Penetrating neck injuries during the Lebanese war: AUBMC experience. American University of Beirut Medical Center.

During the last decade 419 patients were admitted to the American University of Beirut Medical Center with penetrating neck injuries mainly due to shrapnel. During the first 8 1/2 years of the war, all patients with wounds penetrating the platysma were explored. During the last 2 years, a more selective approach was used.

Cigarette smoking and face lift: conservative versus wide undermining.

The effects of cigarette smoking on the skin flaps of the face lift procedure are discussed. Reported elsewhere is a significant incidence of skin slough in smokers with use of wide undermining techniques. This complication is thought to be due to the vasoconstrictive effects of nicotine on the peripheral circulation. Our group has employed a conservative bilateral undermining technique in 407 face lifts. Of these, 32.4 percent were smokers and 67.6 percent were nonsmokers. No cases of skin slough were encountered. Our conservative undermining technique is briefly discussed. Among its advantages are shorter operative time, use of less local and/or general anesthesia, less intraoperative bleeding, adequate exposure for SMAS and platysmal surgery, and snugger skin closure without the risk of flap necrosis. As shown by our statistics, it is a safer procedure in smokers than the usually performed more radical procedure.

Supraorbital and supratrochlear notches and foramina: anatomical variations and surgical relevance.

The anatomy of the supraorbital and supratrochlear notches and foramina has been studied in 111 human skulls. Of 108 skulls, 49.07% had bilateral supraorbital notches, 25.93% had bilateral supraorbital foramina, and 25% had a notch on one side and a foramen on the other side. Of 101 skulls, 97.03% had bilateral supratrochlear notches, 0.99% had bilateral foramina, and 1.98% had a notch on one side and a foramen on the other side. The methods of study and clinical relevance are discussed, along with the varying nomenclature used in the literature for defining the supraorbital and supratrochlear structures. Knowledge of the anatomy of the region is important for those doing forehead and brow lift surgery in order to avoid injuring the neurovascular bundles passing through these notches and foramina.

Rhinoplastic revisions with injectable silicone.

We report 20 years of experience with conservative and cautious injection of small amounts of medical-grade liquid silicone in 347 postrhinoplasty patients for a total of 1,937 treatments. Medical-grade silicone was found to be a safe, effective, and valuable adjunct to cosmetic rhinoplastic procedures. Microdroplet technique with very small doses is recommended for the correction of nasal defects that may not be amenable to revisional surgery. Controlled release of this material to the medical profession after appropriate evaluation is recommended, along with proper training prior to its use.

Injectable silicone for facial soft-tissue augmentation.

Medical-grade injectable silicone has been safely and efficiently used for facial soft-tissue augmentation in 235 patients. Our 20-year experience with the microdroplet technique included 2,811 treatments performed for camouflaging furrows and grooves, augmentation of facial eminences, and elevation of certain depressed scars. The indications and techniques of injection are discussed. The augmenting effect is greater than that produced by the small volumes of silicone injected. Our study supports other work indicating induction of collagen deposition in the patients around the microdroplets of silicone, thus providing augmentation from volumes of collagen and silicone as well.