Perkins SW

In this article, Dr. Stephen W. Perkins, a seasoned facial plastic surgeon, presents his refined techniques in facelift surgery developed over four decades of practice. His evolution from traditional methods to the current composite tissue …

Over the past four decades, the senior author has evolved and perfected his preferred method for face and neck lifting, the extended superficial musculoaponeurotic system deep plane rhytidectomy, and submentoplasty. With this procedure, the…

 Preoperative imaging provides an advantageous balance by helping patients to effectively communicate their aesthetic desires while allowing surgeons to establish realistic expectations of surgical outcomes.  To determine the role of preop…

Management of the platysma is key to achieving an ideal neck contour during rhytidectomy. This article reviews platysmal anatomy, indications for platysmaplasty, preoperative patient assessment, surgical technique for midline platysmaplasty…

Facelift or rhytidectomy has been performed in some form for over 100 years. This article seeks to explore the evolution of this surgical procedure, focusing on the advances of the most recent 40 years. From minimal intervention to aggressi…

[IMPORTANCE] Rhytidectomy, or face-lift surgery, is the mainstay of facial rejuvenation and is constantly evolving. There is continuous research to improve outcomes and minimize complications of this surgery. [OBJECTIVE] To synthesize the …

Achieving a more youthful neckline is one of the most common reasons why patients seek facial plastic surgery. A variety of treatment options are available to contour the neck, ranging from injectable medications to minimally invasive energ…

Hump reduction is one of the most common reasons patients seek cosmetic rhinoplasty. Spreader grafts or spreader flaps have become a key maneuver in supporting and reconstructing the nasal midvault after reductive profileplasty to prevent l…

The ability of a surgeon to create an aesthetically pleasing and functionally competent nasal dorsum weighs heavily on following the foundations of rhinoplasty, beginning with the examination and analysis. These same fundamental principles …

This article addresses several facelift challenges involving anatomic conditions, including platysma banding, endomorphic facial habitus, and midface hypoplasia. In addition, patient counseling and conveying realistic expectations about lim…

Thick skin presents a unique set of challenges within the realm of facial plastic surgery, and addressing the lower lid complex is no exception. There are several procedures for addressing the lower lids, the first and foremost being lower …

[IMPORTANCE] Transcutaneous lower eyelid blepharoplasty is a commonly performed procedure with a postoperative risk of eyelid malposition. [OBJECTIVE] To quantify the change in lower eyelid position after transcutaneous lower eyelid blepha…

Surgical management of the aging upper face has taken on a critical role in total facial rejuvenation, with a variety of techniques available. The hallmarks of the aging upper third of the face and periorbital region most commonly manifest …

Jowling, submental lipoptosis, and platysmal banding can affect self-image and reduce quality of life, leading one to seek facial and neck rejuvenation. With realistic expectations, a facelift can provide the desired improvement in appearan…

[IMPORTANCE] Direct transcutaneous resection has been a widely accepted standard for the removal of benign forehead lesions. In recent years, the endoscopic approach has become more prevalent because of its noninvasiveness. To date, only a …

[OBJECTIVE] A quantitative comparison of immediate and long-term results of surgical correction of the senile upper lip using lip advancement and lip lift. [METHODS] Retrospective review of 30 patients who underwent senile upper lip repair…

Surgical approaches for rhytidectomy continue to evolve. For the past 26 years, the senior author has used a graded approach in combination with the modified deep-plane facelift, consistently achieving natural-appearing results and satisfie…

The authors recommend carbon dioxide (CO(2)) laser resurfacing as an excellent tool for treatment of aging skin, especially when used for moderate to severe facial rhytids, explaining that some of the commonly cited disadvantages of this mo…

In many facial plastic surgery cases, the downward turn to the corner of the mouth can be the single remaining aging factor that "spoils" an otherwise excellent rejuvenative surgical effort and is the area patients report that they wish tha…

Careful analysis of a rhytidectomy patient is an important aspect of facial plastic surgery. Surgeons and physicians are successful when they diagnose patients correctly and apply the correct treatment plan. The skilled facial plastic surge…

[BACKGROUND] The combination of facial rhytidectomy and full-face carbon dioxide laser resurfacing would theoretically provide for superior aesthetic rejuvenation of the face, but some reports have advised against this combination (particul…

Achieving the "natural look" in rhytidectomy and satisfying my aging face patient population are the primary motivating factors that have guided me to develop my personal philosophy and technique for facelifting. The following article will …

We conducted a survey of physician members of the American Academy of Facial Plastic and Reconstructive Surgery to determine the incidence and nature of facial traumas seen in their practices. We solicited information on the anatomic locati…

During the past 20 years, a variety of alloplastic materials have been introduced for chin augmentation. Mersilene mesh (Ethicon, Sommerville, NJ), introduced in 1950, demonstrates many qualities that make it an ideal implant. This article …

[OBJECTIVE] To evaluate the rate of hematoma and seroma formation in a series of rhytidectomies performed with and without the use of intrawound vacuum drains. [DESIGN] Retrospective chart review of 222 consecutive face-lifts performed by …

Cosmetic blepharoplasty is directed at the surgical correction of undesirable changes of the eyelids that are usually of an acquired nature and caused by aging. The goals are to improve the appearance and, many times, the function of the ey…