bluuebunny/crossref_metadata_2025 huggingface dataset:
Fat Injection of the Penis: A Personal Technique
Authors: Hernandez-Perez E. , Marroquin-Burgos R.
Published: January 2017

Fat injection of the penis is a new and innovative procedure to enlarge the penis. This report of a case illustrates the technique and ease of the procedure.
The Thermoplast Nasal Splint in Rhinoplasty
Authors: Middleton William G. , Witterick Ian , Lofchy Neal M.
Published: January 2017

Most surgeons agree that after completion of rhino-plastic surgery, a protective dressing should be applied to provide stabilization of the bony nasal skeleton, approximation of the skin flap to underlying bone, control of edema, and prevention of hematoma formation. Joseph felt that the dressing played a psychological role as well, preventing the patient from being alarmed by postoperative swelling. This has been accomplished by a variety of materials and methods both historically and presently.
Gore-Tex® ePTFE in Nasal Surgery and Review of Long-Term Results
Authors: Berman Mark
Published: January 2017

More than 10 years have passed since the author first used Gore-Tex® expanded polytetrafluoroethylene (ePTFE) as a facial implant material. To date, the material has been tolerated very successfully without any signs of degradation or alteration. Previous research studies have confirmed the stability of the material. It has become increasingly popular and has recently received FDA approval as Subcutaneous Tissue Augmentation Material (SAM®) for use as a soft tissue filler of the face. More importantly, this author has documented two specific areas for consideration. First, the material does not need to be used by itself as an independent implant material. It can be bonded to other materials, such as silicone rubber, and thus be used for its unique surface properties while enjoying the structural integrity of the silicone rubber. (This use has not received FDA approval.) Secondly, as an added precaution, it is wise to prepare the material before implantation by vacuum impregnation with an antibiotic solution. Before use of this type of preparation was started in June 1989, the author experienced 9 infections out of 67 facial implants with Gore-Tex (13%). Since vacuum impregnation was initiated, there has been 1 infection out of 165 implantations (0.61%). There have been no infections or extrusions with nasal surgery since antibiotic impregnation was started.
Nasal Septal Perforation Repair: 25-Year Experience with the Flap and Graft Technique
Authors: Fairbanks David N. F.
Published: January 2017

A predictably successful technique for surgical closure of nasal septal perforation has been employed in over 100 patients in the past 25 years. It employs bipedicled mucosal advancement flaps designed to maximize blood supply (for flap viability) and an underlying connective tissue autograft (fascia or pericranium) for structural reinforcement.
Use of Auricular Cartilage for Reconstruction of Cartilaginous Defects of the Nose: Emphasis on Reconstruction of the Lower Lateral Cartilage Complex
Authors: Bartlett John Andrew , Hilger Peter A.
Published: January 2017

During a year of fellowship with Dr. R. C. Webster, a preceptor with the American Academy of Facial Plastic and Reconstructive Surgery Fellowship Program, the senior author was introduced to innovative techniques utilizing conchal cartilage to repair various defects of the nasal tip. In the past 15 years of practice, we have modified his technique slightly but many of his basic concepts and principles remain. We have replaced the entire lower lateral cartilage complex as well as segmental defects of the nose.

The presentation will review techniques for reconstruction of the entire lower lateral cartilage complex, as well as segmental defects due to trauma, previous surgery, congenital defects and defects secondary to oncologic resection. Preoperative and postoperative case presentations will highlight salient surgical principles.
The O'Connor Tweezer Dexterity Test as a Screening Tool for Hiring Surgical Hair Restoration Assistants
Authors: Brandy Dominic A.
Published: January 2017

Because the use of very large numbers of small hair-grafts has become the norm in hair transplantation, the surgical assistant who cuts and places the hair-grafts into the recipient sites has become a key figure in the operation. Because this activity requires tremendous dexterity and patience, hiring the right individuals to perform this work can be a formidable task. Recently, the author has researched the topic of dexterity tests and discovered an invaluable hand-eye coordination test (The O'Connor Tweezer Dexterity Test) that accurately determines whether or not an individual will be able to perform the task of hair-graft placement with speed and precision. Since utilizing this test during the interview process, it has been found to be a highly invaluable screening tool.
Pocket Grafting with Dermal Grafts: Autologous Collagen Implants for Permanent Correction of Cutaneous Depressions
Authors: Swinehart James M.
Published: January 2017

The objective of this study was to develop the rationale, operative results, and methods obtained from dermal grafting and to compare them with existing methods of soft-tissue augmentation. Techniques for delivery of autologous collagen for permanent correction of cutaneous depressions are described, evaluated, and discussed in detail, including an illustration and discussion of results obtained from correction of broad undulating acne scars and deep rhytides. The method of dermal grafting under study is then compared with existing procedures for soft-tissue augmentation. Pocket grafting with dermal grafts was found to be a promising technique for correction of certain facial defects.
Resorcinol Peels: Gross and Microscopic Study
Authors: Hernández-Pérez Enrique , Carpio Edith
Published: January 2017

Gross and microscopic changes occuring after the application of 53% resorcinol peels are shown in this study. Patients were clearly satisfied, finding noticeable decrease (or disappearance) of the “tired-looking” appearance. From a microscopic point of view, improvement of polarity, horny plugs, and liquefaction of the basal cell layer, as well as in the elastosis of the dermis, was noted.
Post-Rhinoplasty Depression
Authors: Sun George , Carniol Paul , Bortnichak Paula , Baredes Soly
Published: January 2017

Although most patients are satisfied with the results of rhinoplasty surgery, unanticipated postoperative psychological reactions can occur. Depression after rhinoplasty represents a form of adverse psychological reaction toward cosmetic surgery. Here we report a case of postoperative depression after a satisfactory rhinoplasty in a psychologically stable patient. This case of post-rhinoplasty depression should remind cosmetic surgeons that a good result may not consistently produce a happy, satisfied patient. Although preoperative psychological evaluations may be helpful in screening patients, this assessment may not always be predictive. The surgeon should therefore be prepared to help his patients to cope with adverse psychological reactions.
History of the American Journal of Cosmetic Surgery
Authors: Shiffman Melvin A.
Published: January 2017

The first issue of “The American Journal of Cosmetic Surgery” was published in the winter of 1984. At that time, the cover of the journal was not purple, ermine, and gold as it is now. The journal sported a cover with red lettering on a white background. Since there were no funds consigned to the journal in those days, the first Editor-in-Chief Dr. Aronsohn, bore the expense of the first two volumes himself. When Dr, Aronsohn's health began to fail in 1986, Dr. Julius Newman became Managing Editor. In 1993, Dr. Melvin A. Shiffman became Editor-in-Chief. At this time, the quantity and quality of the contributions began to increase. The purpose of the journal was then and is now to inform and educate as well as to act asa forum for new and innovative ideas in cosmetic surgery.
A Single-Scar Technique for Donor Harvesting in Hair Transplantation Surgery
Authors: Brandy Dominic A.
Published: January 2017

The author presents a technique of strip donor harvesting for hair transplantation that excises the scar from the previous harvest, leaving the patient with a single, straight, cosmetically pleasing scar on completion of several surgical hair restoration procedures. Because it is sometimes necessary to perform deep inferior undermining to accomplish scar excision, familiarity with the neck's anatomy is important.
Breast Reduction—An Analysis of 105 Cases Comparing the Superior- and Inferior-Pedicle Techniques
Authors: Tobin Howard A. , Houting Thomas V.
Published: January 2017

An analysis of 105 consecutive breast reduction cases carried out by means of either the superior- or inferior-pedicle technique was undertaken in an effort to compare the two techniques and evaluate patient satisfaction. The two techniques were compared on the basis of weight of tissue excised from each breast, upward nipple displacement required, patient age, complications, operating time, and histopathology. A patient questionnaire sent to each subject in the study evaluated satisfaction with the surgery. It is concluded from this study that both the superior- and inferior-pedicle techniques are safe, versatile, and workable surgical options which can be incorporated within a cosmetic surgical practice. Both procedures, when utilized for appropriate indications, serve as means to address all degrees of breast hypertrophy. There was a high degree of patient satisfaction for both surgical techniques, with evidence of significant reduction in the symptoms that often led patients to consider the operation.
1500 Grafts Using the CO2 Silk Touch Laser, Choi Transplanters, and Calvitron Hair Tomer
Authors: Kourtis Michael
Published: January 2017

Hair transplant sessions of up to 1500 single to triple hair grafts using the CO2 SilkTouch Laser, and the Calvitron Hair Transplant System offer the patient sessions of reasonable length, minimal bleeding, and a natural looking hairline. This article describes a surgical technique that combines the benefits of the most up-to-date laser technology with a transplant session of moderate length. The surgical procedures and tools utilized are described in the article, including preparation of the donor strips, preparation of the recipient holes, and the size of grafts. The 1500-graft session is shown to be a satisfactory compromise between the conventional transplant session, which requires many sessions with only limited results per session, and the 2000- to 3000-graft transplant session which is extremely tiring for the patient who has to spend many hours all in one sitting in surgery.
Hydrogel for Mammary Prostheses
Authors: Arion Henri-Gilbert
Published: January 2017

Since the withdrawal of silicone-gel implants from the market by the Federal Drug Administration in 1992 except for research protocol, there has been continued research to find a substitute filler which is nontoxic and biodegradable. The gel of carboxymethylcellulose has been found to have a mild local tissue reaction which is short in duration, and the substance apparently completely degrades without toxicity. Early research into carboxymethylcellulose is described.
Cosmetic Blepharoplasty: A Comparison of CO2 Laser and Electrosurgical Technique
Authors: Tobin Howard A. , Fink Stephen H.
Published: January 2017

A study of blepharoplasty results was performed comparing a conventional electrosurgical technique to the CO2 laser. Patients were recruited for the study, in which a direct comparison of the techniques was made on each patient using the electrosurgical technique on one eye and the CO2 laser on the other. Both the physician and the patient evaluated the results independently throughout the postoperative period with follow-up to 3 months. Results demonstrated greater operative time with the CO2 laser. No significant difference between techniques was found with regard to pain, bleeding, and itching during the postoperative period or the final postoperative appearance at 3 months. Swelling and discomfort were significantly greater with electrosurgery on day 4 with the trend extending through the third postoperative week. Bruising was significantly greater in the laser-operated eye more often, but the amount relative to the electrosurgical eye for each patient was not significant in the opinion of the surgeon. Both techniques were determined to be safe with acceptable results.
Resorcinol Peel as a Part of a Facial Rejuvenation Program
Authors: Hernández-Pérez Enrique
Published: January 2017

Combination of procedures is necessary to obtain better results in facial rejuvenation. We have combined resorcinol chemical peel, topical tretinoin, oral isotretinoin, fat transplantation, GORE-TEX® implants, and Botox injections with good results and optimal patient acceptance.
Medium-Deep Chemical Peel Utilizing Jessner's Solution, 20% TCA, and Baker's Phenol Solution
Authors: Brandy Dominic A.
Published: January 2017

Chemical peels have revolutionized the care of the cosmetic surgical patient over the past 10 years. Although the technique of peeling has been around since the early 1900s, only recently has the technique gained tremendous popularity. The three basic chemical peels used in the 1990s are the superficial, medium, and deep varieties. Of these three, the Baker's phenol peel gives the most dramatic improvement—primarily because it penetrates deeper than all other peels into the midreticular dermis. With this peel, however, there is a higher risk of scarring, and the actual process takes approximately 1–2 hours owing to organ toxicity concerns. In an attempt to combine the safety of a medium peel with the dramatic results of a deep peel, the author began using a medium peel (multiple coats of Jessner's solution and 20% TCA) all over the face in combination with Baker's phenol solution applied lightly into the deeper rhytids. The results with the first 10 cases have been consistently good and the complications negligible. All patients, however, develop temporary streaking of the area of the Baker's phenol application that lasts for 2 to 3 months. So far, this appears to be an efficacious method for chemical peeling.
New Trends in the Treatment of Varicose Veins
Authors: Olivencia Jose A.
Published: January 2017

The physiologic importance of varicose veins and resulting morbidity has been well established since the 18th Century. However, venous disorders have aroused very little interest in the medical community. New options in the treatment of varicose veins are effective, cosmetically pleasing, and convenient for the patient. Venous disorders represent a significant source of morbidity worldwide. Relatively painless, low-risk outpatient treatments have proven to be effective. These treatments include a combination of surgical removal, ambulatory phlebectomy, and injection sclerotherapy. A review of the history, anatomy, pathophysiology, and diagnosis of venous disorders, including new trends in treatment protocols, is discussed.
Fat Metabolism and its Relevance to Liposuction
Authors: Lack Edward B.
Published: January 2017

Advances in liposuction, primarily involving the tumescent technique of local anesthesia, have fostered the advent of large-volume liposuction. Such major alterations in the volume of an organ system must have physiologic implications. This paper attempts to describe fat metabolism as it relates to fat storage and expenditure and the possible effects of large-volume liposuction on fat metabolism.
Liposuction as the Primary Procedure for Treating Ptotic Abdominal Wall
Authors: Mantse Lefter
Published: January 2017

In 1982 Illouz introduced liposuction to North America. Now, it is the most common aesthetic plastic surgery for females. Indications for the procedure have increased. During a 10-year period we performed liposuction on 1000 patients who were under local anesthesia. On 446 patients the treated area was the abdomen, alone or in combination with other areas. Of the patients who underwent abdominal liposuction, 92 had ptotic abdominal wall. Five of those patients had planned two-stage procedures or touch-ups of the abdomen. We followed 45 of the 92 patients. None have had abdominoplasty by us or other surgeons. The longest follow-up for a patient was 10 years and the shortest follow-up was 1 year.
Ultrasonic Lipoplasty: Physical Basis, Adipolytic Effect, Cadaver Research, and Clinical Studies
Authors: Boutboul Gérard , Cohen Jean-Luc , Bouloudnine Guy
Published: January 2017

Liposuction has developed into one of the most popular of the cosmetic surgical procedures. Addition of ultrasonic lypolysis has improved the ease and efficiency of liposuction and results in less edema and bruising. The authors have tested commercially available appliances and researched this process in association with a protocol established by the French Society of Lipoplasty. The physical basis of ultrasonics, the effects on various tissues through cadaver experiments, and the results of clinical studies are presented.
Comparison of Conventional and Ultrasonic Methods of Liposuction: Update
Authors: Saylan Ziya
Published: January 2017

This article revisits the author's past conclusions and expectations of ultrasound liposuction as they were expressed in the 1995 article “Comparison of the Conventional and the Ultrasound Methods of Liposuction.” Based on his subsequent experience with ultrasound liposuction, the author lists the advantages and disadvantages of ultrasound liposuction, coming to the conclusion that despite the increased expense of the equipment and the media attention given to the techniques, the ultrasound techniques used today are not better than the conventional techniques and the microcannula techniques.
The Relationship of Facial Animation to Smile Aesthetics
Authors: Johns Francis R. , Vigilante Craig , Buckley Michael J. , Johnson Peter C. , Close John M.
Published: January 2017

The aesthetics of a smile have been shown to be related to the symmetry of the smile, the curvature of the upper lip, and the arc of curvature of the lower lip to the incisal edges of the upper teeth. The present study quantitatively compares the magnitude of facial animation (as determined by the Johnson Maximal Static Response Assay) to the aesthetics of a smile in 25 subjects. The assay (software) calculates two-dimensional facial movement changes from the frontal view, as measured by the relative change in position of seven facial landmarks. Smile shape and lip fullness were also categorized. Lip fullness was the only variable found to correlate with the aesthetics of a smile. The magnitude of facial movement, smile shape, and gender did not correlate with aesthetic ratings.
Guidelines for Designing and Locating Hairlines
Authors: Seery Gerard E.
Published: January 2017

Hair restoration literature contains a paucity of information on how to design and locate an aesthetically pleasing hairline. Simple guidelines are formulated for accurately designing and locating hairlines. Certain key topographical landmarks identified on the frontal scalp are used to construct a framework of three parallel lines on which the hairline is designed and positioned. The most appropriate hairline takes into consideration many factors unique for each individual. Regardless of how expertly a hairline zone is constructed, the ultimate aesthetic result is contingent on design and placement.
Technical Note: Repair of the Traumatic Clefted Earlobe
Authors: Ziccardi Vincent B. , Eggleston Todd
Published: January 2017

Patients with traumatic clefts of the earlobes are more frequently presenting for repair. Expectations are changing regarding the desire to wear earrings soon after the repair has been completed. This paper will discuss different repair techniques and indications/limitations for each procedure.
Practice Guidelines
Authors: Shiffman Melvin A.
Published: January 2017

Developing clearly written, scientifically valid, and flexible practice guidelines can aid in cost containment and in the resolution of medical malpractice litigation. Practice guidelines should keep in mind both clinicians and patients and should focus on specific clinical circumstances. Deviation from the guidelines should be supported by peer-reviewed medical literature. These guidelines, if properly researched and prepared, may serve as the standard of care.
Breast Augmentation with Autologous Lipograft
Authors: da Silveira Jacques Wilson
Published: January 2017

The author describes the method and technique used for augmenting the breast through autograft of fat obtained from liposuction. Care should be taken in the collection, preparation, and use of the aspirate in order to preserve the adipocytes' vitality. Thirty-one cases are presented with good results and few complications. Two complications that may occur are resorption, which can be reduced through knowledge of the proper technique, and microcalcifications, which, according to some researchers, may confuse the radiologic diagnosis of mammary carcinoma. The author does not agree. The method is a good alternative to augmentation mammaplasty with prosthesis. Although the method is innocuous, beginners should exercise caution.
Concomitant Use of Malar Implants in Cervicofacial Rhytidectomy
Authors: Fidler John E. , Laney Thomas J.
Published: January 2017

The appeal of youth and beauty has existed since the beginning of time. Cervicofacial rhytidectomy is a frequently used procedure for rejuvenation of the face. Malar implants have been used to increase the dimensions of the hypoplastic midface. This article reviews the history of these procedures and describes the concomitant use of malar implants to enhance the rejuvenation gained by the face-lift. Two case reports are included.
Herpes Simplex Flare-Ups following CO2 Laser Resurfacing
Authors: Fulton James E.
Published: January 2017

Background:

Outbreaks of herpes simplex have plagued the patient and the physician since skin resurfacing began. The outbreaks are becoming more frequent and more difficult to treat.

Objective:

To present several case histories demonstrating unusual cases and therapeutic difficulties of skin resurfacing in patients with herpes simplex.

Methods:

Patients were usually placed on antivirals at the time of skin resurfacing. This therapeutic plan was not always successful.

Results:

Several patients had herpes simplex flare-ups after skin resurfacing. They were not easily controlled with acyclovir.

Conclusions:

A high index of suspension is needed to diagnose herpes simplex flare-ups after skin resurfacing. The new antivirals, famciclovir and valacyclovir, may have a better therapeutic index for success in the future.
A New Camera for Cosmetic Surgery
Authors: Shiffman Melvin A.
Published: January 2017

Introduction:

The use of a camera is essential in cosmetic surgery to record results using preoperative and postoperative photographs. The Polaroid Macro 5 SLR is a new camera for close-up photographs. The camera was examined to evaluate the ease of its use and the quality of the close-up photos.

Materials and Methods:

Photographs were reproduced at the settings available; these settings are: 0.2× (20%), 0.4× (40%), 1× (100%), 2× (200%), and 3× (300%). Multiple exposures were utilized in six patients to show a variety of problems such as skin lesions, facial abnormalities, and ryhtids.

Results:

The instant photos were of high quality with accurate reproduction of the abnormalities. The camera was easy to load, focus, and use.

Discussion:

The Polaroid camera takes exposures with almost instant reproduction of the abnormality. There is no need to wait for the results or to send the film out for processing. Since the Macro 5 SLR is only for close-up photographs, the camera is limited to subjects only as large as the head. Another camera is necessary for exposures requiring larger portions of the body. The close-up photography does not require lens changes but has a convenient rotating magnification selector knob. This easy-to-use camera is an excellent addition to the needs of the cosmetic surgeon who requires photos of small areas.
The Mushroom Technique for Penile Enhancement
Authors: Sito Giuseppe , Sorrentino Laura
Published: January 2017

Introduction:

Penile enhancement is used to increase patient appearance, confidence, and sexual satisfaction. This study was undertaken to evaluate the effect of a mushroom technique in terms of its simplicity, its effectiveness, and in terms of the prolonged enhancement it provides.

Materials and Methods:

Seventy-five male patients were subjected to the mushroom procedure and then followed for 6 months. The technique involved injection of bovine purified collagen conjugated with glutaraldehyde circumferentially into the prepuce area of the penis. This increased the diameter of the penile prepuce.

Results:

No patient reported pain or discomfort following the procedure and there were no infections. Seventy-two patients (96%) had moderate ecchymoses. All patients had early increased sensation during intercourse. Volume was maintained for 3 months, but from 4 to 6 months there was progressive reduction in the volumetric cosmetic appearance. After 6 months, 42 patients (60%) had had a second infiltration.

Discussion:

Total penile enhancement has prompted reports of problems with infection and penile distortion. The procedure can be painful, especially with ligament release. The mushroom enhancement is well tolerated, simple to perform, and has excellent early results. Secondary procedures are usually necessary.
The Aging Face: A Different Perspective on Pathology and Treatment
Authors: Berman Mark
Published: January 2017

Probably because the thrust of the pathology of the aging face has been attributed to the effects of gravity (skin and muscle loosening and falling), treatment of such is generally directed toward lifting procedures. Indeed, results from such procedures are generally beneficial, but in many cases the patient appears unnaturally skeletonized. A brow-lift may eliminate some wrinkles and frown lines, but does anyone (naturally youthful) really have eyebrows a centimeter above the orbital rim? Our goal has been, and continues to be, to strive for excellence, and in the case of the aging face, this would be an improved and more youthful appearance. This paper will discuss the main pathology of the appearance of aging, which is the general dissipation of facial fat over time. It will also provide discussion as to thoughtful correction of the problem not only with lifting techniques but also with consideration to filling procedures. The judicial use of fat-grafting and various synthetic implants serve as the principal tools for volume correction. It is acknowledged that the skin undergoes photo-damage, which also contributes to the appearance of aging, but this is treated by treating the skin in a multitude of ways.
A New Autologous Collagen Technique
Authors: Alkek David S.
Published: January 2017

Introduction:

Autologous tissue culture fibroblasts and collagen (Isolagen) have been evaluated in rhytids, scars, and defects to determine indications and effects of filling.

Materials and Methods:

Forty-nine patients since January 1997 have been injected with Isolagen for depressed scars, rhytids, and lip augmentation.

Results:

Fine lines, such as periorbital and perioral lines, respond better than deeper furrows. Saucer-shaped scars and depressions with soft, distensible shoulders improve with an average of three injections. Lips can be augmented quite well. There were essentially no side effects.

Discussion:

Isolagen is expensive and requires precise patient scheduling since the material degenerates quickly. Patients are impressed by the fact that we are using their own collagen and because it provides a more permanent result than bovine collagen.
Transaxillary Endoscopic Augmentation: An Analysis of 100 Cases
Authors: Yvorchuk William
Published: January 2017

Over the last three decades, there has been a large demand for elective breast enhancement. Endoscopic technology has expanded the techniques available for breast augmentation. There is a relative paucity of information on the outcomes of these endoscopic techniques. This series is presented to report on a series of approximately 100 consecutive patients who have undergone transaxillary endoscopic augmentation mammoplasty, primarily with smooth implants placed in the subpectoral position. This technique has revealed itself to be a safe, reliable, and versatile approach to breast augmentation that has allowed for a high degree of control in the performance of the procedure. The complication rate is relatively low and highly favorable compared with that of other methods of augmentation. The requirement for revisional surgery is minimal, and such surgery can be performed through the original approach and, to date, has been performed without the requirement for a counterincision. This technique can readily be taught with a high degree of predictability in planning and execution.
Aesthetic Changes in Lip Profile following Advancement Genioplasty
Authors: Lupori John P. , Schmitz John P. , Jeter Thomas
Published: January 2017

This study examined the aesthetic changes in the labiomental fold profile after advancement genioplasty. We presented a Cartesian system, based on symphyseal landmarks, to compare both hard and soft tissue changes occurring after advancement genioplasty. This technique was then utilized to compare quantitatively the soft tissue changes in patients who have had advancement genioplasty with or without bone grafts in the anterior osteotomy site.

Thirty-one consecutive patients who had undergone advancement horizontal mandibular osteotomies (HMOs) for the correction of a deficient chin in the period 1989 through 1994 were included in this study. All patients underwent HMO either with or without the insertion of a freeze-dried rib to contour the osteotomy step defect. The majority of patients underwent additional procedures, including Le Fort I osteotomy (LFI) and bilateral sagittal split osteotomy (BSSO), alone or in combination. In the grafted group, after the segment was fixed, a split-thickness freeze-dried rib graft was contoured and secured in the anterior osteotomy site with 2-mm position screws. Cephalograms were taken at two time periods: preoperatively and 1 year postoperatively. The cephalograms were traced, and bony landmarks in the mandibular symphysis were identified: genion, infradentale, and B point. These points were chosen because they were not affected by any surgical procedure. A Cartesian coordinate system was then derived from the preoperative tracings and superimposed on the 1-year postoperative tracings. The depth of the labiomental fold was measured from the soft tissue chin profile. The data were analyzed with a Student's t-test to test the hypothesis that horizontal advancement of the mandibular symphysis produced unfavorable aesthetic changes in the labiomental sulcus in patients with no graft in the anterior osteotomy site. The significance level to reject the null hypothesis was set at P < 0.05.

The mean change in the sulcus depth for nongrafted HMOs was 2.22 mm, while the mean change in sulcus depth for grafted HMOs was −2.79 mm. A positive change represented a deepening of the labiomental fold. The mean difference between the two groups was 5.00 mm (P < 0.0001). The amount of advancement did not correlate with sulcus depth changes in either group (no graft, r2 = 0.012, P = 0.72; with graft, r2 = 0.03, P = 0.15). Significant change occurred at the deepest point of the labiomental fold. The mean change there in patients with no graft was 0.59 mm (P = 0.4); for grafted patients it was 3.42 mm (P < 0.0001). The mean difference between the two groups was 2.83 mm (P = 0.0017). Changes at lower incisor, lower lip, and soft tissue pogonion were not significantly different between the two groups.

We found that the sulcus depth deepens significantly after advancement genioplasty when no graft is placed in the anterior osteotomy site. The significant change occurs at the depth of the sulcus, the site of the anterior step, and does not correlate with the amount of advancement.
Correction of Unilateral Paralysis of the Lower Lip with the Koire-Sling
Authors: Lee Jeffrey , Koire Bernard
Published: January 2017

Injury to the marginal mandibular branch of the facial nerve has led to disturbing functional and cosmetic deformities. Difficulties with speech and eating have often been observed among patients displaying such injuries. The major concern of these patients is the resultant lower lip asymmetry apparent when the patient smiles. Numerous methods for correcting this deformity have been described, most of which require the trade-off of a prominent scar. These techniques are often objectionable to many of the younger patients. The purpose of this article is to describe a simple and effective method, using a suturing technique, to improve the cosmetic and functional problems associated with this condition. The method uses a 3-0 nylon suture, which is used to draw the corner of the lower lip inferiorly and laterally toward the periosteum of the inferior border of the mandible. Good cosmetic and functional results were noted.
Transumbilical Retroglandular Breast Augmentation, a Review of 158 Cases and a Comparison with Traditional Approaches
Authors: Wittenberg Joerg M. , Leventhal Marc
Published: January 2017

Introduction:

The transumbilical (TU) approach for breast augmentation is performed with endoscopical assistance and leaves no visible scar on the breast. The recovery time should be shortened and the complication rate should be decreased compared with those of the standard periareolar (PA) or of the inframammary (IM) approach. This study was undertaken to compare the results of these three surgical procedures.

Materials and Methods:

This retrospective study of 214 patients evaluated 158 patients with the TU approach, 27 patients with the PA approach, and 29 patients with the IM approach. Group I patients are those who had surgery in the first 9 months and Group II patients are those who had surgery in the second 9 months. Statistical data were tabulated for surgery and anesthesia time, blood loss, implant size, patient age, and follow-up time. Complications were reported and compared for the different surgeries.

Results:

There was no significant difference in the age of the patients in these three groups. Surgery time was longest for the PA approach and was not significantly different between the TU and IM approaches. The implant sizes were comparable between the three groups. Less hematoma formation, fewer infections, less sensory dysfunction and postoperative pain and swelling were seen in the TU patients. Also, the complications in the Group II-TU patients was less when compared with patients in Group I-TU. Some problems, like healing of the umbilical incision, disconnection of the filling tube, and irritation of the abdominal tissues, are specific to the TU approach.

Discussion:

The results of this study showed a similar or smaller number of problems with the TU approach if the patient selection is correct. With increasing operator experience, a significant decrease in complications was seen. The TU approach is a good alternative and a valid procedure for the right patient.
Use of Lasers by Health Care Personnel
Authors: Shiffman Melvin A.
Published: January 2017

Laser use has increased in cosmetic surgical procedures. This is not an innocuous tool and the use of lasers should be restricted to health care personnel trained and experienced in its use.

Physicians should be aware of state laws relative to the use of laser by health care personnel other than physicians. State statutes and RN performance of laser procedures are reviewed.
Comparison of Carbon Dioxide Laser to Baker's Phenol Solution to Correct Rhytids of the Lower Eyelids
Authors: Tobin Howard , Burnham Michael A. , Karas Nestor D.
Published: January 2017

Introduction:

Fine rhytids of the lower eyelids have been treated by chemical peels and more recently by carbon dioxide (CO2) lasers. Although histologic studies indicate that both methods of treatment penetrate through the papillary dermis to the reticular dermis, CO2 lasers have been postulated to produce better long-term results in the improvement of rhytids and in skin laxity secondary to the thermal effect of the laser that causes collagen synthesis and reorganization. The purpose of this study was to compare the outcomes in lower eyelids between the CO2 laser and Baker's phenol solution by analyzing both patient response and the clinician's impression of progress.

Materials and Methods:

Seven patients were enrolled in this study, which was conducted at the Facial Plastic and Cosmetic Surgical Center. The patients underwent a 50% phenol peel of the left lower eyelid. The right lower eyelid was treated by a Luxar NovaPulse CO2 laser. After treatment, patients were evaluated at 1–3 days, 1 week, 3 weeks, and at 3 months. At each evaluation period, patients filled out a questionnaire comparing swelling, erythema, pain, discomfort, and itching for each eyelid. The clinicians rated the amount of swelling, erythema, crusting/peeling, and reepithelialization of each eye. At 3 months, a subjective evaluation was done.

Results:

Fifty-seven percent of patients complained of more swelling on the laser side initially; however, at 3 weeks, 57% of patients complained of more swelling on the phenol side. At 3 months, all swelling resolved. Initially, erythema was greater on the laser side in 57% of patients. At 3 months, it was present equally, except in those patients who had used Catrix postoperatively on the phenol side; in these cases, swelling was markedly decreased. Pain was worse on the laser side but resolved for all patients after 3 weeks. Reepithelialization occurred within 7 days on the laser side, whereas it took up to 3 weeks before there was an absence of crusting/peeling on the phenol side. At 3 months, all but one patient felt there was no difference between the two treatments in the correction of fine rhytids; however, four of the seven patients noted that the laser side was smoother to the touch. Five patients would choose the laser over the phenol. One patient was noted to have better correction of the bagginess of her lower lid on the laser side.

Discussion:

For treatment of fine rhytids, there was little difference in the two methods of treatment. However, the CO2 laser seemed to better correct lower lid bagginess. The majority of the patients preferred the laser over the chemical peel.
Central Pedicle Breast Reduction
Authors: Yvorchuk William
Published: January 2017

Many reduction mammaplasty procedures have been proposed of late. Many rely on intraoperative refinements that demand an advanced level of experience with the technique and invoke a steep learning curve fraught with problems for the novice. The central pedicle reduction mammaplasty technique was introduced by Hester et al in 1985. This technique has been shown to be a safe, reliable, and versatile approach to breast reduction that is applicable to the majority of breast sizes and shapes. Its particular advantages are in the predictability in tailoring the skin envelope and glandular component from preoperative judgement, in the flexibility in the intraoperative execution of the procedure, and in the maintenance of a generous neurovascular supply. These advantages allow for a low complication rate. This technique can easily be taught with a high degree of predictability in planning and execution. A series of approximately 50 consecutive cases is presented with an analysis of the results.
Lymphatics and Liposculpture
Authors: Leibaschoff Gustavo M. , Ciucci Jose Luis , Ferreira Julio , Djeredjian Carlos , Banfi Jorge
Published: January 2017

Introduction:

Although lymphatic drainage of the lower extremities is well understood and liposuction-assisted lypectomy has been in existence almost 25 years, this study was undertaken to determine if liposculpture of the lower extremities causes significant damage to the lymphatics.

Materials and Methods:

One patient with bitrochanteric lipodystrophy was selected for the study. Radioisotopic lymphography was performed. Dynamic images were obtained of the distal limbs for 15 to 20 minutes at 3 and 6 hours after injection. Liposculpture was performed on one side and ultrasonic liposculpture on the opposite side using tumescent anesthesia. Four months after the surgery, radioisotopic lymphography was repeated.

Results:

There were no relevant changes from the preoperative study. Lymphographs done early, late, and at 4 months show no abnormalities. There was no evidence of organic block or dermal reflux.
Eliminating Lidocaine from Large-Volume Tumescent Liposuction
Authors: Mangubat E. Antonio
Published: January 2017

Introduction:

The introduction of tumescent anesthesia in 1987 was a major milestone in liposuction history. The technique provided local anesthesia for large areas of liposuction as well as virtually eliminating significant blood loss. With the acceptance of tumescence as a standard in liposuction surgery, surgeons have begun infusing ever-increasing amounts of tumescent fluid and aspirating volumes of fat considered impossible to remove only a decade ago. Large-volume tumescent infusion delivered concomitantly large loads of lidocaine, almost an order of magnitude greater than the maximum load recommended in the Physicians' Desk Reference. Complications are inevitable with lidocaine levels this high. Large-volume liposuction can result in lidocaine toxicity with tumescent anesthesia. This study evaluated whether removing lidocaine from the tumescent formula increases the safety and extends the efficacy of large-volume liposuction by eliminating the danger of lidocaine toxicity.

Methods and Materials:

A retrospective review of 105 patients undergoing large-volume liposuction with a tumescent infusion of greater than 10 L was performed. A high incidence (71%) of nausea and vomiting was noted in 24 patients undergoing large-volume liposuction under tumescent anesthesia with Klein solution. Because of the possibility of toxicity, lidocaine was eliminated from the tumescent formula and anesthesia was provided with epidural block.

Results:

A total of 105 patients undergoing large-volume liposuction were studied; 24 had tumescent anesthesia and 81 had epidural anesthesia and tumescent infusion of epinephrine 1:1000 000 concentration without lidocaine. The incidence of nausea and vomiting dropped from 71% to 14% when lidocaine was removed.

Conclusion:

The possibility of toxicity is virtually eliminated when lidocaine is removed from the tumescent formula and when regional or general anesthesia is used. This allows the surgeon to infuse a greater volume of tumescent solution and remove a larger volume of fat with increased safety.
Abdominal Liposuction in a Patient with a Colostomy
Authors: Raskin Bernard I.
Published: January 2017

Introduction:

Liposuction surgery is associated with a low incidence of infection. Abdominal liposuction is rarely performed in patients with a colostomy, which presents a possible source of infection.

Case Report:

A patient with a colostomy had 2 liposuction procedures performed without a postoperative infection.

Conclusions:

Liposuction surgery can be performed in patients with a colostomy. Risk of infection is minimized if proper sterile draping and prophylactic antibiotics are used.
Conference Report - Empirical Investigation of Social Space II University of Bonn, 12-14 October 2015
Authors: Blasius Jörg , Schmitz Andreas
Published: January 2017

In October 1998, the first international conference on “Empirical Investigation of Social Space” was held in Cologne, Germany. The motivation was to bring together social scientists interested in both traditional and modern methods of constructing social spaces, in line with the work of Pierre Bourdieu. A particular focus was put on methodological and statistical research on correspondence analysis and its application within the social sciences. This contribution reports on the second conference was held in October 2015 in Bonn, Germany.
Agent Cultures and Zombielands – 23-25 June 2016 Leuphana Conference
Authors: Vigni Fabrizio Li
Published: January 2017

This article reports the content of the talks that constituted a three days conference on agent-based modelling (or ABM), held at Leuphana University in Lüneburg, Germany, from 23 to 25 June 2016 (Agent Cultures and Zombielands, 2016). Participants came from several disciplines, such as philosophy, sociology, history, politology, epidemiology, and other areas where ABM are employed. Despite the disciplinary and opinion differences, the dialogue between attendants was always respectful and fruitful. ABM genealogy, epistemology, applications and socio-political implications were discussed. Nonetheless, some more ethnographical accounts were missing, especially on the effects of collaborations – that already exist – between ABM modellers and public or private organisms.
What about Becker?
Authors: Blanc Julie , Hartemann-Piollet Guillaume , Le Mer Hadrien
Published: January 2017

Invité à l’École Normale Supérieure de Lyon, Howard Becker (2014) présente son dernier ouvrage ( What about Mozart?) dans lequel il illustre le raisonnement par cas comme méthodologie privilégiée d’analyse du social. Tout en refusant de s’inscrire dans la filiation de l’École de Chicago, H. Becker insiste sur le métier de sociologue en tant que praxis. L’une des principales ficelles beckerienne (2002) consiste à prendre au sérieux la multiplicité des déterminismes à l’œuvre dans un cas particulier, sans jamais renoncer à l’éclairage que peut apporter la comparaison. Si la rigueur scientifique est indispensable pour mener à bien le raisonnement par cas, l’inspiration continue d’avoir une place irréductible dans le processus d’écriture sociologique.
Five opportunities for healthcare leaders to better support person- and family-centred care in long-term care settings
Authors: Bender Danielle , Lui Kai Yan Grace , Holyoke Paul
Published: January 2017

The benefits of Person- and Family-Centred Care (PFCC) are well documented, and many healthcare organizations have expressed their commitment to take this approach. Yet, it can be a difficult endeavour, with common barriers identified at the point-of-care, organizational and system levels. We implemented a PFCC education program with healthcare leaders, providers, and support staff working in home, community, and long-term care organizations across Canada. Focus groups were then conducted with almost 200 workshop participants and 20 long-term care home residents and family members. Five key opportunities for healthcare leaders to better support the provision of PFCC were revealed. In this article, specific recommendations from focus group participants for addressing each of these five opportunities are provided. These findings can assist healthcare leaders to proactively ensure the supports and processes are in place to enable staff to provide care in a more person- and family-centred way.
The dementia-friendly emergency department
Authors: Parke Belinda , Hunter Kathleen F.
Published: January 2017

Emergency Departments (EDs) are an integral part of the Canadian healthcare system. Older people living with dementia challenge EDs. They have complex health profiles that pose multiple challenges for staff. The current one-size-fits-all approach that aids efficiency in a technologically dependent hospital setting may not always serve older people living with dementia, their caregivers, or staff well. The premise that older people living with dementia are a problem for Canadian EDs must be reconsidered. Understanding the complexity of the situation is aided by the dementia-friendly ED framework. We propose one way to enhance communication between those living with dementia who receive ED services and those providing the service.