Master Techniques in Facial Rejuvenation

Front Cover
Inside Front Cover
Master Techniques in Facial Rejuvenation
Copyright Page
Table Of Contents
Video Contents
Preface
List of Contributors
Acknowledgments
Dedication
1 Facial Embryology
Embryogenesis
Embryology
The Branchial/Pharyngeal Apparatus
Embryology of the External Ear
Embryology of the Eye
Embryology of the Face and Nose
Embryology of the Nasal Cavity and Paranasal Sinuses
Embryology of the Palate
Conclusion
References
2 Applied Facial Anatomy
Introduction
Layers of the Face
Layer I: Skin
Layer II: Subcutaneous Tissue
Layer III: Superficial Fascia
Layer IV: Deep Areolar Layer
Layer V: Deep Fascia
Regional Considerations
Forehead
Upper Eyelid Anatomy
Lower Eyelids
Midface
Lips and Perioral Region
Facial Artery and Vein
Summary
References
3 Addressing Facial Shape and Proportions With Injectable Agents in Youth and Age
History and Introduction
Personal Philosophy
Facial Anatomy: Introduction and Overview
Facial Anatomy and Aging: Regional Thirds of the Face
Upper Face
Midface
Lower Face
Facial Anatomy and Aging: Functional and Structural
Preprocedural Assessment
Current Concepts in the Anatomy of Aging
Skin: Layer 1
Fat: Layer 2
Facial Muscles: Layer 3
Ligaments and Facial Spaces: Layer 4
Periosteum and Deep Fascia: Layer 5
Bone
Case Histories
Complications
Summary
References
References
4 Injectables and Resurfacing Techniques
Introduction
Basic Science
Pharmacology and Pharmacokinetics
Commercial Sources of BoNT-A
Commercial Source of BoNT-B
Cosmetic Indications
Warnings and Contraindications
Adverse Effects
Dosing
Patient Selection
Decision-Making Details of Selecting a Patient for BoNT-A
Treatment Technique
Glabella
Forehead
Crow’s Feet and Lower Eyelids
Brow Elevation
Neck
Nasolabial Folds
Perioral Lines
Mentalis
Depressor Anguli Oris
Repair of Surgical Complications
Hyperhidrosis
Salivary Glands
Postoperative Care
Outcomes, Prognosis, Complications
Potential Adverse Reactions
Secondary Procedures
Treating Patients Who Had the Procedure but Desire Improved Results
References
References
5 Topical Skin Care and the Cosmetic Patient
Cleansers and Toners
Moisturizers
Sunscreen
Cosmeceuticals
Retinol and Synthetic Retinoids
Vitamin C
Niacinamide
Hydroxy Acids
Botanicals
Peptides
Growth Factors
References
References
6 Skin Resurfacing
Introduction
Laser Principles
Skin Optics and Selective Photothermolysis
History of Laser Resurfacing
Fractional Resurfacing
Patient Selection
Procedure
Complications
Conclusion
References
References
7 The Open Browlift
History
Personal Philosophy
Anatomy
Preoperative Assessment
Technique
Postoperative Care
Complications
Future Considerations
References
References
8 Endoscopic Foreheadplasty
History
Personal Philosophy
Anatomy
Preoperative Assessment
Instrumentation
Surgical Technique
The Incisions
Creation of the Frontal Cavity
Creation of the Temporal Cavity
Release of Tissue Attachments to Bone and Deep Fascia
Tissue Modifications
Fixation
Lowering the Brow
Summarizing Key Steps in the Endoscopic Foreheadplasty Procedure: “Keller’s Rules of Fours”
Postoperative Care
Complications
References
9 Nonsurgical Brow and Eyelid Rejuvenation
Introduction
Anatomy
Skin Rejuvenation
Neurotoxins
Soft Tissue Fillers
Injection Technique
Filler Placement
Eyebrow.
Superior Sulcus.
Lower Eyelid.
Summary
References
References
10 Minimally Invasive Complementary Adjuncts to Upper Blepharoplasty
Introduction
Clinical Anatomy (Forehead/Eyebrow/Eyelid)
Eyebrow/Eyelid Aging
Indications
Surgical Procedures
Internal and External Browpexy
Nasal Fat Pad Preservation and Translocation in Upper Blepharoplasty
Management of Lacrimal Gland Prolapse
Brow Fat Pad Fixation or “Brassiere Suture”
Postoperative Course, Care, and Complications
Conclusion
References
References
11 Ptosis Repair and Blepharoplasty
History
Personal Philosophy
Anatomy
Levator Muscle
Müller’s Muscle
Tarsal Plate
Preoperative Evaluation
Patient Selection
History
Examination
External Levator Advancement
Müller’s Muscle Conjunctival Resection
Postoperative Care
Complications
Asymmetry
Lagophthalmos/Dry Eye
Corneal Abrasion
Orbital Hemorrhage
Infection
Incision-Related Complications
Conclusion
References
References
12 Transconjunctival Lower Blepharoplasty With and Without Fat Repositioning
Introduction
Relevant Anatomy
Lower Eyelid Aging Changes
Indications
Surgical Technique
Postoperative Course and Care and Complications
Conclusion
References
References
13 Transcutaneous Lower Blepharoplasty
Introduction
Aging Eyelid Anatomy
Preoperative Evaluation, Indications, and Contraindications
Surgical Procedure
Step 1. Skin Flap Elevation and Preservation of Orbicularis Muscle
Step 2. Submuscular Dissection and Release of Orbital Retaining Ligaments
Step 3. Volumization With Fat Transposition
Step 4. Support of Lateral Retinaculum With Tarsal Fixation
Step 5. Superior Midface Elevation With Orbicularis Flap Redraping and Periosteal Fixation
Step 6. Conservative Superolateral Skin Resection
Complications and Management
Conclusion
References
References
14 The Spectrum of Canthal Suspension Techniques in Lower Blepharoplasty
Introduction
Canthal Nomenclature
Canthal Anatomy
Canthal Aging Changes
Preoperative Assessment
Surgery
Open Canthal Suspension
Lateral Tarsal Strip
Commissure-Sparing Open Canthal Suspension
Open Canthopexy
Closed Canthal Suspension
Hang-Back Canthal Suspension
Postoperative Care and Complications
Conclusion
References
References
15 Aesthetic Rejuvenation in the Patient of Asian Ancestry
Introduction
Anatomy
Face
Skin
Eyelid
Eyelid Crease
Septum
Fat
Epicanthus
Preoperative Evaluation
Surgical Techniques
Complications
Conclusion
References
References
16 The Deep Plane Facelift
History
Personal Philosophy
Anatomy
Preoperative Assessment
Surgical Technique
Postoperative Care
Complications
Future Considerations
References
References
17 Deep Plane Rhytidectomy Modifications
Introduction
Anatomy and Aging Pathophysiology With Surgical Implications
Midfacial Aging
Jawline and Neck
The Deep Plane Rhytidectomy
Modifications of the Deep Plane Rhytidectomy
Surgical Technique
Preoperative Marking
Anesthesia
Incision and Skin Flap Elevation
Deep Plane Dissection: Release of the Zygomatic-Cutaneous Ligament, Zygomaticus Major Muscle Fibrous Attachments, and Masseteric Cutaneous Ligaments
Release of the Cervical-retaining Ligaments
Deep Plane Flap Suspension
Mandibular Ligament Release
Lateral Platymsa Suspension in the Neck
Midline Platysmaplasty Indications
Adjunctive Submental Procedures and Platysmaplasty
Future Considerations
Efficacy
Tobacco Use
Complications
Conclusion
References
References
18 Lateral SMASectomy Facelift
History
Senior Author’s Personal Philosophy
Surgical Technique
Anesthesia
Incisions
Skin Flap Elevation
Defatting the Neck and Jowls
Open Submental Incision With Medial Platysma Approximation
Lateral SMASectomy Including Platysma Resection
Vectors
Skin Closure, Temporal and Earlobe
Dog-Ears
Postoperative Care
Complications
Suggested Reading
19 Reshaping Rhytidectomy
History
Personal Philosophy
Facial Anatomy
Preoperative Assessment
Surgical Technique
Postoperative Care
Complications
Future Considerations
References
References
20 Tridimensional Endoscopic Facelift
History
Personal Philosophy
Anatomy of Facial Aging
Preoperative Assessment
Photographic Documentation
Addressing the Central Oval of the Face
Surgical Technique
Endoscopic Forehead Lift Procedure
Endoscopic Midface Lift Procedure
Mentopexy
Adjunctive Procedures in the Central Oval of the Face
Skin-Only Blepharoplasty
Bichat’s Fat Pad Excision
Fat Grafting
Addressing the Peripheral Hemicircle of the Face
Cervicoplasty Versus Cervicofacial Rhytidectomy
Anterior Approach Cervicoplasty
Mandibular Matrix System
The Implant System
Extended Wrap-Around Chin Implant
Mandibular Angle Implant
Prejowl Implant
Button Chin Implant
Implant Placement
Postoperative Care
Complications
Future Considerations
References
References
21 Midface Implants
Introduction
Diagnosis
Presurgical Considerations
Surgical Technique
Postoperative Care
Clinical Cases
Complications
Conclusion
Suggested Reading
22 Mentoplasty
History
Personal Philosophy
Anatomy
Preoperative Assessment
Surgical Technique
Postoperative Care
Complications
References
23 Orthognathic Aesthetic Facial Surgery
Introduction
Aesthetic Facial Analysis
Dental Analysis and Occlusion
Skeletal Analysis
Soft Tissue Analysis
Photographic Analysis
Treatment Philosophy
Dental Treatment
Preoperative Orthodontic Treatment
Preoperative Work-Up and Dental Model Surgery
Surgical Procedures
Le Fort I Osteotomy
Sagittal Split Mandibular Osteotomy
Bony Genioplasty
Summary
References
References
24 Facial and Cervical Lipectomy
History
Personal Philosophy
Anatomy
Preoperative Assessment
Surgical Technique
Equipment
Markings
Anesthesia
Technique
Suction Lipectomy
Direct Excision
Postoperative Care
Complications
Future Considerations
References
References
25 Complementary Fat Grafting
History
Personal Philosophy
Anatomy
The Upper Third
The Middle Third
The Lower Third
Preoperative Assessment
Surgical Technique
General Considerations
Fat Harvesting
Processing the Fat
Infiltrating the Fat
Upper Third
Middle Third
Lower Third
Postoperative Care
Complications
Future Considerations
References
26 Rhinoplasty in the Aging Patient
Personal Philosophy
Nasal Analysis
Preoperative Assessment
Surgical Technique
Preoperative Considerations
The External Approach
Profile Alignment and Narrowing the Nose
Septal Surgery
Narrowed Middle Vault
Ptotic Nasal Tip
Acute Nasolabial Angle and Retracted Columella
Nasal Tip Contour
Nasal Valve Collapse
Materials for Grafting
Postoperative Care
Complications
Conclusion
References
References
Index
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
R
S
T
U
V
W
X
Z
Inside Back Cover