Nonsurgical Tissue Repositioning: Analysis of Long-Term Results and Patient Satisfaction From 100 Absorbable Suture Suspension Cases.

Background: Absorbable suspension sutures are the only nonsurgical modality approved for tissue repositioning.

Objectives: To quantitate patient perceptions of treatment at 24 months and determine the impact of age and prior surgical procedures on perceptions of efficacy, treatment longevity, and overall satisfaction. In addition, the authors sought to describe the impact of treatment with absorbable suspension sutures on the likelihood a patient will undergo future surgical procedures.

Practical Guidance for Optimizing Patient Comfort During Microfocused Ultrasound with Visualization and Improving Patient Satisfaction.

Background: Microfocused ultrasound with visualization (MFU-V; Ultherapy®) is an effective method for correction of skin laxity through lifting and tightening skin on the face, neck, and décolleté as well as on other parts of the body such as the knees, arms, and abdomen. In addition to being a noninvasive modality for tissue tightening, MFU-V has a biological effect on tissue, rejuvenating the skin through stimulation of elastogenesis and neocollagenesis. MFU-V is also commonly combined with other interventions such as fillers, neuromodulators, and absorbable suspension sutures.

Rejuvenating the Face: An Analysis of 100 Absorbable Suture Suspension Patients.

Background: Absorbable suture suspension (Silhouette InstaLift, Sinclair Pharma, Irvine, CA) is a novel, minimally invasive system that utilizes a specially manufactured synthetic suture to help address the issues of facial aging, while minimizing the risks associated with historic thread lifting modalities.

Objectives: The purpose of the study was to assess the safety, efficacy, and patient satisfaction of the absorbable suture suspension system in regards to facial rejuvenation and midface volume enhancement.

Methods: The first 100 treated patients who underwent absorbable suture suspension, by the senior author, were critically evaluated.

What Neurotoxins Have Taught Us About the Brow: The Reintroduction and Review of the Transpalpebral Browpexy.

Introduction: The use of neuromodulators has grown substantially in our society, particularly in the temporary treatment of brow ptosis. This study revisits the use of the transpalpebral browpexy for upper face and brow rejuvenation in the context of what has been learned from neuromodulators.

Methods: A retrospective review of 97 subjects was conducted who had transpalpebral browpexy performed for lateral brow ptosis.

Advancing the Care of Post-Acne Scarring: Expert Insights Into New Treatment Options.

Most patients with acne have some degree of facial scarring even after their acne resolves, extending the period of psychosocial distress. Unfortunately, management of acne scars remains challenging. Many treatments for post-acne scarring including chemical peels, skin needling, laser resurfacing, surgical repair, subcision lifting, and punch elevation lifting, are limited by moderate and unpredictable results, significant morbidity, and substantial patient investments in time and money.

Facial Aesthetic Surgery: The Safe Use of Oral Sedation in an Office-Based Facility.

Background: The desire for efficient and safe office-based facial plastic surgery procedures has continued to rise. Oral sedation is a safe and effective method to provide anesthesia for facial aesthetic surgery.

Objectives: This study reviewed private practice anesthesia-related outcomes using oral sedation combined with local anesthesia for office-based facial aesthetic surgery procedures.

A novel, multistep, combination facial rejuvenation procedure for treatment of the whole face with incobotulinumtoxinA, and two dermal fillers- calcium hydroxylapatite and a monophasic, polydensified hyaluronic acid filler.

Facial aging is a three-dimensional process, and facial rejuvenation procedures intended to reverse the effects of aging need to address this by combining products that relax hyperkinetic musculature, volumize/fill, and recontour/lift the whole face. In line with the desire of patients to achieve an overall youthful facial appearance, we report for the first time three cases where patients have been successfully treated across the whole face with a novel, three-step approach, layering incobotulinumtoxinA and two dermal fillers (calcium hydroxylapatite and a monophasic hyaluronic acid filler with CPM Technology) injected at three separate treatment visits. The results suggest that this layering approach based on an understanding of the underlying causes of facial aging, where different products are used in combination to treat the entire face, can enable patients to achieve the desired outcome of a return to the characteristics of a more youthful face.

Current aesthetic use of abobotulinumtoxinA in clinical practice: an evidence-based consensus review.

The amount and complexity of scientific and clinical evidence for aesthetic use of botulinum neurotoxin type A (BoNT-A) has expanded rapidly in recent years, especially for abobotulinumtoxinA, necessitating reassessment of current knowledge about aesthetic use of abobotulinumtoxinA and other BoNT-A preparations. A committee of 13 plastic surgeons, facial plastic surgeons, and dermatologists engaged in a live discussion of information from a systematic literature review and an Internet-based survey of their beliefs and practices. The committee achieved consensus on most issues.

The transconjunctival deep-plane midface lift: a 9-year experience working under the muscle.

Background: Rejuvenation of the midface with a natural-looking, safe, and long-lasting result is a challenge in aesthetic surgery. The ideal approach should be easy to perform, with minimal risk and significant benefit. The combination of transconjunctival exposure and preservation of the periosteum may result in lower morbidity than traditional midface rejuvenation.

Rejuvenation of the african american periorbital area: dynamic considerations.

The rejuvenation of the African American periorbit is rooted in select modifications of traditional techniques. The African American patient presents with dynamic considerations and needs. Whereas this subset is at risk for pigmentation and scar concerns, the natural resistance to actinic damage makes rejuvenation efforts rewarding.

Periorbital aging and ethnic considerations: a focus on the lateral canthal complex.

Background: There is a general perception that skin from various ethnic groups possesses different properties that may affect barrier function, responsiveness to topical agents, sebum production, chemical sensitivities, and aging changes. The first noticeable signs of facial aging are frequently localized to the upper face, brow, and eyes. The authors postulate that a greater relative descent of the lateral canthal complex in African Americans contributes to periorbital aging more so than in Caucasians.

Modern endovascular and aesthetic surgery techniques to treat arteriovenous malformations of the scalp: case illustration.

Background: Arteriovenous malformations of the scalp consist of abnormally connecting arterial feeding vessels and draining veins, devoid of a normal capillary bed within the subcutaneous fatty layer of the scalp. We present a case of a left temporal scalp AVM treated for aesthetic and pain-related concerns. A multidisciplinary approach combining endovascular AVM embolization and AVM excision with local flap reconstruction was chosen.

Restylane and people of color.

Background: Ethnic skin presents a unique paradox. Its melanin content provides protection from the sun, but the same skin can react to the slightest of injuries. The safety of Restylane in patients with increased susceptibility to keloid formation, hypertrophic scarring, hypersensitivity, and hyperpigmentation has not been studied.

Periorbital rejuvenation and the African American patient: a survey approach.

Background: The number of African Americans pursuing cosmetic plastic surgery is increasing. Nonetheless, the authors postulate that the African American patients pursuing certain cosmetic procedures still have preconceived notions and concerns distinct from their Caucasian counterparts, thereby demanding a different surgical strategy. A questionnaire approach was used to determine the concerns, expectations, and desires of African American patients regarding periorbital rejuvenation and to compare these outcomes with those of Caucasian patients.

Anterior thoracic spine reconstruction using a titanium mesh cage and pedicled rib flap.

Study Design: A retrospective clinical study.

Objectives: To evaluate the safety and efficacy of using an integrated titanium mesh cage and pedicled rib flap for thoracic spine reconstruction in patients at high risk of pseudarthrosis.

Summary Of Background Data: A variety of materials are available for interbody thoracic reconstruction; however, the optimal treatment of patients at high risk of pseudarthrosis remains a challenging problem.