Mild to Moderate Dysphagia Following Very Low-dose Abobotulinumtoxin A for Platysmal Bands.

Onabotulinumtoxin A (Botox) can be a safe and successful off-label treatment of vertical platysma bands of various severities. Due to risk of the botulinum toxin diffusing to the underlying anatomic structures such as the deglutition muscles, the larynx, and the neck flexors, a maximal dose of 100 units has been suggested and there have been no known reports of untoward effects with doses less than 60 units. We present a case of mild to moderate dysphagia in a patient after very low doses of Abobutulinumtoxin (60 units, equivalent to 20 units of Onabotulinumtoxin using a 3:1 conversion ratio).

ASDS Cosmetic Dermatologic Surgery Fellowship Milestones.

Background: The American Council of Graduate Medical Education, which oversees much of postgraduate medical education in the United States, has championed the concept of "milestones," standard levels of achievement keyed to particular time points, to assess trainee performance during residency.

Objective: To develop a milestones document for the American Society for Dermatologic Surgery (ASDS) Cosmetic Dermatologic Surgery (CDS) fellowship program.

Methods: An ad hoc milestone drafting committee was convened that included members of the ASDS Accreditation Work Group and program directors of ASDS-approved Cosmetic Dermatologic Surgery (CDC) fellowship training programs.

Blue foot: a second case of "tattoo blow-out" pigment spread successfully treated with the QS-Nd:YAG laser.

The "tattoo blow-out" phenomenon occurs when tattoo pigments spread outside the border of a tattoo. It is thought to occur when ink is injected too deeply. A healthy 36-year-old female presented to a dermatologist with diffuse spread of tattoo pigment outside the original tattoo that occurred within one day of the placement of a professional tattoo on the dorsum of her foot.

Diagnosis and management of skin resurfacing-related complications.

The field of skin resurfacing is undergoing rapid evolution with many new technologies that have developed, providing more choices for physicians and patients. Knowing the potential adverse effects associated with each skin resurfacing modality is paramount in selecting the appropriate approach for each candidate, thereby minimizing complications and achieving optimal results.

Specific techniques for fat transfer.

At no time in the past has the field of cosmetic reconstruction paid as much attention to the contribution of volume loss to facial aging. Volume replacement can be achieved with synthetic fillers, implants, and patients' own adipose tissue. However, the results of autologous fat transfer procedures yield variable results among patients and surgeons.

Rejuvenation of the periorbital complex with autologous fat transfer: current therapy.

Purpose: This article examines the pathophysiology of periorbital aging and details a technique, autologous fat transfer, to restore a youthful appearance to the periorbital complex. The use of photographs taken of patients in their late teens or early 20s shows that the main changes of periorbital aging are consistent with volume loss more so than gravitational changes. This article reflects on the shortcomings of currently accepted surgical approaches to the rejuvenation of the periorbital region.

Autologous fat augmentation for addressing facial volume loss.

Autologous fat augmentation is in vogue again. The realization that traditional cosmetic surgery has often failed to achieve a truly rejuvenated look has refocused attention on volume replacement. Autologous fat is truly the ideal filler, being available in relative abundance, nonimmunogenic, a living tissue, and able to take on the properties of the area into which it is infiltrated.

Repair of partial and complete earlobe clefts: a review of 21 methods.

Background: Partially or completely spilt earlobes are a common reason for patient presentation to the cosmetic surgeon.

Methods: In this article, we review the different techniques of repairing both partial and complete cleft earlobes.

Results: We review and illustrate 4 methods to repair a partial cleft earlobe and 17 methods to correct a complete cleft earlobe.

Autologous fat augmentation: a perfect fit in new and emerging technologies.

The focus of recent cosmetic surgery is on the replacement of lost facial volume. Much of aging is a complex set of changes, including bone loss, muscle atrophy, and subcutaneous loss. For this reason, autologous fat augmentation is the perfect fit in the realm of new and emerging technologies.

Autologous fat transfer for periorbital rejuvenation: indications, technique, and complications.

Background: The periorbital region is one of the first facial regions to show signs of aging. Traditional surgical approaches consisted of lifting and excisional procedures including brow lifts and blepharoplasties. Suboptimal results, however, have led surgeons to reassess their approach to the periorbita to address volume loss.

Histologic comparison of autologous fat processing methods.

Purpose: To perform a quantitative analysis of adipocyte viability after fat processing during autologous fat transfer, comparing the processing methods of washing, centrifuging, and sedimentation.

Methods: An experimental study was conducted in which 24 fat samples were obtained after processing from 22 patients undergoing autologous fat transfer. Histologic analysis of periodic acid-Schiff-stained specimens was then performed.

Subcision and 1320-nm Nd:YAG nonablative laser resurfacing for the treatment of acne scars: a simultaneous split-face single patient trial.

Background: Many methods have been proposed for the treatment of acne scars with variable cosmetic results. Subcision has been successfully used, although complications often include a hyperpigmented and hypertrophic wound healing response. Nonablative skin resurfacing with a 1320-nm Nd:YAG laser has also been proposed; however, the results are generally inferior to those of more invasive modalities.

Correction of surface deformities: Botox, soft-tissue fillers, lasers and intense pulsed light, and radiofrequency.

The field of cosmetic surgery continues to be rapidly changing and expanding one. With the understanding of the changes that take place in aging and contribute to photodamaged skin, technologic advances have become more based in science. Patients are aware of these changes and are enthusiastically tracking them through all media channels.