Key points • The embryological components of the facial skeleton are derived from the three divisions of the skull: the desmocranium, the chondrocranium and the viscerocranium. • The ectomeninx has chondrogenic and osteogenic properties which translate into intramembranous bone that…
• Centrifuged fat has three layers: (1) the upper supernatant, containing lipid; (2) the middle stromal vascular fraction, containing adipose-derived stem cells, stromal cells, vascular cells, and mural cells; and (3) the lower layer, containing blood, local anesthetic, and tissue…
• Visible changes in the aging face (such as jowls, sagging, crow’s feet) are, in part, due to thinning skin that has lost its intrinsic elasticity and nonuniform loss of subcutaneous fat. • The bony skeletal provides the framework on…
Key points • The success of any implant depends not only on minimizing the inflammatory reaction of the material but also on the prosthetic porosity and stress at the tissue–implant interface. • The porosity of an implant will dictate whether…
• Autologous bone and cartilage grafts remain important tissue sources for surgery of the facial skeleton due to their biocompatibility and long-term success rates. • The revascularization of autologous grafts reduces long-term complications because the graft ultimately establishes a blood…
Key points • Select an access incision that will provide the most direct route to the underlying bone. • A coronal incision can be used to access the cranial vault, forehead, zygoma, orbit, nasal dorsum, temporomandibular joint (TMJ), and condylar/subcondylar…
Key points • The visible surgical result is related to the soft tissue envelope and not the underlying skeletal structures that support the facial surfaces and volumes. • Predicting how a procedure will change the skeletal framework is simple; forecasting…
• Photography is an essential tool to objectively document patient conditions, evaluate physical deformities, plan treatment approaches, and assess surgical outcomes. • In plastic surgery, clinical photography accomplishes two goals primarily: first, documentation of preoperative conditions and postoperative surgical results,…
Key points • The deleterious effects of ionizing radiation are cumulative, necessitating the judicious use of ionizing radiation. • Cone beam CT (CBCT) allows for image capture that displays excellent spatial resolution (image detail) of hard tissue at a relatively…
Key points • Patient-reported outcome instruments (PROIs) are questionnaires that measure concepts by asking patients directly, without clinician interpretation, and should be used to measure procedural outcomes. • The FACE-Q is a new validated, reliable, and responsive PROI. • There…