Brain perivascular spaces and autism: clinical and pathogenic implications from an innovative volumetric MRI study.

Introduction: Our single-center case-control study aimed to evaluate the unclear glymphatic system alteration in autism spectrum disorder (ASD) through an innovative neuroimaging tool which allows to segment and quantify perivascular spaces in the white matter (WM-PVS) with filtering of non-structured noise and increase of the contrast-ratio between perivascular spaces and the surrounding parenchyma.

Methods: Briefly, files of 65 ASD and 71 control patients were studied. We considered: ASD type, diagnosis and severity level and comorbidities (i.

The Effect of a Novel Platysma Hammock Flap During Extended Deep Plane Facelift on the Signs of Aging in the Neck.

Background: Aging changes in the neck, including platysma banding (PB), skin laxity (SL), and submandibular gland visibility (SGV), have a high degree of recurrence after rhytidectomy.

Objectives: The authors sought to assess the long-term improvement in PB, SL, and SGV with addition of aplatysmal hammock flap to the extended deep-plane facelift and assess patient satisfaction.

Methods: This was a prospective study of 123 consecutive patients undergoing extended deep-plane facelift incorporating platysma hammock flap with or without midline platysmaplasty.

Transcutaneous Blepharoplasty with Volume Preservation: Indications, Advantages, Technique, Contraindications, and Alternatives.

The aging appearance of the lower eyelids is multifactorial, involving changes in the skin, orbital fat, orbicularis muscle, soft tissue of the midface, and tear trough. The extent of these changes differs in each case and happens in a background of volume loss that occurs with facial aging. We present the indications, advantages, and technique for volumizing transcutaneous lower blepharoplasty with fat transposition.

A Novel Volumizing Extended Deep-Plane Facelift: Using Composite Flap Shifts to Volumize the Midface and Jawline.

Traditional superficial musculoaponeurotic system (SMAS) facelifting surgery uses a laminar surgical dissection. This approach does not treat areas of facial volume loss, and requires additional volume supplementation with fat grafting or fillers. The novel volumizing extended deep-plane facelift uses a composite approach to the facelift flap.

Optimal Facelift Vector and its Relation to Zygomaticus Major Orientation.

Background: The vector of superficial musculoaponeurotic system (SMAS) redraping in rhytidectomy is often described in relation to the zygomaticus major muscle (ZMM), so that suspension prevents distortion of the mimetic musculature and a "facelifted appearance." There are no data describing the true orientation of this muscle in the midface.

Objectives: The aim of this study was to define the vector of the ZMM relative to the Frankfort horizontal plane.

A Meta-Analysis of Complication Rates Among Different SMAS Facelift Techniques.

Background: Sub-superficial musculo-aponeurotic system (SMAS) rhytidectomy techniques are considered to have a higher complication profile, especially for facial nerve injury, compared with less invasive SMAS techniques. This results in surgeons avoiding sub-SMAS dissection.

Objectives: The authors sought to aggregate and summarize data on complications among different SMAS facelift techniques.

A Novel Extended Deep Plane Facelift Technique for Jawline Rejuvenation and Volumization.

Background: Jawline aging is a complex process. We believe loss of posterior jawline definition and volume depletion is an underappreciated factor in the aging face.

Objectives: The aim of this study was to describe a novel composite, rotational flap modification of an extended deep-plane rhytidectomy.

Extended Deep Plane Facelift: Incorporating Facial Retaining Ligament Release and Composite Flap Shifts to Maximize Midface, Jawline and Neck Rejuvenation.

This article describes our extended, deep plane facelift technique. This procedure releases 4 key retaining ligaments in the face and neck, the zygomatic cutaneous, masseteric cutaneous, mandibular cutaneous, and cervical retaining ligaments. Once released, the composite deep plane flap is repositioned to volumize the midface and gonial angle.

Characterization of the Cervical Retaining Ligaments During Subplatysmal Facelift Dissection and its Implications.

Background: The cervical retaining ligaments anchor the platysma and soft tissues of the neck to the deep cervical fascia and deeper skeletal structures. The cervical retaining ligaments tether the platysma and prohibit free mobilization and redraping of the platysma muscle in rhytidectomy. This ligament system has previously been described in the literature only qualitatively.

Nonsurgical Facial Rejuvenation Procedures in Patients Under 50 Prior to Undergoing Facelift: Habits, Costs, and Results.

Background: Facial rejuvenation in patients younger than 50 years of age has experienced an unprecedented growth with multimodality nonsurgical and less invasive rhytidectomy techniques.

Objectives: To analyze the nonsurgical treatment habits of patients prior to undergoing rhytidectomy at <50 years of age.

Methods: Retrospective study to enlist patients who underwent primary rhytidectomy at age <50 years between January 1, 2003 and December 31, 2013 by the senior author (AAJ) to complete a survey.

The Effect of Midline Corset Platysmaplasty on Degree of Face-lift Flap Elevation During Concomitant Deep-Plane Face-lift: A Cadaveric Study.

Importance: The evaluation of the effects of midline platysmaplasty concomitant with rhytidectomy.

Objective: To determine whether midline platysmaplasty limits the degree of lift during deep-plane face-lift.

Design, Setting, And Participants: Deep-plane rhytidectomy was performed on 10 cadaveric hemifaces.

Association of Patient Self-esteem With Perceived Outcome After Face-lift Surgery.

Importance: It is well understood that optimal psychological health is imperative to success in aesthetic surgical procedures. Self-esteem is a very sensitive psychological factor that can influence patients' motivations for seeking surgery as well as their perceptions of outcomes.

Objective: To use the Rosenberg Self-Esteem Scale (RSES) to correlate the outcome of rhytidectomy as perceived by the patient to further understand the association of self-esteem and the results of aesthetic facial rejuvenation.

Three-Dimensional Analysis of Long-Term Midface Volume Change After Vertical Vector Deep-Plane Rhytidectomy.

Background: Facial aging is a complicated process that includes volume loss and soft tissue descent. This study provides quantitative 3-dimensional (3D) data on the long-term effect of vertical vector deep-plane rhytidectomy on restoring volume to the midface.

Objective: To determine if primary vertical vector deep-plane rhytidectomy resulted in long-term volume change in the midface.

Bilateral Transposition Lip Flaps: A Novel Single-Stage Reconstruction of Central Upper Lip Defects Involving Cupid's Bow.

Importance: Defects of the central upper lip present a challenge. A variety of techniques have been described, but most tend to efface the natural contours present in the philtrum and the cutaneous-mucosal vermilion border (Cupid's bow). Furthermore, the techniques typically require a second-stage procedure to improve the upper lip aesthetic.

Stop Blaming the Septum.

Purpose: To identify if isolated surgical violation of the orbital septum predisposes to "middle lamellar" scarring and subsequent postblepharoplasty lower eyelid retraction.

Methods: A retrospective review of patients who underwent transconjunctival blepharoplasty in either a postseptal (orbital septum undisturbed) or preseptal (septal incision required) plane was performed. Patients undergoing skin excision, orbicularis muscle plication, and canthal suspension were excluded.

An algorithmic approach to multimodality midfacial rejuvenation using a new classification system for midfacial aging.

Midfacial aging is the result of the complex interplay between the osseous skeleton, facial retaining ligaments, soft tissues envelope, facial fat compartments, and the overlying skin elasticity. As a result of the many anatomic components involved in midfacial aging, the authors proposed a classification system based on distinct anatomic factors to direct surgical treatment. Evidence based data suggest that midface rejuvenation often requires a multimodality approach to obtain desired results, especially in patients with more advanced aging and poor tissue elasticity, or those with hypoplastic midfacial skeletal structure.