Midface and Neck Aesthetic Plastic Surgery_Vol 2

CHAPTER XI - AGEING OF THE ORBITO-MALAR REGION
	The physiognomy of the malar region
	Our philosophy regarding midface ageing
	Midface = orbito-malar area
	Implants
		Implantech prostheses
		Some practical anatomical details
	Dissection of the malar region in an anatomical specimen
	Choosing the implant
		Indications for different implants
	Surgical techniques
		Intraoral approach
	The limits of the pocket
		The transpalpebral approach
		The preauricular approach
		Surgical techniques
			Closing the pocket without any manoeuvres on the S M A S
			Closing the pocket and associating a SMAS plication
			Closing the pocket and associating a SMAS plication
		A didactic-anatomical explanation
			Placing the lateral part of the implant in the deep subcutaneous layer covered by
 the SMAS fla p
			Increasing the volume in the lateral zygomatic area by creating a dog ear plication
			Contemporaneous fat grafting
			Lipofilling performed separately at a later s ta g e
	Lipofilling in the midface
	The orbital region
		Some examples of patients belonging to the first cla ss
		Some examples of patients belonging to the second c la s s
		Some cases of patients in whom a midface lifting was associated to augmentation
 malarplasty with some intraoperative images to show some of the manoeuvres exposed
 above
		Clinical cases
		A surgical sequence of a midface lifting with an associated augmentation malarplasty
CHAPTER XII - SOME CONSIDERATIONS ON PROMINENT EYES
	Orbital and malar prominence
	Measuring the malar prominence
	Identifying the optimal treatment strategy for these cases
	Technical suggestions for the upper eye lid
		Lipofilling of the eyebrows area
		Limited or non-removal of cutaneous and muscular tissue
		Canthopexy
		Fat grafting
	Technical suggestions for the lower eyelid
	The vertical dimensions of the eyelids in patients with prominent eyes
		Lack of skin
		Hypotone of the orbicularis muscle
		Slackening of the fibro-ligamentous structures
		Shortness of internal lamella
	Fat grafting
		Improper fat positioning
		The formation of a bolus
		The “mulberry effect"
CHAPTER XIII - SURGICAL TREATMENT OF AGEING IN THE NECK
	Criteria of beauty of the neck
	The various layers of the neck
	I - The skin
		Skin undermining
	1st Class
		The extent of skin undermining in 1st class patients
	2nd Class
		Extent of skin undermining in 2nd class patients
	3rd Class
		The thickness of the flap
	Some considerations on treatment of the deep layers
		A didactic-anatomical explanation
	Some considerations on limited undermining technique
	II - The subcutaneous adipose tissue
		Infraauricular and submandibular lipectomy
	III - The superficial muscular layer (the platysma muscle)
		Undermining the muscle
			Some observations on the surgical anatomy of the platysma
			Undermining of the platysma: surgical techniques
			Why undermine the platysma
		Traction vectors
		The sections
			Lateral section
			Anterior section
			Complete section
		The level of muscular section
			Observations on neuro-muscular complications in the region
			Platysmal bands
		Sutures
			Anterior sutures
			Lateral sutures
			Central sutures
		Plication and imbrication
			Cranial suspension by undermining and imbrication
			The technique of cranial suspension by plication
	Application of plications and imbrications in special cases
	Plications and imbrications in particular cases
	IV - The deep adipose tissue
		Subplatysmal lipectomy
	V - The submandibular gland
	VI - The deep musculo-fascial layer
		The digastric muscles
		The mylohyoid muscles
		The perihyoid fascia
	The mandibular contour
	The anterior mandibular region
		Some psychosocial considerations
		An implant versus an osteotomy
		Implantech protheses for augmentation mentoplasty
		Mental ptosis (witch’s chin)
	The mid mandibular region
		Lateromental depressions
		Lateromental bulges
	The posterior mandibular region
		Surgical techniques
	An intraoperative photographic sequence of a cervico-facial lift
	Cervico-facial lifting with SMAS - platysma plication
	Cervico-facial lifting with imbrication of the SMAS and lateral section of the platysma
	Anterior cervicoplasty, complete section of the platysma, plication, deep  lipectomy and corsetplasty
	Submandibular gland reduction
		Clinical cases
BIBLIOGRAPHY
ANALYTICAL INDEX