Direct browplasty.

To the facial plastic and reconstructive surgeon, direct browplasty is a useful adjunct to other facial rejuvenative procedures. Unlike other procedures designed to correct the ptotic brow, direct browplasty allows the surgeon to reposition the brow more accurately. In addition, use of a layered plastic closure results in an acceptable surgical scar that can further be camouflaged with appropriate cosmetic techniques in selected patients. The indications, surgical technique, and postoperative care are described.

Achieving symmetry in browplasty.

As is well known by facial plastic surgeons, the browplasty serves to augment the favorable aesthetic effect of blepharoplasty as well as delay or reduce the effect on the forehead that the ptotic brow creates in compensatory elevation. A method of achieving postoperative symmetry in performing direct browplasty is described utilizing: direct measurement of the amount of preoperative ptosis; and known anatomic reference points in which to correlate these measurements on the face. The surgical technique involving a layered plastic closure is also described in order to further obtain the most desirable postoperative result.

Metastatic basal cell carcinoma: report of a case.

Although basal cell carcinoma (BCC) accounts for as high as 75% of all malignant skin tumors, its metastatic rate is only 0.1%. Predisposing factors for metastasis are generally thought to be: 1. a head and neck primary BCC; 2. a long standing lesion; 3. deep local invasion with ulceration. This paper presents a patient with metastatic BCC with a history of other malignancies and probable immune system compromise. These factors should also alert the clinician to the possibility of metastatic BCC.