» Articles



  Alar Retraction: Etiology, Treatment, and Prevention
Alar retraction is classically thought to be an unsightly stigmata of overly aggressive rhinoplasty. However, it has been the authors’ experience that alar retraction is also prevalent in the general population, and can be seen in patients without a prior history of rhinoplasty. continue
  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

  Safety of Cranial Fixation in Endoscopic Browlifts
The use of endoscopes and minimally invasive procedures has permeated nearly all fields of surgery. In the case of browlifts, the majority of surgeons are utilizing endoscopic brow lifts, rather than coronal or open brow lifting... continue
  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



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



  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


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