ABSTRACT
Reconstruction of defects of the lip presents a significant challenge to the facial plastic surgeon. Both functional and aesthetic considerations exist. Each defect should be evaluated in terms of its location, size, and depth. Using these three factors, the appropriate reconstructive options can be chosen in a systematic fashion.
Subject(s)
Lip/surgery , Surgical Flaps/methods , Humans , Surgery, Plastic/methodsABSTRACT
Endoscopic applications in facial plastic surgery have recently increased with the advent of new instrumentation and as surgeons have become more accustomed to their use. We report the first case (to our knowledge) of an endoscopic removal of a forehead soft tissue mass. The endoscopic approach allows the surgeon access to the forehead area with placement of a skin incision in the hair-bearing scalp. This type of approach is especially of value in patients with a predisposition to unusual scar formation or in those with smooth skin in which a direct incision would yield a noticeable scar.
Subject(s)
Endoscopy , Facial Neoplasms/surgery , Lipoma/surgery , Adult , Female , HumansABSTRACT
OBJECTIVE: To review the intraoperative and postoperative complications of the transconjunctival approach, as well as their prevention, management, and outcomes. DESIGN: A retrospective study of the complications in 400 patients who underwent the transconjunctival approach to the lower eyelid or orbit for treatment of orbital trauma or the aging face. SETTING: Academic tertiary referral medical center. RESULTS: There were 8 cases of conjunctival granuloma, 2 cases of entropion, and 1 case each of hematoma, ectropion, prolonged chemosis, conjunctival inclusion cyst, lower eyelid laceration, and avulsion with lacrimal system injury. CONCLUSIONS: Complications of the transconjunctival approach are uncommon. When they do occur, proper management results in a successful outcome.
Subject(s)
Orbital Fractures/surgery , Postoperative Complications , Adult , Child , Conjunctival Diseases/etiology , Eyelids/surgery , Facial Bones/injuries , Female , Granuloma/etiology , Humans , Intraoperative Complications , Male , Middle Aged , Otolaryngology/methods , Retrospective Studies , Skull Fractures/surgery , Surgery, PlasticABSTRACT
Chemical peel and dermabrasion are traditional, well-proven methods for the rejuvenation of the skin. The medium-depth trichloroacetic acid peel and the deep phenol peel offer distinct advantages and disadvantages and are discussed in detail in this article. The management of complications associated with both peel techniques is also discussed. Regional dermabrasion is an effective adjunct to facial rejuvenative surgery, such as face lift and blepharoplasty. Full-face dermabrasion and spot or local dermabrasion are most often used in the treatment of facial scarring. The technique of dermabrasion is discussed as well as its indications and postoperative care. Results are shown for both dermabrasion and peel.
Subject(s)
Chemexfoliation/methods , Dermabrasion/methods , Face/surgery , Keratolytic Agents/administration & dosage , Phenols/administration & dosage , Rejuvenation , Skin Aging , Trichloroacetic Acid/administration & dosage , Administration, Topical , Chemexfoliation/adverse effects , Cicatrix, Hypertrophic/etiology , Dermabrasion/adverse effects , Dermatologic Surgical Procedures , Drug Combinations , Ethanol/administration & dosage , Ethanol/therapeutic use , Herpes Simplex/etiology , Humans , Hyperpigmentation/etiology , Keratolytic Agents/adverse effects , Keratolytic Agents/therapeutic use , Lactic Acid/administration & dosage , Lactic Acid/therapeutic use , Patient Selection , Phenols/adverse effects , Phenols/therapeutic use , Resorcinols/administration & dosage , Resorcinols/therapeutic use , Salicylates/administration & dosage , Salicylates/therapeutic use , Skin/drug effects , Trichloroacetic Acid/adverse effects , Trichloroacetic Acid/therapeutic use , Virus ActivationABSTRACT
The techniques of partial-thickness and full-thickness skin grafting are reviewed, including choice of donor site, preparation of recipient site, graft harvesting, and postoperative dressings and care. A review of the basic principles of skin graft healing is included to increase understanding of the reasons these techniques are used and to show how to avoid complications associated with skin grafting. The areas of usefulness of skin grafts are discussed in relation to the face, head, and neck.
Subject(s)
Face/surgery , Neck/surgery , Skin Transplantation/methods , Humans , Postoperative Care , Skin Transplantation/adverse effects , Skin Transplantation/physiology , Wound HealingSubject(s)
Paraganglioma/pathology , Paranasal Sinus Neoplasms/pathology , Adult , Airway Obstruction/etiology , Female , Head and Neck Neoplasms/diagnostic imaging , Head and Neck Neoplasms/pathology , Humans , Nose , Paraganglioma/diagnostic imaging , Paranasal Sinus Neoplasms/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
From July, 1982 through March, 1986, 253 patients with moderate to severe sleep apnea (OSA) were treated and had polysomnographic assessment of treatment. The treatment modalities were: 1. uvulopalatopharyngoplasty (UPP), 2. nasal continuous positive airway pressure (CPAP), 3. tracheostomy, 4. medication (tricyclic antidepressants), 5. tongue retaining device (TRD), and 6. orthodontic device. Uvulopalatopharyngoplasty was performed in 98 patients. The patients were categorized according to post-treatment improvement in the apnea/hypopnea index (A+HI) and severity index (SI) into good, moderate, and poor responders. There were 37 (37.7%) good, 33 (33.6%) moderate, and 28 (28.5%) poor responders in this group. Twenty-four patients underwent tracheostomy. Eighteen (75%) patients continue to have their tracheostomies without complications (mean follow-up time 32 months). One hundred thirty-eight patients were evaluated with CPAP. Of the 100 patients who began home CPAP use, 53 continue to use CPAP successfully at 18 months. Medical treatment (tricyclic antidepressants) was used in 35 patients. The response to this modality was generally poor. Six patients were fitted with TRD. The compliance to this device was poor, although two have had significant improvement in their apnea. An orthodontic appliance was used in two patients with one responding successfully.
