Smith RC

In this article, face lift, forehead lift, and blepharoplasty procedures are addressed. Special emphasis is made on anatomical and surgical guidelines. Some results and complications of the different procedures are presented.…

Medical-grade injectable silicone has been safely and efficiently used for facial soft-tissue augmentation in 235 patients. Our 20-year experience with the microdroplet technique included 2,811 treatments performed for camouflaging furrows …

The effects of cigarette smoking on the skin flaps of the face lift procedure are discussed. Reported elsewhere is a significant incidence of skin slough in smokers with use of wide undermining techniques. This complication is thought to be…

A new rapid strength loss catgut suture material can be used for skin closures in wounds of the face and body. Seventy-six comparisons were made under controlled conditions between the new material and one formerly recommended. The new mate…

We describe nonabsorbable sutures running from one or more sites in the superficial musculoaponeurotic system (SMAS), to other sites at a distance, or to fixed sites beyond or deep to SMAS for the purpose of pulling on or suspending the dis…

We describe the technical details used in applying nonabsorbable sutures running from the anterior platysma muscles and/or adjacent fascia back to the fascia just in front of or covering the sternocleidomastoid muscles. These sutures usuall…

One theory in cheek-neck lifting is that it is necessary to undermine skin flaps widely to achieve adequate short and long term results. We have proven that extensive undermining allows no more skin to be excised than is permitted by more c…

Based on examination of many necks and observations at surgery and on cadavers, we believe that "platysma cords"' or cervical folds are normal when the muscles are being contracted. In the aged, they do not disappear when the muscle is rela…

It is thought that plicating or folding the superficial musculoaponeurotic system (SMAS) upon itself near the ear with permanent sutures will improve and help maintain the results of cheek-neck lifting of the skin layer alone. Getting proof…

The factors and differences in incisions for face-lifting in women and men are presented and discussed in detail. The recommended approaches hide scars effectively, allow the hair growing in front of the ear to be left in its original locat…

The iconoclast is an instrument that facilitates blunt dissection in areas where this basic technique is difficult because of anatomical or postsurgical adherence. Medical and inferior undermining in augmentation mammaplasty in primary and …

Some patients coming for esthetic blepharoplasty should have one of three supplemental procedures performed to elevate or change the position of the eyebrows. The most precise eyebrow alterations are effected with brow lifting procedures, b…

Lateral canthopexy using permanent suspending sutures to shorten the lateral canthal tendon helps prevent scleral show, increased sloping of the upper lid, and inferomedial displacement of the lateral canthus following lower lid blepharopla…

Otolaryngology shares responsibility for provision of plastic surgical services involving facial and cervical structures, but many training programs have been weak in this part of the specialty. Some still are. Beginning in 1963 when a nati…

Many surgeons have difficulty in cutting small split thickness skin grafts of consistent thickness and width. We demonstrate techniques using equipment and supplies almost always available for expeditious cutting and handling of small split…

Blepharoplasty on lower lids frequently results in a downward pull on the free border of the lid and inferomedially on the lateral canthus. Extending the incision in the lower lid upward and lateral to the outer canthus allows most of the e…

We have shown the use of two techniques for preventing or treating undesirable sequelae noted so often following the closure of gouging or beveled U- or V-shaped flaps. These simple expedients have prevented "trap door deformities" in many …

Excisions from the face are performed to cure diseases and to remove blemishes. Satisfactory cosmetic appearances can be achieved in most cases, even when large defects result from the excisions, if the surgeon employs cosmetic surgical pri…

Brow modifications are discussed with respect to their role as aids in achieving certain aesthetic effects when rhinoplasty is being performed. If a deep nasofrontal angle should not be brought forward, reduction of the brow may be indicate…

Implants placed in subperiosteal pockets may erode more deeply into the mandible than those placed above the periosteum. Those positioned supraperiosteally are more likely to shift and certainly are more mobile when pressure is put on the c…

An anteriorly-based lateral chest flap gives volar coverage to the opposite denuded hand, while a flap from the adjacent inner arm gives dorsal coverage. While transferring the flaps, the donor sites are joined together to form a temporary …

For many years, we have used 6-0 catgut for closure of epithelial and superficial dermal wound edges. Only when absolutely necessary do we use deeper dermal or subcutaneous sutures. The superficial suturing is supplemented with antitension …

Face lift surgery almost always is elective; and, because its purpose is to diminish aging problems, it most often is done in those who are aged. Local and general risks, therefore, should be minimized. Wide undermining dictates flaps disse…

Conventional closure of surgical defects in skin may cause unsightly protrusions (dog ears). Fusiform excisions with angles of 30 degrees or less reduce protrusion but may require excision of larger volumes and lengths of healthy skin and s…