Enhanced Submentoplasty as an Adjunct to Orthognathic Surgery for the Improvement of the Neck-Throat Point.

Orthognathic surgery has been used to enhance the function of the maxillomandibular complex with numerous positive effects on facial esthetics, as it can profoundly alter the skeletal architecture of the face. Numerous adjunctive surgical techniques are used to enhance the overall cosmetic results of orthognathic surgery to include the following: genioplasty, midface augmentation, rhinoplasty, fillers, and liposuction. Mandibular advancement, submental liposuction and genioplasty are all techniques that help to define the neck throat point (NTP), minimize submental sagging, and enhance throat length (TL) in order to establish a more harmonious facial profile. However, these procedures may still be insufficient to define the NTP in the low hyoid, retrognathic patient. This report presents the case of an adult male, with a non-existent NTP and retrognathia, who underwent corrective orthognathic surgery with the novel enhanced submentoplasty and a suture assisted resuspension of the platysma in order to establish the NTP, increase TL, minimize submental sagging, and enhance mandibular border definition.

Complications after superficial plane cervicofacial rhytidectomy: a retrospective analysis of 178 consecutive facelifts and review of the literature.

PURPOSE: It is well-recognized that postoperative hematoma is the most common complication of cervicofacial rhytidectomy (facelift surgery), and several strategies aimed at reducing the incidence of hematoma have been developed and studied. Other common complications include skin necrosis, seroma, motor and sensory nerve injury, alopecia, auricular deformity/displacement, and dyspigmentation. The purpose of this study was to retrospectively analyze the incidence of complications after superficial cervicofacial rhytidectomy performed by a single surgeon and his fellows and to compare our findings with those reported in the literature. MATERIALS AND METHODS: Based on a retrospective chart review of patients who underwent cervicofacial rhytidectomy, 178 consecutive patients were enrolled in this study. The charts were reviewed for any notable complications after facelift surgery, especially postoperative hematoma. The charts of those patients with complications were reviewed to identify the presence of perioperative anomalies that may have increased the risk of such complications. Our findings were then compared with those reported in the literature. RESULTS: Of 178 patients who underwent cervicofacial rhytidectomy, 11 (6.2%) had a postoperative complications. These 11 complications included 5 cases (2.8%) of a major postoperative hematoma requiring surgical intervention, 3 cases (1.7%) of minor hematomas ("microhematomas"), and 1 case each of hypertrophic scarring necessitating surgical excision and steroid injection, superficial skin necrosis, and dehiscence. There were no cases of seroma, parotid pseudocyst, or permanent motor nerve injury. CONCLUSION: The incidence of postoperative complications associated with superficial plane rhytidectomy is very low, with hematoma the most common complication.

Management of forehead and brow deformities.

The subcutaneous trichophytic forehead browlift allows rejuvenation of the forehead with precise, stable brow positioning, excellent visualization, and direct treatment of the brow and forehead musculature. This method avoids lengthening the forehead and, with meticulous closure, can produce an imperceptible scar and natural-appearing hairline.