Chapter Summary Psychosocial factors are important in cosmetic surgery patient selection. An appropriate preoperative psychiatric examination is essential. By recognizing the key features of common personality and mental disorders, cosmetic surgeons can plan effective treatment for each individual patient. Body…
Chapter Summary Scar revision methodology includes intralesional steroids, lasers targeting superficial vasculature, non-ablative and ablative lasers – including fractional resurfacing devices, surgical excision, and dermabrasion, and is occasionally as simple as allowing more time for the original scar to mature.…
Chapter Summary Post-acne scarring remains a common entity despite advances in our understanding and treatment of acne. The management of post-acne scarring remains as much an ongoing challenge as ever, with improvement not eradication as the goal. This strategy or…
Chapter Summary A skin graft is a portion of skin that has been separated from its vascular supply. Full-thickness grafts (epidermis and dermis plus adnexal structures) generally give better results than split-thickness grafts (epidermis and partial-thickness dermis only) because there…
Chapter Summary Axial pattern flaps have a pedicle containing a named cutaneous artery, compared with random pattern flaps whose blood supply is based on the less robust subdermal plexus. As a result of their robust blood supply, axial pattern flaps…
Chapter Summary Random pattern flaps are ideal closures for surgical wounds that will neither predictably heal by second intention nor be easily repaired by direct linear closure. For each operative wound, several flaps may be suitable, but one will likely…
Chapter Summary The best results in ellipse excision are achieved by: designing the simplest repair that will achieve optimal cosmesis avoiding unnecessary flaps or grafts undermining only as needed. The repair type is selected according to patient characteristics and clinical…
Chapter Summary Physiologic hemostasis occurs in three interrelated phases: initiation (thrombin formation); amplification (platelet aggregation and activation); and propagation (fibrin formation and clot stabilization). In general, anticoagulation prescribed for secondary thrombotic prophylaxis should not be discontinued for dermatologic surgery procedures.…
Chapter Summary Facial skin is divided into discrete cosmetic subunits whose aesthetic characteristics are derived from regional variations in the composition of the underlying tissue layers. Careful attention to restoring these subunits during reconstruction is critical. The human face is…
Chapter Summary Choice and placement of wound closure materials play critical roles in the outcome of incisional surgery. The properties of suture materials combine to give each suture unique characteristics. Sutures must be placed at the same vertical level across…