Three Decades of Outpatient Plastic Surgery Safety: A Review of 42,720 Consecutive Cases.

Background: Outpatient plastic surgery offers cost-effective solutions and enhanced privacy but demands careful patient assessment for suitability and vigilant anticipation of adverse events. This study provides recommendations to enhance patient safety in outpatient settings by analyzing over 40,000 consecutive cases spanning across three decades.

Methods: We retrospectively reviewed all consecutive cases completed by board-certified plastic surgeons at an accredited outpatient surgical center between 1995-2023.

Finesse in Primary Open Rhinoplasty.

Rhinoplasty remains one of the most technically demanding operations in plastic surgery, and it continues to be one of the top 5 aesthetic surgical procedures performed. The focus of this article is open rhinoplasty, the central focus of the practice of the senior author (R.J.

Management of the Posthemangioma Nose: 5 Key Rhinoplasty Components.

Hemangiomas of the nasal tip are a relatively uncommon presentation of a common tumor. While optimal medical and surgical management of nasal tip infantile hemangiomas has been described and debated extensively in the literature, to our knowledge, there is no report of secondary aesthetic and functional rhinoplasty in these patients at skeletal maturity, until now. This special topic article provides an excellent example of the 5 key technical elements to revision rhinoplasty in the skeletally mature patient with a history of nasal tip infantile hemangioma.

Role of Rib Graft for Tip Shaping in Primary Rhinoplasty: A Retrospective Case Series of 30 Patients.

Background: In primary rhinoplasty, use of harvested septal cartilage often precludes the need for rib graft. Nonetheless, there are a number of indications for the use of rib graft in primary rhinoplasty. The purpose of this study was to identify the indications and techniques for rib graft use in primary rhinoplasty.

Soft-Tissue Filler for Secondary Nasal Deformities.

One common indication for soft-tissue filler in the nose, or liquid rhinoplasty, is the temporary treatment of secondary nasal deformities after rhinoplasty. Multiple aspects of the patient evaluation, timing with respect to the previous rhinoplasty and planned revision, and procedural principles and steps must be carefully considered. When appropriately implemented, the procedure can help avoid unnecessary patient angst and displeasure before a formal revision rhinoplasty.

Neuromodulator Finesse for Masseter Hypertrophy and Bruxism.

A particularly prominent mandibular angle or a hypertrophied masseter muscle can result in an excessively wide facial appearance, which some individuals may find less aesthetically pleasing. Although normally a benign condition and strictly an aesthetic concern, a hypertrophied masseter can also cause pain, bruxism, and headaches. Neuromodulator for masseter reduction and treatment of bruxism has become first-line treatment.

Beyond Alar Base Resection: Contouring of the Alar Rim and Base.

Summary: Alar base surgery is approached with hesitancy and is often avoided by many surgeons because of inexperience and a lack of understanding. However, with a thorough knowledge of the anatomy and dynamic nature of the lower third of the nose, alar base resection can achieve favorable and reproducible results. Beyond correcting alar flare, an appropriately diagnosed and performed alar base procedure serves to contour both the alar rim and the alar base.

Differential Fat Grafting to Address Facial Asymmetry in Face Lifting.

The modern face lift is a complex operation involving the repositioning of tissues and the refilling of volume atrophy. Preoperative analysis is key to the successful diagnosis of aging changes. Facial asymmetry is universal, and must be recognized and incorporated into surgical planning.

Neuromodulator Injection for Gummy Smile.

Neuromodulators have become a treatment of choice for the management of excess gingival show, or "gummy smile." There have been many proposed algorithms for the optimal placement and dosage of neuromodulator to inject in these locations. The authors aim to clarify these points and provide surgeons with a reliable way to manage the gummy smile that results from hyperactive muscles of the midface.

Revision Rhinoplasty Finesse with Digital Osteotomies.

Revision rhinoplasty is a finesse procedure requiring careful consideration of all of its requisite steps. Lateral osteotomies are required in many cases and, in the setting of prior lateral osteotomies, can often be recreated with digital pressure alone, without the use of an osteotome. The advantages of doing so include decreased dead-space creation and preservation of attachments between the skeleton and overlying soft tissue.

Hand Rejuvenation with Fat Grafting.

Hand rejuvenation with autologous fat grafting has continued to increase in popularity since its description by Fournier in the 1980s. The use of autologous fat has multiple benefits in comparison with dermal fillers, including biocompatibility, availability, revascularization, and long-term results. The authors describe their technique for fat grafting to the hand, using a single access incision combined with the massage technique.

An Evidence-Based and Case-Based Comparison of Modern Face Lift Techniques.

Background: Facial aging is a multifactorial process that affects each component of facial anatomy. The two general groups of face lift techniques are superficial musculoaponeurotic system (SMAS) elevation and SMAS manipulation. The purpose of this article is to describe and compare the advantages, disadvantages, and limitations of face lift techniques.

Five-Principle and Five-Step Liquid Rhinoplasty.

Liquid rhinoplasty, otherwise known as nonsurgical or filler rhinoplasty, has earned increased attention for its ability to provide surgical rhinoplasty results at a fraction of the cost and without incising the skin. However, significant complications can arise, such as tissue necrosis, filler embolus, and vascular compromise if the procedure is performed without consideration of the principles and anatomy of the face and nose. As demonstrated in this article, a stepwise and patient-specific approach to performing liquid rhinoplasty will ensure safe, consistent, and desirable results.

Impact of the COVID-19 Pandemic on Manuscript Submission by Women to Plastic and Reconstructive Surgery.

Background: The coronavirus disease of 2019 (COVID-19) pandemic has had far-reaching consequences, occasionally amplifying preexisting disparities. This study examines the impact of COVID-19 on Plastic and Reconstructive Surgery (PRS) manuscript submissions by female authors.

Methods: All manuscripts submitted to PRS during the months of March and April of 2018 through 2021 were examined.

Refinements in Component Dorsal Reshaping in Primary Rhinoplasty.

Dorsal reduction and reshaping is an essential part of many rhinoplasty procedures. The steps of component dorsal reduction have been well established. The authors describe refinement of the dorsal reshaping process to improve the quality and consistency of results.

Male Face-Lift Finesse.

Male face lifts account for approximately 10% of the total number of face-lift procedures performed annually in the United States. Although many face-lift principles apply universally, there are certain characteristics of the male face that make the management and surgical procedure unique. A systematic and patient-specific approach to the preoperative markings, facial analysis, and surgical technique in the male face lift will ensure safe, consistent, and natural appearing results.

Finesse Buccal Fat Pad Excision.

The buccal fat pad has long been noted for its complex anatomy and its significance to facial aesthetics. Its bulk is mostly deep facial fat immediately superficial to the buccinator muscle. The buccal fat pad has a main body and four extensions: buccal, pterygoid, superficial temporal, and deep temporal.

Rhinoplasty in the COVID-19 Era: Practice and Safety Considerations.

The COVID-19 pandemic has required changes in health care practices to decrease the risk of disease transmission during the provision of medical care. The risk of transmission is high in procedures involving the nasopharyngeal and oropharyngeal tissues. This article describes simple preventative strategies at a single institution to minimize the risk of disease transmission during rhinoplasty procedures.

Modern Concepts in Nasal Deprojection.

The overprojected nose, also known as a long nose, is a consequence of several interrelated factors. Standardized nasofacial assessment typically is approached through the anterior, lateral, and basal views. The senior author (R.