Perioperative Estrogen Hormonal Therapy Does Not Increase Venous Thromboembolism Risk in Facial Feminization Surgery.

Background: Conflicting data exist regarding increased perioperative venous thromboembolism (VTE) risk with feminizing hormone therapy. The effect has been poorly studied within the transgender population. Acute perioperative cessation of feminizing hormone therapy often leads to unpleasant side effects and exacerbates gender dysphoria in the perioperative period.

First Female-to-Male Facial Confirmation Surgery with Description of a New Procedure for Masculinization of the Thyroid Cartilage (Adam's Apple).

Unlabelled: Although male-to-female transgender patients commonly seek facial feminization surgery, facial masculinization surgery in the female-to-male transgender population is unreported in the literature. This report documents the first known female-to-male facial masculinization surgery, including a new technique for creating an "Adam's apple" to enhance the facial masculine appearance of a natal female. The authors "reversed" the methods typically used to feminize male facial features, and modified the forehead, nose, and chin to masculinize the patient's natal female facial features.

Dr. Paul Tessier and facial skeletal masculinization.

The male facial skeleton is larger and more angular than that of the female. The male skull has bossing in the area of the frontal sinuses (there is bossing even without presence of the sinuses--5% of people do not have a frontal sinus) and a small flat spot in the mid forehead between the areas of bossing and usually slightly above them. Also there is bossing in the superior lateral orbital angle.

Hemimaxillofacial dysplasia: a variable presentation.

We report a case of hemimaxillofacial dysplasia followed in our clinic for 34 years. A recent literature review has brought to our attention that the subject may have a variant of hemimaxillofacial dysplasia, but with some unique features. The reconstruction procedures are detailed, and long-term follow-up findings are described.

Hydroxyapatite paste (BoneSource) used as an onlay implant for supraorbital and malar augmentation.

This study was designed to evaluate hydroxyapatite paste (BoneSource; Leibinger Corp., Dallas, TX) as an alloplastic implant for supraorbital and malar augmentation. Ten male Sprague-Dawley rats had cylindrical onlay implants made of the hydroxyapatite cement placed above their left orbits on the supraorbital rim.

A method for repairing zygomatic arch fractures using a hydroxyapatite cement paste (BoneSource).

A new method has been developed for the closed reduction of minimally displaced, noncomminuted zygomatic arch fractures that is minimally invasive and precludes the use of nonresorbable materials such as plates and wires in the repair. Twenty rats received simple, minimally displaced right-sided zygomatic arch fractures under general anesthesia. In 10 animals these fractures were treated with closed reduction through a temporal approach (Gillies method) to reapproximate the fractured segments.

Correction of enophthalmos in progressive hemifacial atrophy: a case report.

This case report describes a technique used for correction of enophthalmos secondary to progressive hemifacial atrophy (Parry-Romberg syndrome). The only previous described technique utilized an orbital floor implant, but this method was apparently only partially successful in correcting the conditions, i.e.

Airway changes after Le Fort III osteotomy in craniosynostosis syndromes.

The purpose of this study was to investigate changes in the nasopharyngeal airway and surrounding structures after Le Fort III advancement in Apert's and Crouzon's syndromes. Sixteen status post Le Fort III osteotomy Apert's and Crouzon's patients with pre- and postoperative lateral cephalograms were evaluated. The cephalograms were traced, and linear and angular measurements were obtained.

Sliding genioplasty, avoiding mental nerve injuries.

Mental nerve injuries have been inculcated in sliding genioplasty. An anatomical study was completed (and published) that demonstrated a surgical approach that would, it was hoped, prevent such nerve injuries. A prospective clinical study to test this hypothesis has now been completed.

Prevention of thermal tissue injury induced by the application of polymethylmethacrylate to the calvarium.

The exothermic reaction produced during the polymerization of polymethylmethacrylate yields temperatures in excess of 180 degrees F (81.4 degrees C). At these elevated temperatures, significant bone and dural necrosis occurs.

Plastic surgery's plastics.

Alloplastic materials have become an essential part of reconstructing the craniofacial skeleton. This article reviews several of the more commonly used implant materials and summarizes their mechanical properties and use in reconstructive surgery.

Polymeric implants in craniomaxillofacial reconstruction.

With advances in polymer chemistry, polymeric implants are becoming an increasingly attractive alternative to autogenous bone. Although polymeric implants were traditionally used to bridge bony defects and modify the overlying soft tissue envelope, new resorbable polymers may allow bony replacement and may be used as alternatives to metals in rigid fixation. This article contains an overview of polymeric implants from acrylics to modern resorbable polymers.

Recipient vessels for microvascular transplants in patients with hemifacial microsomia.

Hemifacial microsomia is a developmental abnormality involving structures derived from the first and second branchial arches. Microvascular transplants are increasingly being used to improve facial contour in patients with this condition. We have reviewed 9 patients with this abnormality to determine which recipient vessels have been used.

The course of the inferior alveolar neurovascular canal in relation to sliding genioplasty.

The anterior course of the inferior alveolar neurovascular canal was determined in 52 hemimandibles using high-resolution radiographs. Significant variability was found in its course. It was noted that if the osteotomies for sliding genioplasty were performed at least 6 mm below the inferior border of the mental foramen, injury to the mental nerve would be reduced.

Mandibular angle augmentation and reduction.

The mandibular angle is receiving more attention as now every area of the craniofacial skeleton is a candidate for aesthetic modification. Both reduction and augmentation of this posterior area of the mandible are addressed. Surgical techniques, results, and complications are described after the cosmetic problems are demonstrated.

Combined suction-assisted lipectomy, surgical lipectomy, and surgical abdominoplasty.

Although combined suction-assisted lipectomy (SAL) and surgical abdominoplasties have been described, the surgical excisions have in general been small and limited to the lower portion of the lower abdomen (i.e., just above the pubis).

Long-term follow-up on a case of untreated trigonocephaly.

Trigonocephaly is typically treated during the second 3 months of life by metopic suture synostectomy, orbital rim advancement, and cranioplasty. The results are generally very pleasing in nonsyndromic patients. We have not, however, seen adults with residual deformity who preceded the present basic approach to treatment first described by Hoffman and Mohr (1976).

Aesthetic improvement of the forehead utilizing methylmethacrylate onlay implants.

Forehead augmentation occasionally is necessary for obtaining a desirable upper facial contour. The final contour must be sexually appropriate and must project beyond the cornea of the eyes an amount that makes the contour aesthetically pleasing. Methylmethacrylate onlay implants, preformed or sculpted at the time of surgery, lend themselves to obtaining a desirable contour which can be modified easily at surgery, which is completed in a one-stage procedure, has few complications, and yields an aesthetically pleasing result.

Histologic evaluation of the coronal sutures in trigonocephaly.

Thirteen cases of trigonocephaly, seven isolated and six syndromic cases, were evaluated by preoperative neurologic and genetic evaluation and by radiographic evaluation (CT scans). All 13 were treated in an identical surgical manner. Specimens from the coronal sutures were obtained during surgery for histologic evaluation.