Preventing Lateral Canthal Malposition in Modern Blepharoplasty.

Current goals in lower eyelid blepharoplasty include blending the lower eyelid-cheek junction, which is highlighted in the authors' six-step lower lid blepharoplasty technique. One major question in lower lid blepharoplasty is how to prevent lower lid malposition and ectropion, because these are untoward outcomes after an aesthetic procedure. In the authors' technique, they perform a superficial lateral retinacular canthopexy that is effective and safe and also prevents lower lid malposition or ectropion.

Endoscopic Temporal Brow Lift: Surgical Indications, Technique, and 10-Year Outcome Analysis.

Background: Brow-lift techniques have evolved from the most invasive approach, such as a coronal brow lift, to a minimally invasive technique, such as an endoscopic brow lift over the past century. Although an endoscopic brow lift offers the advantage of being minimally invasive, it suffers from a high recurrence rate. The authors present their experience of combining an endoscopic and temporal brow lift approach for long-lasting results, and discuss the surgical indication, techniques, and outcome of an endoscopic temporal brow lift.

Safety and Adjuncts in Face Lifting.

Learning Objectives: After studying this article, the participant should be able to: 1. Classify the commonly performed types of face-lift procedures based on the extent of skin incision and face and neck dissection, and superficial musculoaponeurotic system treatment and perform the appropriate amount of skin undermining in variations of superficial musculoaponeurotic system techniques. 2.

Role of Fresh Frozen Cartilage in Revision Rhinoplasty.

Background: Correction of secondary nasal deformities frequently requires cartilage to build the framework of the nose. Traditionally, autologous costal cartilage has been used because of the paucity of the septal cartilage. Because of associated donor-site complications and increased operating time, irradiated allografts have been used.

Revisiting the Alar-Columellar Relationship: Classification and Correction.

The alar-columellar relationship has tremendous aesthetic significance in the lower one-third of the nose. Aberrancies in the alar-columellar relationship detract from nasal aesthetics, and are classified into six types: type I, hanging columella; type II, retracted ala; type III, combination of a hanging columella and retracted ala; type IV, hanging ala; type V, retracted columella, and type VI, combination of a hanging ala and retracted columella. This article describes the methods for proper evaluation and diagnosis of aberrancies in the alar-columellar relationship, and current strategies to restore the ideal alar-columellar relationship.

Primary Open Rhinoplasty.

Learning Objectives: After studying this article and viewing the videos, the participant should be able to: 1. Describe the operative technique necessary to perform open rhinoplasty. 2.

Silicone Implant Illness: Science versus Myth?

The purpose of this Special Topic article is to present the current state of scientific evidence related to the safety of silicone breast implants. There is presently overwhelming evidence to support the safety of silicone breast implants. Ultimately, the decision to obtain, keep, or remove breast implants is the choice of the patient.

Tissue-Based Planning and Technique for Breast Augmentation with Anatomical Implants.

Breast augmentation with anatomical implants offers several potential advantages. Tissue-based planning is patient specific and essential in choosing the correct dimensions of an implant, thereby providing greater control in breast shape following augmentation. This video vignette demonstrates tissue-based planning in a patient with a constricted breast, allowing the surgeon to accurately choose the proper implant dimensions, which correct the constriction while providing aesthetic control of breast shape.

Achieving Aesthetic Results in the Umbilical Float Mini-Abdominoplasty: Patient Selection and Surgical Technique.

Background: The umbilical float mini-abdominoplasty has been criticized for low final umbilicus position and umbilical distortion. The authors believe that in the properly selected patient and with proper technique, the umbilical float can achieve superior aesthetic results in a subset of patients.

Methods: A retrospective review was performed of all umbilical floats performed by two surgeons (B.

Making Sense of Stem Cells and Fat Grafting in Plastic Surgery: The Hype, Evidence, and Evolving U.S. Food and Drug Administration Regulations.

Autologous fat grafting and adipose-derived stem cells are two distinct entities with two different risk profiles, and should be regulated as such. Autologous fat grafting prepared with the additional step of stromal vascular fraction isolation is considered a form of "stem cell therapy" given the high concentration of stem cells found in stromal vascular fraction. Much ambiguity existed in the distinction between autologous fat grafting and stromal vascular fraction initially, in terms of both their biological properties and how they should be regulated.

Finesse in Face Lifting: The Role of Facial Fat Compartment Augmentation in Facial Rejuvenation.

Much of facial aging can be attributed to volume deflation and tissue laxity. Successful surgical rejuvenation can be achieved through volume restoration with autologous fat grafting of the facial fat compartments. In conjunction with volume restoration, correction of tissue laxity and recontouring of the face and neck can be achieved.

Modern Primary Breast Augmentation: Best Recommendations for Best Results.

Learning Objectives: After reading this article, the participant should be able to: 1. Develop a practical method for preoperative implant size selection. 2.

When Is Teenage Plastic Surgery versus Cosmetic Surgery Okay? Reality versus Hype: A Systematic Review.

Plastic surgery in teenagers has become popular in past decades because of an increase in self-awareness and desire to "fit in" with their peers. In 2016, over 229,551 cosmetic procedures were performed in patients who are younger than 19 years. The trend of plastic surgery in adolescents is increasing, and it is important for plastic surgeons to perform safe and appropriate procedures in this group.

Role of Fractionated Fat in Blending the Lid-Cheek Junction.

Background: Fat grafting has been used extensively in plastic surgery in the past two decades. Here, the authors report the retrospective comparison of patients who underwent fractionated fat injection to blend the lid-cheek junction with those who had regular fat injection.

Methods: After obtaining institutional review board approval, a retrospective review of patients who underwent lower blepharoplasty with fractionated fat injection for blending the lid-cheek junction from January of 2014 through October of 2015 was performed.

Refinements in Upper Blepharoplasty: The Five-Step Technique.

Periorbital tissues are a keystone in facial beauty and a representation of youth. The aesthetically pleasing and youthful upper eyelids are full, with a defined tarsal upper lid crease and with smooth, taut pretarsal and preseptal skin. The upper blepharoplasty is a critical component of any facial rejuvenation procedure.

An Update on the Safety and Efficacy of Outpatient Plastic Surgery: A Review of 26,032 Consecutive Cases.

Background: Outpatient surgery offers many advantages, including cost-containment, privacy, and convenience. However, patient safety must take precedence over these benefits. Limited well-designed studies exist in the plastic surgery literature on patient safety in the outpatient setting, particularly those that identify risk factors for adverse outcomes.

The Infratip Lobule Butterfly Graft: Balancing the Transition from the Tip Lobule to the Alar Lobule.

The nasal alae and the soft-tissue triangles are delicate structures, the contours of which are largely dependent on soft tissue and the indirect influence of the lower lateral cartilages. Creating appropriate and continuous contour from the tip lobule to the alar lobule can be challenging. The alar contour graft is one reliable method of achieving predictable contour.

The Keystone: Consistency in Restoring the Aesthetic Dorsum in Rhinoplasty.

The keystone represents the union of six distinct anatomical structures between the bony vault and the cartilaginous midvault. In reshaping the nasal dorsum, the individual components of the nose respond variably as the fusion points of the keystone are released. In restoring the nasal dorsum, meticulous effort is made to equalize the width between the bony vault and the cartilaginous midvault.

Components of the Hanging Columella: Strategies for Refinement.

The columella is a significant factor in the aesthetic balance of the nose, particularly the lower one-third of the nose. Its position is dependent on the anatomical constituents of the columella, and neighboring anatomical structures. Six components of the hanging columella have been identified: the caudal septum, medial crura, columellar skin, membranous septum, anterior nasal spine, and depressor septi nasi muscle.