Pearls and Pitfalls in Cosmetic Oculoplastic Surgery

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Title Page......Page 3
Copyright Page......Page 4
Foreword......Page 5
Preface......Page 7
Table of Contents......Page 8
Contributors......Page 21
1 Preoperative Evaluation of the Cosmetic Patient......Page 31
Reference......Page 33
Manage the Balance of Power Between Doctor and Patient......Page 34
Determine Realistic Surgical Goals......Page 35
Screen Out the Diffificult Patient......Page 36
Conduct a Thorough Informed Consent......Page 37
Create an Aesthetic Environment......Page 38
Bupivacaine......Page 42
EMLA......Page 43
References......Page 44
Facial Nerve Blocks......Page 45
References......Page 48
Frontal Nerve Block......Page 49
Zygomaticofacial Nerve Block......Page 50
Monitoring......Page 54
Antagonists/Reversal Agents......Page 55
References......Page 56
Selection of Local Anesthesia......Page 60
Procedure......Page 61
References......Page 62
11 Upper Eyelid Blepharoplasty: The Evaluation......Page 65
15 Orbit Size and Lid Marking in Upper Blepharoplasty......Page 74
17 Marking the Proposed Upper Eyelid Crease: Determining the Safe Amount of Skin Removal—The Pinch Technique......Page 79
19 Keys to Success When Marking the Skin in Upper Blepharoplasty......Page 83
20 Skin Marking in Upper Blepharoplasty—Avoiding Pitfalls......Page 86
25 Fewer Hematomas in Upper Blepharoplasty......Page 95
26 Blepharoplasty Incisional Modalities: 4.0 Radiowave Surgery vs. CO2 Laser......Page 100
Results......Page 101
References......Page 102
27 Fat Preservation and Other Tips for Upper Blepharoplasty......Page 103
28 Asian Blepharoplasty......Page 106
29 Internal Brow Elevation with Corrugator Removal......Page 111
39 Lower Eyelid Blepharoplasty: The Evaluation......Page 131
Step 2: “V” Suture Lateral Lower Eyelid Horizontal Tightening After Creation of the Eyelid (skin muscle)–Cheek Flap with the Carbon Dioxide Laser......Page 137
Rationale for the Three-Step Procedure......Page 139
Pearls......Page 140
References......Page 144
Reposition the Eyelid and Ballottement to Look for Any Residual Bulging Fat......Page 155
50 The Treatment of Festoons in Lower Blepharoplasty......Page 159
Surgical Technique......Page 164
Complications......Page 166
Comments......Page 167
References......Page 171
Procedure......Page 172
Postoperative......Page 173
Conclusion......Page 174
References......Page 175
56 Use of Tisseel in Lower Eyelid Blepharoplasty with Fat Repositioning......Page 178
Fat-Repositioning Procedure......Page 181
58 Managing Postblepharoplasty Lower Eyelid Malposition......Page 186
References......Page 189
59 Retroauricular Dermal Spacer Graft for Lower Lid Retraction Repair......Page 190
Indications......Page 193
Stage 1......Page 194
Conclusions......Page 195
References......Page 200
Surgical Technique......Page 201
References......Page 203
Local Infifi ltration......Page 210
Avoiding Anesthetic Toxicity......Page 211
References......Page 212
68 Endoscopic Forehead Rejuvenation: Equipment and Setup......Page 215
Paracentral Incisions......Page 218
Prevention of Alopecia......Page 219
71 Endoscopic Midforehead Techniques: Improved Outcomes with Decreased Operative Time and Cost......Page 222
72 Fifteen Principles of Enhanced Success in Endoscopic Browlift......Page 226
Suggested Reading......Page 228
Dissection of Temporal Space......Page 229
Release of Periosteum......Page 230
Temporal Lift......Page 236
Temporal Dissection and Release of the Periosteum and Lateral Supraorbital Orbicularis Oculi Muscle......Page 237
Brow Elevation and Fixation......Page 238
Results (Before and After Photographs)......Page 239
Surgical Technique......Page 245
Conclusions......Page 247
References......Page 251
79 Scalp Fixation in Endoscopic Browlift......Page 252
Suggested Reading......Page 254
Patient Selection......Page 259
Conclusion......Page 260
Introduction......Page 263
Conclusions......Page 264
References......Page 267
86 The Subperiosteal Mid-Face Lift Using Bioabsorbable Implants for Fixation*......Page 273
References......Page 279
88 Mid-Face Implants......Page 282
Modifying the Position of the Lateral Eyebrows......Page 315
Treating Eyebrow Asymmetry......Page 316
Conclusion......Page 317
References......Page 318
109 Botox Injection to the Lacrimal Gland for the Treatment of Epiphora......Page 325
Preparations......Page 333
Expectations......Page 334
115 List of Fillers......Page 337
Anesthesia......Page 348
Anatomic Guidelines......Page 349
Technique......Page 350
Summary......Page 351
References......Page 352
121 Liquid Injectable Silicone for the Upper Third of the Face......Page 355
References......Page 358
General Principles......Page 360
Calcium Hydroxyapatite......Page 361
123 Pearls and Pitfalls of Botox and Filler Substances in the Upper Third of the Face......Page 364
References......Page 369
125 Pearls for Periorbital Fat Transfer......Page 372
Background......Page 381
Suggested Reading......Page 383
130 Evaluation of Skin Lesions in the Cosmetic Patient Made Simple: Actinic Keratosis......Page 384
131 Chemical Peels for Facial Rejuvenation......Page 387
132 Nonablative Laser and Light Facial Rejuvenation......Page 390
Infrared vs. Pulsed Dye......Page 391
KTP or Frequency-Doubled Nd:YAG laser (532 nm)......Page 392
Low Intensity Sources......Page 393
Laser and Light Sources for Skin Rejuvenation......Page 394
Surgical Planning......Page 397
Postoperative Care......Page 398
Technology......Page 403
Patient Selection......Page 404
Treatment......Page 405
Conclusion......Page 406
139 Dual-Mode Erbium-YAG Laser Skin Resurfacing......Page 408
Procedure......Page 409
Conclusion......Page 410
References......Page 411
142 Periocular Suture Lifts: Brow and Malar Repositioning......Page 417
145 Repair of the Torn Earlobe......Page 425
Surgical Technique for Complete Earlobe Tears......Page 426
Surgical Repair for Partial Torn Earlobes......Page 427
References......Page 431
Technique......Page 432
Conclusion......Page 433
Reference......Page 436
147 SMAS Malar Fat Pad Lift with Short Scar Face Lift......Page 437
Tip 1. Marking (Figure 148.1)......Page 440
Tip 5. Creating the SMAS Flap (Figure 148.5 and 148.6)......Page 441
Tip 7. Skin Flap Fixation (Figure 148.8)......Page 442
Tip 10. Addressing the Neck (Figure 148.11)......Page 443
References......Page 450
Surgical Technique......Page 458
Reference......Page 460
Surgical Technique......Page 461
Suggested Reading......Page 466
Suggested Reading......Page 468
157 Small Incision External Levator Repair......Page 471
Further Reading......Page 472
158 Ptosis Repair by a Single-Stitch Levator Advancement......Page 474
Reference......Page 476
160 Pearls for Müller’s Muscle–Conjunctival Resection–Ptosis Procedure Combined with Upper Blepharoplasty......Page 478
References......Page 479
167 “Simple-Dimple” Lateral Tarsus Fixation......Page 491
171 Medial Canthorraphy......Page 498
Index......Page 504