahlad, Travis T Tollefson","doi":"10.1001/archfacial.2012.696","DOIUrl":"https://doi.org/10.1001/archfacial.2012.696","url":null,"abstract":"<p><strong>Background: </strong>Current management of permanent facial paralysis centers on nerve grafting and muscle transfer; however, limitations of those procedures call for other options.</p><p><strong>Objectives: </strong>To determine the durability and biocompatibility of implanted artificial muscle in a gerbil model and the degree of inflammation and fibrosis at the host tissue-artificial muscle interface.</p><p><strong>Methods: </strong>Electroactive polymer artificial muscle (EPAM) devices engineered in medical-grade silicone were implanted subcutaneously in 13 gerbils. The implanted units were stimulated with 1 kV at 1 Hz, 24 h/d via a function generator. Electrical signal input/output was recorded up to 40 days after implantation. The animals were euthanized between 23 and 65 days after implantation, and the host tissue-implant interface was evaluated histologically.</p><p><strong>Results: </strong>The animals tolerated implantation of the EPAM devices well, with no perioperative deaths. The muscle devices created motion for a mean of 30.3 days (range, 19-40 days), with a mean of 2.6 × 106 cycles (range, 1.6 × 106 to 3.5 × 106 cycles). Histologic examination of the explanted devices revealed the development of a minimal fibrous capsule surrounding the implants, with no evidence of bacterial infection or inflammatory infiltrate. No evidence of device compromise, corrosion, or silicone breakdown was noted.</p><p><strong>Conclusions: </strong>Artificial muscle implanted in this short-term animal model was safe and functional in this preliminary study. We believe that EPAM devices will be a safe and viable option for restoration of facial motions in patients with irreversible facial paralysis.</p>","PeriodicalId":55470,"journal":{"name":"Archives of Facial Plastic Surgery","volume":"14 6","pages":"413-8"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archfacial.2012.696","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30913850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Highlights of archives of facial plastic surgery.","authors":"","doi":"10.1001/jamafacial.2013.406","DOIUrl":"https://doi.org/10.1001/jamafacial.2013.406","url":null,"abstract":"","PeriodicalId":55470,"journal":{"name":"Archives of Facial Plastic Surgery","volume":"14 6","pages":"384"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/jamafacial.2013.406","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"31495704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ashley G O'Reilly, William R Schmitt, Randall K Roenigk, Eric J Moore, Daniel L Price
{"title":"Closure of scalp and forehead defects using external tissue expander.","authors":"Ashley G O'Reilly, William R Schmitt, Randall K Roenigk, Eric J Moore, Daniel L Price","doi":"10.1001/archfacial.2012.662","DOIUrl":"https://doi.org/10.1001/archfacial.2012.662","url":null,"abstract":"<p><strong>Objective: </strong>To describe the novel use of an external tissue expander in the reconstruction of scalp and forehead defects.</p><p><strong>Methods: </strong>A prospective review was performed on 7 patients who underwent extirpation of head and neck malignant neoplasms resulting in scalp and forehead defects. Reconstruction was performed using an external tissue expander device. Patient clinical factors, defect size, and photographs were collected.</p><p><strong>Results: </strong>Seven patients had large scalp and forehead defects ranging in greatest dimension from 5.0 ×4.0 to 8.0 ×7.0 cm. The external tissue expander was in place for 6 to 14 days, reducing the defect sizes by 50% to 99%. At the time of device removal, primary closure was achieved in 5 patients. One patient required bilateral advancement rotation flaps, and 1 patient healed by second intention. One patient with a history of scalp irradiation and diabetes had partial skin loss after device removal and required reconstruction with a latissimus dorsi myocutaneous free flap. There were no other postoperative complications, wound breakdown, or device failures.</p><p><strong>Conclusion: </strong>External tissue expansion is a safe and effective technique for closing large scalp and forehead defects that would otherwise require skin grafting or free flap reconstruction.</p>","PeriodicalId":55470,"journal":{"name":"Archives of Facial Plastic Surgery","volume":"14 6","pages":"419-22"},"PeriodicalIF":0.0,"publicationDate":"2012-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1001/archfacial.2012.662","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30878886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}