RESUMO
PURPOSE: The advent of the endoscopic forehead lift has provided an alternative to the conventional open approach. This article describes the basic technique, with some modifications, and reports three clinical cases. RESULTS: The subperiosteal forehead technique rejuvenates the upper third of the face with no scalp resection, minimal risks of hypesthesia, limited risk of alopecia, reduced tissue trauma, small camouflaged scars, less bleeding and edema, improved postoperative comfort and faster recovery compared with the standard open techniques. CONCLUSIONS: The endoscopic subperiosteal forehead lift is a useful technique for providing rejuvenation of the upper third of the face. It reduces or eliminates forehead rhytids by eliminating the reflex contracture of the frontalis and contributes to softening of the vertical glabellar rhytids. Longitudinal studies will be required to assess the effectiveness of this technique compared with open techniques.
Assuntos
Endoscopia , Testa/cirurgia , Ritidoplastia/métodos , Adulto , Idoso , Alopecia/prevenção & controle , Cicatriz/prevenção & controle , Contratura/prevenção & controle , Edema/prevenção & controle , Endoscópios , Endoscopia/métodos , Músculos Faciais/patologia , Feminino , Hemorragia/prevenção & controle , Humanos , Hipestesia/prevenção & controle , Complicações Intraoperatórias/prevenção & controle , Pessoa de Meia-Idade , Dor Pós-Operatória/prevenção & controle , Periósteo/cirurgia , Fatores de RiscoRESUMO
Numerous implant materials have been used in nasal surgery, including autogenous, homogeneous, and alloplastic grafts. Autogenous cartilage remains the ideal graft material; however, situations exist where an alternative or an additional grafting material is needed. Homogeneous materials have demonstrated significant resorption. Alloplastic grafts have offered varying degrees of success but have resulted in significant complications as well. Gore-Tex has undergone extensive research and clinical application in various surgical fields with reported success. This analysis examines 106 patients over a 5-year time period in which the Gore-Tex soft-tissue patch was used in a wide variety of situations from extensive nasal dorsal reconstruction to small localized nasal defects or irregularities. Postoperative follow-up has revealed a stable implant material with no complications relating to the graft material.
Assuntos
Politetrafluoretileno , Próteses e Implantes , Rinoplastia/métodos , Adulto , Estudos de Avaliação como Assunto , Feminino , Seguimentos , Humanos , Estudos RetrospectivosRESUMO
The tumescent technique of local anesthetic administration was originally spawned by the desire to facilitate full-body, large volume liposuction in a safe and efficient outpatient manner. The numerous advantages of this technique are readily applied to cervicofacial rhytidectomy. The method described creates an essentially bloodless field via hydrodissection with overall decreased surgical morbidity secondary to the decreased necessity of sharp surgical dissection.
Assuntos
Anestesia Local/métodos , Ritidoplastia/métodos , Epinefrina/administração & dosagem , Feminino , Humanos , Injeções Subcutâneas , Lidocaína/administração & dosagem , Lipectomia/métodosRESUMO
Surgical management of the nasal tip in esthetic rhinoplasty has long proved to be a challenging and frustrating task. While standard reductive tip techniques work well in many cases, there are those cases that require augmentation to yield an ideal cosmetic result. In this article, both reductive as well as augmentation techniques are presented to illustrate the advantages of each treatment.
Assuntos
Cartilagem/transplante , Osso Nasal/cirurgia , Rinoplastia/métodos , Adulto , Estética , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Esthetic assessment and treatment planning for the upper one third of the face is reviewed. The importance of esthetic anatomy in evaluation of the face as a whole is stressed. Three basic approaches to the forehead and brow lift are discussed, with particular regard to patient selection, indications, and contraindications. Clinical cases are presented as examples.
Assuntos
Estética , Face/cirurgia , Adulto , Sobrancelhas , Face/anatomia & histologia , Feminino , Testa/patologia , Testa/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Cirurgia Plástica/métodosRESUMO
A case of histologically documented transformation of benign intraoral melanosis into malignant melanoma is presented. Because benign oral melanotic lesions can transform into malignant melanoma, all intraoral melanotic lesions should be completely excised with histologically proven free margins.
Assuntos
Transformação Celular Neoplásica/patologia , Doenças da Gengiva/patologia , Neoplasias Gengivais/patologia , Melanoma/patologia , Melanose/patologia , Adulto , Neoplasias Gengivais/cirurgia , Humanos , MasculinoRESUMO
Hemophilus influenzae type B is known for its predilection to produce infections in the cheeks of infants. Early recognition and aggressive intervention are essential to avoid potentially life-threatening sequelae. A case is presented in which a resistant strain obscured the diagnosis and prolonged the illness. Clinical manifestations and differential diagnosis of the disease are discussed.
