Use of the orbicularis muscle flap for complex lower lid problems: a 6-year analysis.

There are several groups of patients seeking lower lid blepharoplasty who present with the potential for unsatisfactory postoperative results, such as those presenting with atonic eyelids, patients with severe blepharochalasis alone or with large fat bags, patients with festoons, those with abnormal anatomy, and patients with deformity due to prior surgery. The orbicularis muscle flap technique provides good results in patients with potentially problematic lower eyelids. Of 600 blepharoplasties, 8.

Breast reduction for asymmetrical hypertrophy.

Design details of reduction of asymmetrical hypertrophy of the breasts are discussed. The concepts apply to nearly any breast reduction technique, although here they are presented in the context of the inferior segment method, which we favor. Although most of these points may seem self-evident to the experienced plastic surgeon, there has been little written about the details.

Surgical considerations in managing the remaining breast during postmastectomy breast reconstruction.

The age and general condition of the patient, size and shape of the remaining breast, various risk factors such as the histologic type of carcinoma, and family history are all critical in governing the definitive management of the remaining breast during postmastectomy breast reconstruction. The philosophy, timing, and method of dealing with the remaining breast must be discussed carefully with the patient. The psychological, social, and physical status of the patient must be addressed, with special emphasis in regard to her future and the degree of risk involved.

Fasciocutaneous flap, secondary axial pattern flap, and microvascular free flap in socket reconstruction.

Three techniques are described to rebuild a missing or recurrently contracted socket, the selection of which is based on the anatomy of the periorbital tissue and vascular supply. When the superficial temporal vessels are present, the ipsilateral fasciocutaneous postauricular flap is used. When the vessels are present but the postauricular flap has been used, a secondary axial pattern flap is used.