Dissociative anesthesia in an office-based plastic surgery practice.

In 1974, the author began to use ketamine in association with diazepam for cosmetic and reconstructive procedures. Since then, through courses in the United States and abroad, well over a thousand plastic surgeons have been taught the technique. Ketamine, by itself, ablates sensory input of pain at the thalamic level but has been associated with hallucinations, bad dreams, and other untoward effects.

Injectable silicone: cause of facial nodules, cellulitis, ulceration, and migration.

Fifty-four patients with problems following "medical grade" silicone injections into the face and legs were seen from 1974 until 1995. Complications consisted of chronic cellulitis, nodules, foreign body reactions, and movement of material to near and distant parts of the body. These difficulties usually demonstrated themselves many years after injection.

Dimethylsulfoxide (DMSO) for human single-stage intraoperative tissue expansion and circulatory enhancement.

Dimethylsulfoxide (DMSO) has been in clinical use since the early 1960s. In 1967 the discovery that DMSO can greatly reduce ischemia in experimental pedicle flaps stimulated its use in plastic surgery by the authors since 1976. In 1987 its ability to soften collagen, thus permitting degrees of immediate intraoperative tissue expansion hitherto unknown, was applied clinically for the first time.