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1.
Plast Reconstr Surg ; 149(1): 107-115, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34936610

RESUMO

SUMMARY: Iatrogenic jowling can be an unintended consequence of facial feminization surgery. Reduction of the mandible and chin without overlying changes to the soft tissue can lead to a redundant and deflated soft-tissue envelope, requiring a face lift to address jowling, cervicofacial laxity, and/or lower facial rhytids. Prospective quality-of-life outcomes data support this hypothesis, as patients who underwent mandible contouring with or without angle osteotomies were significantly more likely to express interest in face lift following facial feminization surgery on univariable analysis (90.0 percent versus 10.0 percent, p = 0.038). Patients with inherent skin laxity are at particularly high risk, such as those with advancing age, extrinsic skin damage (e.g., sun exposure, cigarette smoke), and history of massive weight loss. Before facial feminization surgery, the authors recommend comprehensive patient counseling that includes a discussion of the possible future need for a face lift, preferably around 1 year after facial feminization surgery. When performing a face lift after facial feminization surgery, technical considerations include those related to sequelae of prior facial surgery, anatomical differences between cismale and cisfemale facial soft tissue, and the mechanism of jowling after facial feminization surgery versus normal facial aging. The authors believe that these considerations can set more realistic expectations for facial feminization surgery patients, improve surgeons' ability to skillfully execute this procedure, and ultimately contribute to ongoing quality-of-life improvements in facial feminization surgery patients.

2.
Plast Reconstr Surg ; 149(1): 25e-27e, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34936611

RESUMO

SUMMARY: The bulbous and box tips are two common morphologies encountered in rhinoplasty. Nasal tip reshaping is a challenging aspect of rhinoplasty. Understanding the classifications of nasal tip morphologies aids when performing a nasal-facial analysis. The management algorithm for both tip morphologies shares various techniques. These techniques include but are not limited to cephalic trim, transdomal sutures, and interdomal sutures. A graduated approach to managing the variations in bulbous and boxy tips will help in achieving consistent results. New concepts applied to the management include supporting alar rims with alar contour grafts, closing dead space through a series of techniques, and managing the soft-tissue envelope, which is often in excess.

3.
Clin Plast Surg ; 49(1): 191-195, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782136

RESUMO

Nonsurgical rhinoplasty is increasing in popularity, and when used appropriately, can be less costly and have less downtime than surgical rhinoplasty. It can offer patients a means of seeing how they would feel about a surgical rhinoplasty later. Injection can be safe but patients should still be counseled regarding the rare, possible risks of tissue loss and potentially irreversible tissue ischemia and irreversible blindness. Treatment with hyaluronidase can be partially effective when signs and symptoms are caught early; however, avoidance is still the best medicine along with seeking an experienced, qualified rhinoplasty plastic surgeon.


Assuntos
Rinoplastia , Humanos , Isquemia , Nariz/cirurgia
4.
Clin Plast Surg ; 49(1): 71-79, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34782141
5.
Plast Reconstr Surg ; 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34851883

RESUMO

BACKGROUND: Venous thromboembolism is a significant cause of postoperative death and morbidity. While prophylactic and treatment regimens exist, they usually come with some risk of clinically relevant bleeding and, thus, must be considered carefully for each individual patient. METHODS: This special topic article represents a review of current evidence regarding venous thromboembolism risk, biology, and prevention in plastic surgery patients. The specific types and duration of available prophylaxis are also reviewed. The balance of venous thromboembolism risk must be weighed against the risk of hemorrhage. RESULTS: Though alternatives exist, the most validated risk assessment tool is the 2005 modification of the Caprini Risk Assessment Model. Controversies remain regarding recommendations for outpatient and low risk cosmetic patients. The authors additionally make recommendations for high-risk patients regarding the use of tranexamic acid, estrogen therapy, anesthesia, and prophylaxis regimens. CONCLUSION: The authors have made great strides in understanding the science behind venous thromboembolism, risk stratification for patients, and prophylactic regimens; yet, continued studies and definitive data are needed.

6.
Plast Reconstr Surg ; 148(6S): 1S-2S, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34847089
7.
Plast Reconstr Surg ; 148(6S): 5S-6S, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34847091
8.
Plast Reconstr Surg ; 148(6): 1278-1279, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34847114

RESUMO

SUMMARY: Anatomic subtleties of the nasal tip have a dramatic impact on the overall appearance of the nose. Mastery of normal nasal aesthetics and anatomy is a critical prerequisite to adeptly performing nasal tip refinement during open rhinoplasty. This article and series of videos aim to provide a focused review of nasal tip analysis, anatomy, and surgical technique, with particular emphasis on pertinent tip sutures and cartilage grafts.

9.
Plast Reconstr Surg ; 148(6): 1436-1438, 2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34847138
10.
Plast Reconstr Surg ; 148(5): 1021-1027, 2021 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-34705776

RESUMO

SUMMARY: Rhinoplasty remains one of the most challenging operations performed by plastic surgeons. The complexity lies in the ability to have a consistent and predictable aesthetic result. The unpredictability is mainly attributable to the interplay of manipulated internal structures and wound healing dynamics. In addition, setting realistic expectations with the patient is essential for achieving high postoperative patient satisfaction. An open rhinoplasty approach enables an accurate and in-depth evaluation and intervention. The authors provide a detailed analysis and discussion on why primary rhinoplasty fails, along with the surgical approach for preventing these failures.

12.
Plast Reconstr Surg ; 148(6): 1401-1406, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34705809

RESUMO

SUMMARY: Virtual education is a promising tool for expanding surgical training and continuing education. The authors present their preferred platforms for virtual surgical education, and discuss security and privacy concerns. Maintaining communication and keeping sessions engaging require special consideration when education is done virtually. The limitations to virtual education may soon be mitigated by new technologies. In this article, the authors aim to describe the benefits, current modalities, tips for use, and future directions for virtual education as it pertains to plastic surgeons and trainees during the current coronavirus pandemic.

14.
15.
Plast Reconstr Surg ; 148(5S): 6S-7S, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34699468
16.
Plast Reconstr Surg ; 148(5S): 8S-9S, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34699469
17.
Plast Reconstr Surg ; 148(5S): 10S-11S, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34699470
18.
Plast Reconstr Surg ; 148(5S): 12S, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34699471
19.
Plast Reconstr Surg ; 148(5S): 13S-14S, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34699472
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