Articles

Rhinoplasty

		Effects of various submucous resection techniques of septal cartilage on nasal tip projection Approximately 80% of the general population has septal deviation, with up to one-third suffering from some degree of anatomic nasal obstruction. Many patients seeking nasal septal surgery desire... continue

		Bilateral auricular seromas: A case report and review of the literature Hematomas, pseudocysts, and seromas are all part of the differential diagnosis of auricular swellings. Seromas are benign collections of serous fluid that have a tendency to recur. The fluid accumulates in the spacer... continue

		Nasal septal deviation in the pediatric and adult populations A significant proportion of the population has nasal septal deviation of varying degrees. Recent reports of such deviation occurring at younger ages suggest a congenital etiology. To the best of our knowledge, no previous clinical studies ... continue

		Finesse Rhinoplasty Rhinoplasty is the most challenging operation in plastic surgery. First of all, the anatomy in each nose is distinct. The wide amount of variation is seen in part due to differences within skin soft tissue envelope thickness and the shape... continue

		Nasal Reconstruction of the Leprosy Nose using Costal Cartilage Anil R. Shah MD, Clinical Instructor, Division of Facial Plastic Surgery, Section of Otolaryngology, University of Chicago, Chicago, IL, Private Practice, Chicago, IL, Daniel Zeitler MD, Resident, Department of Otolaryngology, New York University School of Medicine, New York, NY ... continue

		Open Septoplasty: Indications and Treatment Mohamad Chaaban, MDa, Anil R. Shah, MDb,* a Department of Otolaryngology, Head and Neck Surgery, University of Chicago Hospitals, 5841 S Maryland Avenue E-102, Chicago, IL 60637, USA b Division of Facial Plastic Surgery... continue

		Concentric and Eccentric Carved Costal Cartilage COSTAL CARTILAGE GRAFTing in rhinoplasty has gained increasing popularity in recent years. This technique is valuable when a significant degree of structural augmentation and support is needed in the nasal dorsum and tip... continue

		Revision Rhinoplasty Analysis Rhinoplasty anatomy and analysis often go hand in hand. It is important to know anatomic terms so that communication between surgeon and patient can be facilitated. The descriptions of anatomy and analysis have been oversimplified... continue

		Congenital Anomalies of the Nose Congenital midline nasal masses, which include nasal dermoid cysts, nasal encephaloceles, and nasal gliomas (Figures 91, 92 and 95), are rare malformations; one occurs in 20,00040,000 live births in the United States... continue

		Open Rhinoplasty On the surface, open, or external rhinoplasty differs from endonasal rhinoplasty by just a single incision along the midcolumella. However, both of these operations are based on vastly different core philosophies... continue

		Alar Base Resection and Repair Revision The alar base plays an important role in the overall appearance and proportion of the nose. An overly wide or flared alar base will lead to a bottom heavy nose and disrupt the delicate balance of an otherwise properly executed rhinoplasty... continue

		Quantitative Comparison Between Microperforating Osteotomies and Continuous Lateral Osteotomies in Rhinoplasty Lateral Osteotomies are used in rhinoplasty to narrow the nasal bones, close the open roof deformity after hump removal, and achieve symmetry of an asymmetrical framework. The 2 basic techniques for performing lateral osteotomies are continuous and perforating... continue

		Aligning the bony nasal vault in rhinoplasty The bony nasal vault represents a complex three dimensional structure. With a widely divergent spectrum of nasal bony deformities, use of a single technique will often result in inconsistent results... continue

		Loss of smell The ability to smell is often taken for granted. Not only are there many life enhancing odors such as the smell of fresh baked goods from a bakery or a rose garden in the spring, but the ability to smell can warn of life... continue

		Costal cartilage in a Porcine Model The project was conducted at a large university animal research laboratory. The costal cartilage of eight thirty-kilogram domestic pigs was harvested. The cartilage was cut into central and peripheral segments... continue

		How much does a rhinoplasty cost? The cost of cosmetic surgery is dependent on several factors. First of all, the location of the surgery will have a major impact on cost. Generally speaking, the same procedure performed in the Midwest will cost less than either the west or east coasts... continue

		How I Do It: Treating the crooked nose with a suture suspension technique Well intended osteotomies of the ascending process of the maxilla are often performed in an attempt to shift the nasal pyramid into a central position; however, this maneuver is doomed to fail if the deviation is secondary to a septal misdirection... continue

		Maximizing Nasal Projection By Release and Advancement of the Medial Crus Achieving maximal nasal projection in the under projected nose is a difficult task. The medial crura complex is the main projector of the tip. In the subset of patients with short to medium length medial crura, projecting the nasal tip is limited... continue

		Nuances in Tip Modification: Specific Applications of Cartilage Splitting in Rhinoplasty Division of the lower lateral cartilages in rhinoplasty has long been maligned for producing unnatural results. However, recognition of medial, intermediate, or lateral crural discrepancies allows for their division and overlay... continue

		Structural approach to endonasal rhinoplasty Without question, the introduction of open rhinoplasty has increased the emphasis on preservation and support of existing structure in rhinoplasty. The unparalleled view afforded by open rhinoplasty has decreased the learning curve of surgeons in the most difficult of plastic surgery procedures... continue

Aging Face

		Biomechanical Analysis of Anchoring Points in Rhytidectomy Almost all modern Rhytidectomy techniques use suture suspension of deeper tissues to fixed points along the face. These fixed points can be termed anchor points because they provide the lifted tissue an anchor on which to suspend and thus prevent relaxation of the tissue to the original undesirable position... continue

		Defining the Facial Extent of the Platysma Muscle Despite the myriad of face-lift techniques available, few surgeons who perform face-lifts would question the role that the platysma muscle plays in rejuvenation of the aging neck. However, the extension of the platysma into the face has not been well described... continue

		The Minilift Mini-lifts have been used for almost a century, with the first description of a mini-lift by Passot in 1919. Originally, these operations involved minimal subcutaneous skin undermining and limited skin excision with subsequently minimal improvement and short-lived results... continue

		Fibrin Tissue Adhesives The dura mater is a structure necessary for protection and sterility of the central nervous system1. It may be disrupted due to a variety of processes including trauma, tumor removal and other surgical procedures... continue

		Eyelid Malposition Inside Out Blepharoplasty 78 of the 171 patients with the inside out blepharoplasty had follow up of 3 months. Preoperative MR2 distance was found to be (.942). Postoperatively the modified MR2 distance was found to be (.903)... continue

		Zygomaticus Major Muscle Landmark The identification of the course of the zygomaticus major muscle plays an important role in facial plastic surgery. First of all, it serves as an important landmark in deep plane rhytidectomy... continue

		Botulinum Toxin Botulinum toxin A decreases facial lines and wrinkles at sites of skin pleating caused by hyperfunctioning mimetic muscles. BOTOX (Allergan, Irvine, CA) is FDA approved for treatment of the glabella... continue

		Hyaluronic Acid Derivatives Hyaluronic acid derivatives are glycosaminoglycan biopolymers similar to the substance found in the intercellular layers of the dermis of the skin and are very biocompatible. They are used primarily for lip augmentation and fine wrinkles... continue

		FDA Approval Everyday our local news broadcasters report to us about the latest and greatest medical devices or product that is designed to help us lose weight, reduce wrinkles, or stop smoking. Many of these new advancements prove worthy... continue

		Should your procedure be FDA approved? Are FDA approved products and devices safer and better than unapproved products and procedures? This article will examine what an FDA approved device or product means, how to find out whether a device... continue

		LASERS In Head & Neck Surgery The word "laser" is an acronym for Light Amplification by Stimulated Emission of Radiation. A laser is a device that produces an intense beam by amplifying light... continue

		Pitfalls of Photography for Facial Resurfacing and Rejuvenation Procedures Photography serves an important role in facial resurfacing procedures in that it allows objective comparison of the pre- and post-procedure state. When properly performed, standardized photography can accurately illustrate these subtle differences... continue

		Rhytidectomy, Browlifts, and Midface lifts Facial aging generally consists of intrinsic and extrinsic processes. Intrinsically, the most extensive changes occur in the dermis, especially in its upper third. The total amount of ground substance,... continue

		Superficial Skin Resurfacing Options for both the cosmetic surgeon offering and patients seeking treatment for cutaneous aging have expanded greatly in recent years and continue to grow. Increasingly sophisticated aesthetic patients are seeking procedures to rejuvenate ... continue

Otoplasty

		Otoplasty Jeffrey B. Wise MD, Anil R. Shah MD, and Minas Constantinides MD Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head & Neck Surgery, New York University School of Medicine... continue

Other

		The Impact of Technology and the Internet on Facial Plastic Surgery An Electronic Survey Study David H. Burstein MD, Minas Constantindes MD, Anil R. Shah MD Objective: Determine the impact of technology on facial plastic surgery Methods: An electronic survey with 38 detailed questions... continue

		The use of ultrasound activated pin osteosynthesis (Sonic Weld) with resorbable plating in the repair of orbital floor fractures: a preliminary report. Reitzen S1, Jacobsen J1, Conrad D1, Shah AR1,2,* 1. Department of Otolaryngology- Head and Neck Surgery, Division of Facial Plastic & Reconstructive Surgery, New York University School of Medicine... continue

		Effects of Low Frequency Ultrasound on Epidermal and Dermal Structures: A Clinical and Histological study Low frequency ultrasound is used in many arenas of medicine to allow for deeper penetration of topical agents. However, there have only been limited studies... continue

		Photographic Standards for Facial Plastic Surgery Facial pore size and excessive sebum production are notoriously difficult skin conditions to treat. Numerous techniques have been described with limited results or significant drawbacks. A variety of skin resurfacing modalities have been described,... continue

		Use of Intradermal Botulinium Toxin to Reduce Sebum Production and Facial Pore Size Facial pore size and excessive sebum production are notoriously difficult skin conditions to treat. Numerous techniques have been described with limited results or significant drawbacks. A variety of skin resurfacing modalities have been described,... continue

		Zitelli Bilobed Flap First described by Esser in 1918, the bilobed flap is a transposition flap used to reconstruct defects of the lower third of the nose.1 It is a random-pattern single-stage flap which lacks a large caliber vessel at its base... continue

		Repair of Small to Medium Size Defects Reconstruction of small and medium-sized defects of the nose poses a challenge to the facial plastic surgeon. Every Mohs repair is inimitable based on the unique characteristics of the defect itself... continue

		Body Piercing Body piercing was once considered the stigmata of deviant youth. However, within the last several years, the popularity of piercing has increased. A 2001 survey of an undergraduate campus revealed that 51% of its students had a body piercing... continue

		Scar Revision With advances in the knowledge of wound healing, as well as the development of better materials and techniques, many options have become available in the treatment of patients with unsightly scars... continue