Malignancy of, or injury to, the tissues of the head and neck uniquely affects the senses of taste and smell and the vital processes of speech, breathing, ingesting food, and human interaction. Today, microvascular free tissue transfer provides surgeons the potential to restore form, function, and quality of life for individuals with such afflictions. Eric M. Genden, MD, reviews the complex history in oromaxillofacial rehabilitation and the development of the operative techniques that have now shaped the current standards in patient care.
Senescence of the upper and lower lips is a difficult challenge in the treatment of the aging face. While surgeons have attempted to provide lasting results with a wide array of autogenous and nonautogenous materials, the ideal intervention, for patient and physician alike, has remained elusive. Anurag Agarwal, MD, and colleagues present their long-term findings of lip enhancement in 25 consecutive patients who underwent sternocleidomastoid muscle and fascia transfer. The authors detail their operative technique, objectively review their clinical findings of vermilion show and lip projection, and openly highlight the potential pitfalls of lip augmentation.
The bony nasal pyramid has long been a focus in the treatment of nasal asymmetry, ventral nasal width, and the closure of open roof defects. Surgical correction often requires division along the bony interface between the nasal process of the maxilla and the lateral nasal bone. Richard A. Zoumalan, MD, and colleagues investigate the quantitative differences between perforating and continuous osteotomy techniques in a population of 60 patients. Statistically significant narrowing of ventral width was observed in each of the 2 consecutive groups, while dorsal width remained stable. The authors further emphasize that their findings did not reveal a statistically significant difference between the 2 lateral osteotomy techniques.
The definition of the ideal aesthetic brow has continued to evolve as the subtle complexities in this mimetic region are appreciated. The consistent lack of a uniform definition underscores the anatomic-, cultural-, ethnic-, sex-, and age-related considerations necessary in the development of the ideal brow position and shape. Anthony P. Sclafani, MD, and Matthew Jung, BA, MS, discuss the characteristics of the adult eyebrow, parameters in the range of motion, as well as the aesthetic shape and position as determined by the patient. The authors detail the ideal eyebrow height as referenced to 6 anatomic points, aesthetic differences between men and women, and surgical considerations in eyebrow elevation.
The Painter and His Pug by William Hogarth (1697-1764).
This issue's Highlights were written by James Ridgway, MD, Department of Otolaryngology–Head and Neck Surgery, University of Washington, Seattle.
Highlights of Archives of Facial Plastic Surgery. Arch Facial Plast Surg. 2010;12(2):81. doi:10.1001/archfacial.2010.11