R J Rohrich

..J.R.) with a specific focus directed toward the effect of the columellar strut on final tip position, namely, tip projection and tip rotation...

..Optical Diffusion Imaging Spectroscopy (ViOptix T.Ox Tissue Oximeter) measures the ratio of oxyhemoglobin to deoxyhemoglobin over a 1 x 1 cm area to obtain a non-invasive measurement of perfusion (StO2)...

..Botulinum toxin, derived from Clostridium botulinum, is the most widely used agent; therefore, this new modality, its applications in cosmetic plastic surgery, and its applications to other areas will be discussed...

..CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV...

..Case examples are analyzed also. A description of nondestructive suturing techniques and cartilage grafts to restore nasal tip symmetry is provided for each deformity. An open rhinoplasty approach is advocated in all cases...

..These tools should allow plastic surgeons to produce a balanced harmonious nose in relation to the rest of the face...

..Education and preoperative demonstration can help prevent medicolegal ramifications. The umbilicus is rarely midline and, when critically analyzed, is located lateral to the midline axis more often than not...

..This article reviews the literature with particular respect to the transcutaneous approaches of subciliary versus subtarsal techniques in the treatment of orbitozygomatic fractures...

..During postoperative recovery, care and reassurance combined with an ability to recognize and manage complications lead to successful outcomes following rhinoplasty...

..This has detracted surgeons from performing the technical maneuvers necessary for optimal periorbital rejuvenation. A simplified, "five-step" clinical approach based on sound anatomical principles is presented...

..Becoming familiar with the common anatomic differences as well as the aesthetic goals in the ethnic rhinoplasty patient will assist the surgeon in attaining consistent, ethnically congruent, and aesthetically pleasing results...

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..The authors provide a systematic approach to evaluation and improvement of surgical outcomes in this patient population...

..Understanding the concept of "facial shaping" with respect to symmetry and soft-tissue (fat) distribution preoperatively is critical to optimizing aesthetic outcomes in various face lift techniques...

..Current hyaluronic acid fillers do not require preinjection skin testing and produce reproducible, longer-lasting, nonpermanent results compared with other fillers, such as collagen...

..The purpose of this article is to review the literature regarding the psychological impact of breast augmentation and assesses current scientific findings, with emphasis on the validity of suicide risk in breast augmentation patients...

..The authors created a simplified anatomic approach to the most common cervical deformities encountered in the patient seeking facial rejuvenation...

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..The results of this survey have been used to create a quantitative decision-making framework or a "road map" for patients and plastic surgeons to use for navigating toward successful long-term results...

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..Plastic surgeons should weigh the advantages and limitations of each technique to correctly address breast ptosis. This article reviews an algorithmic approach to correct all degrees of ptosis with mastopexy...

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..Specific case analyses are presented to demonstrate utilization of the technique...

..This article discusses the safe approach to revision reduction mammaplasty. Current concepts are discussed and presented. An algorithm for decision-making is presented and discussed...

..Concepts in nasal reconstruction are reviewed, and the authors' approach to alar reconstruction is presented...

..This article describes the role of the external perforated osteotomy technique in reproducing consistent results in rhinoplasty with minimal postoperative complications...

..2. The etiology and epidemiology of rhinophyma. 3. Associated diagnosis that can complicate rhinophyma. 4. Common nonsurgical and surgical therapies for rhinophyma. 5. A safe and integrated treatment plan for the patient with rhinophyma...

..No clear consensus exists on how best to treat these individuals. Advancements in wound healing research and smoking cessation aids will provide more insight into this treatment dilemma...

..A sound appreciation of the blood supply to the nasal tip and adherence to the guidelines presented above will prevent vascular compromise of the nasal tip skin...

..These cases also delineate how to prevent and/or minimize deformities after liposuction...

..This article addresses the underlying pathophysiology of xanthelasma and the currently accepted modes of treatment...

..Over the past 14 years, the senior author (R.J.R.) has performed inferior turbinates surgery on 648 patients as part of a rhinoplasty...

..Excisional techniques are reserved for severe gynecomastia with significant skin excess after attempted ultrasound-assisted liposuction...

..Using an individualized algorithmic approach with intraoperative nasal tip analysis and three nasal tip suture reshaping techniques, consistent aesthetic results can be obtained in the correction of the boxy nasal tip...

..An operative algorithm is described that emphasizes simplicity and reproducibility, and case studies demonstrate the results that can be achieved with this approach...

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..Numerous variations in the evolution of brachioplasty have been described to improve on complications and outcomes. Liposuction-assisted posterior brachioplasty is the next step in the series of refinements in upper arm contouring...

..Those patients who were unsatisfied and were less likely to refer patients were those who had the lowest opinion of their appearance...

..This study presents a detailed three- and four-dimensional appraisal of the arterial and venous anatomy and perfusion of the anterolateral thigh flap using a novel computed tomographic technique...

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..Forehead vasculature has been studied; however, anatomical relationships to the forehead flap have not been adequately examined. This anatomical study evaluated the vascular anatomy of the paramedian forehead flap...

..CONCLUSION: The authors discuss the nasal component of naso-orbital ethmoid complex injuries and detail the key principles in their algorithm for aesthetic nasal reconstruction...

..Observations in the anatomy laboratory suggested the presence of discrete regions of subplatysmal fat. This information may be useful during surgical procedures in the subplatysmal plane...

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..This study also demonstrated a reliable animal model for future investigation into examining novel applications for augmenting fat graft survival...

..This article discusses the anatomic and aesthetic considerations of alar rim deformities and the indications and the surgical technique for the alar contour graft...

..In the office setting, this priority requires both administrative and clinical emphasis. The physician who gives the healing touch of quality care must always have patient safety as the foremost priority...

..The resulting asymmetries should then be discussed with the patient, along with the potential for continued or even more pronounced asymmetry postoperatively...

..This review will present a practical approach to the management of the nose in the aging patient...

..This low incidence of revision is attributed to complete nasal assessment (bony and septum), use of outpatient controlled general anesthesia, and primary septal reconstruction in cases with severe septal fracture dislocation...

..These design modifications enhance the aesthetic result and simplify the use of this flap in dorsal nasal reconstruction...

..By educating and providing guidelines to those patients who smoke and by refusing to operate on individuals who fail to abstain, tobacco-associated surgical morbidity in the plastic and reconstructive surgery patient can be eliminated...

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..Further experimental studies are necessary to evaluate the role and efficacy of alternative techniques for body contouring...

..Finally, an algorithm is presented to guide the surgeon in selecting the optimal reconstructive technique...

..The overall complication rate was 4 percent (4 of 94). Our early results by using acellular allogeneic dermal grafts for lip augmentation are encouraging. Further studies are under way to better objectively define long-term results...

..The low rate of clinically significant fistula was attributed to early delayed primary closure, with smaller secondary clefts allowing repair with a minimum of dissection and disruption of vascularity...

..Fat tissue transfers from these common sites may be considered equal, and centrifugation does not appear to enhance immediate fat tissue viability before implantation...