ABSTRACT
Rejuvenation of the midface is a challenge in facial plastic surgery. To this end, several techniques have been developed to address the changes seen in the midface with aging. Specifically, ptosis of the malar fat pad and deepening of the nasolabial fold contribute to the aesthetic changes that characterize midfacial aging. The history of modern facelifts and deep-plane facelift techniques to correct the nasolabial fold are presented.
Subject(s)
Rhytidoplasty/methods , Adipocytes/transplantation , Adipose Tissue/surgery , Humans , Platelet Transfusion , RejuvenationABSTRACT
Sinusitis has been reported as a complication of sinus lift surgery with antral bone augmentation. The procedure involves the creation of a submucoperiosteal pocket in the floor of the maxillary sinus for placement of a graft consisting of autogenous, allogenic, or alloplastic material. This can result in inadvertent tearing of the mucoperiosteal flap with extrusion of graft material into the antrum. Obstruction of the sinus outflow tract by mucosal edema and particulate graft material may result in sinusitis. We will discuss the clinical presentation and management of 14 cases of chronic sinusitis following sinus lift surgery with alloplastic hydroxyapatite (HA) augmentation of the maxillary antrum.
Subject(s)
Alveolar Ridge Augmentation/adverse effects , Maxillary Sinus/surgery , Sinusitis/etiology , Adult , Aged , Aged, 80 and over , Alveolar Ridge Augmentation/methods , Female , Humans , Male , Maxillary Sinusitis/etiology , Maxillary Sinusitis/surgery , Middle Aged , Sinusitis/surgeryABSTRACT
BACKGROUND: Expanded polytetrafluoroethylene (ePTFE) is a synthetic porous material that has been used for static suspension in facial paralysis. It is manufactured in thin (1-mm or 2-mm) sheets that can be cut into strips and implanted through keyhole facial incisions. Regional deformities are addressed by multiple suspensions that provide cosmetic and functional therapy. The use of ePTFE eliminates donor site morbidity associated with the traditional harvest of fascia from either the temporal area or fascia lata. However, properties unique to this alloplast contribute to the complications that have occurred after its use in facial reanimation. OBJECTIVE: To describe complications with the use of ePTFE for facial suspension. SETTING: Academic medical center. METHOD: Retrospective chart review and review of literature. RESULTS: Six patients with facial paralysis who were treated with the ePTFE sling procedure had complications. Five slings failed because of stretch despite prestretching at implantation. One patient developed a late wound infection requiring removal of the sling. CONCLUSION: An ePTFE facial sling is an option for static facial suspension that can be therapeutic for patients with seventh nerve damage. There is a high rate of complications leading to revision surgery. Future studies are needed to evaluate alloplastic alternatives to ePTFE.
Subject(s)
Facial Paralysis/surgery , Polytetrafluoroethylene , Prosthesis Implantation , Adolescent , Adult , Aged , Device Removal , Facial Paralysis/etiology , Female , Humans , Male , Middle Aged , Postoperative Complications/etiology , Postoperative Complications/surgery , Prosthesis-Related Infections/etiology , Prosthesis-Related Infections/surgery , Reoperation , Retrospective Studies , Surgical Wound Infection/etiology , Surgical Wound Infection/surgeryABSTRACT
A resurgence of malar augmentation using alloplastic implants can be attributed to the safety, simplicity of technique, and reliable good results of these implants. As the more sculpted face becomes a common aesthetic goal, malar augmentation plays an increased role in facial plastic surgery practices. It provides a natural, "unoperated" look that is preferred by most patients today. The history of our current aesthetic and how new alloplasts have contributed is reviewed. The development of simpler techniques of malar analysis will also be reviewed. An indepth look at aesthetic analysis, implant choice, surgical approach, postoperative results, and possible complications will provide a thorough review of current malar implantation.
