RESUMEN
There has been no ideal option for patients who are unhappy with their facial shape but do not want to undergo complex surgeries or pay the high price of temporary injectable treatments. In this article, we describe the treatment of facial complaints such as the gaunt face, long face, bottom-heavy face, chubby face, midface retrusion, and asymmetric face, as well as the modification of racial and ethnic characteristics, through the use of less invasive methods. Fat grafting was used to accentuate the cheekbones in most patients complaining about their facial shape. For the long face, this technique increased the horizontal facial diameter. Lipoplasty combined with buccal lipectomy effectively decreased the fullness of the lower face and improved facial contour in the bottom-heavy face and chubby face. A skin-tightening face lift may also be necessary in patients with neck laxity. Fat grafting was used to fill in depressions or defects in the gaunt face and to treat midface retrusion and facial asymmetry. Added facial projection was obtained with nasal and chin implants. Photographs of representative patients treated for facial reshaping using the described techniques are presented. By using the less invasive techniques described, plastic surgeons can reshape a patient's face without the prolonged downtime or morbidities associated with more invasive procedures.
RESUMEN
The authors prefer an open approach to brow lift involving a completely autogenous fixation method. They contend that scarring produced by electrocautery "checkerboarding" of the frontalis and periosteum results in adhesion of the forehead dermis and soft tissues to the frontal cranium.
RESUMEN
BACKGROUND: Many face lift techniques that manipulate the superficial musculoaponeurotic system (SMAS) in order to correct a perceived descent of deeper facial structures have been presented. However, such procedures can result in insufficient volume restoration, which may be correctable only by actual fat replacement. OBJECTIVE: We describe a face lift technique that combines volume restoration by fat grafting and results in removal of descended fat below the mandible as well as conservative skin redraping. METHODS: A short-scar incision was utilized and limited flap dissection was performed in the subcutaneous plane. Direct defatting of the fat superficial to the platysma and inferior to the mandibular border was performed. Submental fat near the midline that could not be excised was removed by lipoplasty under direct vision. The platysma was treated only if prominent banding was present preoperatively. The skin was redraped utilizing a suspension suture between the flap and the cartilaginous canal of the ear, and excess skin was excised. Fat grafting was performed into volume-deficient areas using a blunt-tipped cannula. The SMAS and other deeper layers were not manipulated. RESULTS: A retrospective review of 83 consecutive patients revealed high patient satisfaction and an overall complication rate of 6% after a mean follow-up of 12 months. CONCLUSIONS: The described procedure represents an evolution to a simpler and effective technique that produces a natural, youthful appearance with minimal morbidity and downtime.
RESUMEN
BACKGROUND: Capsular contracture after breast augmentation or reconstructive breast surgery is a difficult problem. Previous studies have suggested that alteration of the inflammatory response could have a role in reducing the incidence of capsular contracture. OBJECTIVE: We report a series of patients with Baker class III or IV capsular contracture who underwent treatment with zafirlukast. METHODS: Patients received a regimen of zafirlukast 20 mg by mouth 2 times daily for 3 months. RESULTS: In many cases, dramatic softening of the breast capsule was evident after 1 to 3 months of treatment. CONCLUSIONS: Zafirlukast appears to effectively soften early capsular contracture and may prevent the formation of capsular contracture in those patients at risk. (Aesthetic Surg J 2002;22:329-336.).
