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The Keystone: Consistency in Restoring the Aesthetic Dorsum in Rhinoplasty.
The keystone represents the union of six distinct anatomical structures between the bony vault and the cartilaginous midvault. In reshaping the nasal dorsum, the individual components of the nose respond variably as the fusion points of the…
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Middle Eastern Rhinoplasty: Update.
Middle Eastern rhinoplasty requires especially precise preoperative planning to achieve a successful result. Among all aesthetic surgery procedures, there is a higher demand for rhinoplasty among Middle Eastern cultures. The key is to maint…
- Defining Outcomes Articles for the Journal.
- Reply: Public Perception of Cosmetic Surgeons versus Plastic Surgeons: Increasing Transparency to Educate Patients.
- So, You Want to Be a Success? Aspire, Inspire, and Perspire-A Lot!
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Gender Differences in the Professional and Personal Lives of Plastic Surgeons.
[BACKGROUND] Although the number of women becoming plastic surgeons has increased during the past six decades, in comparison with the current gender parity in medical schools, plastic surgery still attracts disproportionately more men. Prev…
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Facial Assessment and Injection Guide for Botulinum Toxin and Injectable Hyaluronic Acid Fillers: Focus on the Midface.
This second article of a three-part series addresses techniques and recommendations for aesthetic treatment of the midface. Injectable fillers are important for rejuvenation of the midface by replacing lost volume and providing structural s…
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The Modern Male Rhytidectomy: Lessons Learned.
[BACKGROUND] Cosmetic surgery among male patients has become increasingly popular. The face-lift technique is different in male patients, specifically regarding preservation of hair follicles, restoration of a youthful and well appearance, …
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Neck Rejuvenation through the Lateral Platysma Window: A Key Component of Face-Lift Surgery.
Rejuvenating an aged face relies on maintaining facial harmony to provide optimal aesthetic results. Restoration of more youthful facial contours is dependent on blending the aesthetic facial topographic units. Many authors continue to deba…
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Making Sense of Implant "Profile" in Breast Augmentation.
The increasing variety of breast implants has led to their classification into "profile" types to guide implant cataloguing and selection. Implant "profile" describes the overall silhouette of the implant. It represents a permutation of all…
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The Six-Step Lower Blepharoplasty: Using Fractionated Fat to Enhance Blending of the Lid-Cheek Junction.
Lower lid blepharoplasty is one of the most complex procedures performed by plastic surgeons and may cause significant long-term sequelae, including inadequate aesthetic outcomes if not performed with a thorough understanding of anatomy and…
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The Importance of the Anterior Septal Angle in the Open Dorsal Approach to Rhinoplasty.
Functional and aesthetic manipulation of the nose relies on a detailed understanding of nasal anatomy and a meticulous dissection. Maneuvers are performed in four regions of the nose: nasal tip, dorsum, posterior septum, and caudal septum. …
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Preventing Soft-Tissue Triangle Collapse in Modern Rhinoplasty.
The unique anatomy of the soft-tissue triangle makes it prone to notching in primary, secondary, and reconstructive rhinoplasty. Understanding the anatomy of the region is critical to appropriate treatment. This article is meant to further …
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Finesse in Nasal Tip Refinement.
Nasal tip refinement is one of the most difficult aspects of rhinoplasty surgery. In this article, the senior author (R.J.R.) presents his technique for nasal tip analysis and identifies the factors that contribute to nasal tip shape. Vario…
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Implications of Facial Asymmetry in Rhinoplasty.
[UNLABELLED] Many rhinoplasty patients present with a chief complaint of nasal deviation and are unaware of any inherent facial asymmetries; however, recognizing and discussing the interrelation between the deviated nose and facial asymmetr…
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Rhinoplasty Refinements: The Role of the Open Approach.
The open rhinoplasty technique facilitates accurate visualization of deformities and aesthetic disharmonies in addition to visualization for precise correction. Through a series of videos, this case represents the evolution of the open rhin…
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Managing Alar Flare in Rhinoplasty.
[UNLABELLED] Alar flare is a common feature that contributes to the width of the lower third of the nose. In the right patient, alar flare reduction can improve nasal harmony and facial aesthetic balance; however, it is also difficult to co…
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Public Perception of Cosmetic Surgeons versus Plastic Surgeons: Increasing Transparency to Educate Patients.
[BACKGROUND] The American Society of Plastic Surgeons' "Do Your Homework" campaign strives to educate the public on how to identify providers who can safely perform aesthetic/cosmetic/plastic surgery. Although the campaign continues to heig…
- Will the Real Cosmetic Surgeon/Physician Please Stand Up?
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Evidence-Based Medicine in Aesthetic Surgery: The Significance of Level to Aesthetic Surgery.
Since its popularization in the 1980s, evidence-based medicine has become the cornerstone of American health care. Many specialties rapidly adapted to the paradigm shift of health care by delivering treatment using the evidence-based guidel…
- Just Because You Can, Doesn't Mean You Should.
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Current Uses of Botulinum Neurotoxins in Plastic Surgery.
[LEARNING OBJECTIVES] After reading this article, the participant should be able to: 1. Recognize the various types of botulinum toxins and their differences. 2. Identify current indications, both approved and off-label. 3. Inject botulinum…
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Advancements and Refinement in Facial Neuromodulators.
The use of neuromodulators has increased by approximately 748 percent from 2000 to 2014 and has become an integral adjunct for facial rejuvenation. Knowledge of facial anatomy, accurate facial analysis, and familiarity with neurotoxin chara…
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Ear Lobule Rejuvenation in Face-Lifting: The Role of Fat Augmentation.
[BACKGROUND] Ear lobule ptosis and deflation are characteristics of facial aging. A rhytidectomy without rejuvenation of a deflated ear lobule may fail to address all aspects of facial aging. Fillers have been used to treat ear lobule defla…
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Gynecomastia Management: An Evolution and Refinement in Technique at UT Southwestern Medical Center.
Gynecomastia is a benign proliferation of male breast glandular tissue. Gynecomastia can affect men at any stage of life. Traditional treatment options involved excisional surgeries with periareolar or T-shaped scars, which can leave more v…
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Liposuction-Assisted Short-Scar Brachioplasty: Technical Highlights.
Upper arm contouring is based on the location and amount of excess skin and fat. The short-scar brachioplasty addresses minimal to moderate skin laxity and lipodystrophy in the proximal arm in patients with appropriate skin tone and quality…
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Revisiting the Management of Capsular Contracture in Breast Augmentation: A Systematic Review.
[BACKGROUND] Capsular contracture is a complication of breast augmentation that frequently requires revision surgery. "Capsulectomy, site change, and implant exchange" has been referred to as the gold standard treatment of clinically signif…
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The Crooked Nose.
Correction of a crooked nose is one of the most common requests from patients presenting for rhinoplasty. Both esthetic and functional issues are typically present in patients with this deformity. Rhinoplasty for the crooked nose is particu…
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Alar Contour Grafts in Rhinoplasty: A Safe and Reproducible Way to Refine Alar Contour Aesthetics.
[BACKGROUND] Alar rim deformities such as retraction, notching, collapse, and asymmetry are common problems in rhinoplasty patients. Although alar rim deformities may be improved through rhinoplasty, this area is prone to late changes becau…
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Role of the Cephalic Trim in Modern Rhinoplasty.
There have been a variety of techniques describing nasal tip refinement. The cephalic trim has long been accepted as a means for shaping the nasal tip, but it has been misinterpreted by many surgeons. The improper use of a cephalic trim pos…