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Synopsis The results of lipoadominoplasty with anatomical definition include: ■ Better aesthetic result and greater definition of the body contour through refined and selective liposuction. ■ Less morbidity due to preservation of the perforating vessels and the absence of dead space. ■ Preservation of Scarpa's fascia with decrease in seroma rate, less bleeding and shorter scar. ■ Narrow central tunnel that allows for safe plication of…
Synopsis ■ Abdominolipoplasty is a system of classification and treatment for abdominal contour surgery based on the treatable soft-tissue layers of skin, fat, and muscle of the abdominal wall. ■ Lipoabdominoplasty is a modification of traditional abdominoplasty that incorporates liposuction of the underlying flap and potentially other areas. The safety of lipoabdominoplasty is based on the manner in which the flap is undermined (inverted “V” style),…
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Synopsis ■ Liposuction is growing in popularity and technological sophistication but sometimes results require revision. ■ Revision and secondary liposuction differ. Although much of the information in this chapter pertains to both procedures, the focus will be on secondary procedures. ■ When considering repeat liposuction, surgeons must accept that the result will never be as good as could have been achieved from an optimally performed primary…
Synopsis ■ Incorporation of a diet and exercise program in conjunction with liposuction will allow patients to achieve their optimal shape and contour. Patients who do not adhere to diet and exercise are least happy with their results. ■ A thorough history and physical exam should be performed and a preoperative clearance obtained when necessary. ■ Over-the-counter herbal and diet medications may have unfavorable interaction with…
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Access video and video lecture content for this chapter online at Elsevier eBooks+ Introduction This chapter represents a 28-year journey of hair transplantation practice, initially treating primarily cases of male pattern baldness and then expanding to other applications, such as enhancing aesthetics in the reconstruction of the face and scalp and treating complications of facial aesthetic surgery. Specific examples include addressing scarring alopecia after facial rejuvenation…
Synopsis ■ Analysis: analyze the problem in thirds. ■ Endpoint: know what normal looks like, so you know your surgical endpoint. ■ Do not be destructive. Do not do anything to the ear that cannot be reversed. ■ Skin is precious. Preserve skin in the sulcus, and do not rely on skin tension to maintain ear position. ■ Lobule: consider lobule setback in every case. ■…
Synopsis ■ Secondary rhinoplasty may be done to correct a complication, to correct an untoward result, or simply to pursue further improvement. ■ Secondary rhinoplasty is more difficult than primary. All measures to help the surgeon should be used, including preoperative imaging and the intraoperative use of models. ■ Opening the nose is done by hyperinfiltration and patient dissection. ■ The nasal tip is “deconstructed” first…
Synopsis ■ A thorough history and physical examination are crucial. History of nasal trauma, prior surgery, airway complaints, and allergies are carefully recorded. ■ Three-dimensional evaluation, as well as cephalometric analysis of life-size photographs, is performed in order to evaluate the location and severity of asymmetry. ■ A detailed evaluation of the upper nose (nasal bones and upper lateral cartilages [ULC]), septum, lower lateral cartilages, anterior…
Synopsis ■ Secondary nasal deformities are not limitless but group into three patterns that can be anticipated in the primary nose – therefore their solutions follow patterns. ■ The most common motivation for secondary surgery is an iatrogenic deformity from prior rhinoplasty. ■ All key planning decisions can be made from the nasal surface and follow one of two surgical plans. Each anatomical point translates directly…
Synopsis ■ Accurate preoperative analysis and clinical diagnosis set the foundation for successful primary open rhinoplasty. ■ Open rhinoplasty allows anatomic exposure, identification, and correction of nasal deformities. ■ Component dorsal hump reduction and reconstitution of the dorsum allow accurate and incremental reduction of the nasal dorsum while preventing problems with internal valve collapse or dorsal irregularities. ■ Nasal tip suturing techniques allow control of definition…
Synopsis ■ Surgery begins with a careful preoperative analysis utilizing standardized measurements. ■ All tissues including bone, cartilage, and soft tissue may contribute to any one measurement, e.g., nasal length. ■ Nasal anatomy is considered within the context of facial shape, facial proportions, and the size and shape of adjacent structures. ■ Knowledge of nasal anatomy facilitates the use of an algorithmic approach to surgery that…
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Synopsis ■ Facial aging is characterized by fat atrophy and gravitational descent of facial soft tissue. ■ Careful facial analysis and planning are key for success. ■ Fat grafting offers a minimally invasive technique to improve facial aesthetic and skin quality. ■ The Coleman technique for harvesting, processing, and grafting, provides a reliable strategy for consistent results. Access video and video lecture content for this chapter…
Synopsis ■ Currently most Asian patients want aesthetic improvement with ethnic preservation. ■ Asian blepharoplasty deals with widening of the eye from all quarters, not just creating a supratarsal fold. ■ Asian rhinoplasty is revolutionized with various new concepts and techniques, such as quadripod theory, septum-based nasal tip plasty, and various extension graft techniques. ■ Asian facial bone contouring is evolving from simple bony resection to…
Access video lecture content for this chapter online at Elsevier eBooks+ Introduction The eyelids are one of the first areas on the face to show signs of aging. They undergo a predictable pattern of anatomical changes, typically producing a tired appearance, and may also develop functional issues such as eyelid malposition. Optimal periocular rejuvenation with blepharoplasty necessitates not only addressing aesthetic and functional concerns of the…
Synopsis ■ Blepharoplasty is a vital part of facial rejuvenation. The traditional removal of tissue may or may not be the preferred approach when assessed in relation to modern cosmetic goals. ■ A thorough understanding of orbital and eyelid anatomy is necessary to understand aging in the periorbital region and to devise appropriate surgical strategies. ■ Preoperative assessment includes a review of the patient's perceptions, assessment…
Synopsis ■ Advances in endoscopic brow lift technique provide a more precise and safer procedure to the aesthetic facial surgeon. ■ Brow shape, position, and hyperactivity of the frontalis and corrugator muscles are an integral part of periocular rejuvenation. ■ An upper blepharoplasty should not be indicated or performed for treatment of periocular aging until the brow position and symmetry is fully evaluated and treated. ■…