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Highlights of Archives of Facial Plastic Surgery
October 1999

Highlights of Archives of Facial Plastic Surgery

Arch Facial Plast Surg. 1999;1(4):243. doi:
The Tongue-in-Groove Technique in Septorhinoplasty: A 10-Year Experience

Reconstruction of the lower third of the nose is one of the most challenging aspects of rhinoplasty surgery. The many techniques reported to correct or change the columellar show, caudal deviation, and nasal tip rotation and projection demonstrate the complexities of this area. Russell W. H. Kridel, MD, and colleagues describe a significant series of 287 cases in which the tongue-in-groove technique was performed. A retrospective analysis of their patients revealed a 97% satisfaction rate with the results of the technique. It has proved to be a direct solution to the problems of columellar show and a reliable technique to change tip rotation and projection. The Commentary by Dean M. Toriumi, MD, places the technique in clinical perspective. Article Article

Resorption Beneath Silastic Mandibular Implants: Effects of Placement and Pressure

Whether Silastic mandibular implants should be placed above or beneath the mandibular periosteum has been a source of debate over the years. Advocates who prefer the placement of the implant superficial to the periosteum believe this decreases the occurrence of bone resorption seen with these implants. Others, who place the implants in a subperiosteal position, believe this is more precise and that the clinical effects, if any, or resorption are not significant. An important clinical study by David C. Pearson, MD, and David A. Sherris, MD, finds no statistically significant difference between supraperiosteal and subperiosteal placement of implants. The commentary by Dale S. Bloomquist, DDS, MS, places this study in historical and clinical perspective. Article Article

Evaluation of Past and Present Hair Replacement Techniques With Regard to Aesthetic Improvement, Effectiveness, Postoperative Pain, and Complications

During the last several decades there have been many changes in hair replacement techniques, including standard grafts, minigrafts, micrografts, scalp reductions, scalp flaps, strip harvesting, and punch harvesting. Stephen C. Adler, MD, and Daniel Rousso, MD, have provided a retrospective, statistically valid study comparing the aesthetic improvement, effectiveness, postoperative pain, and complications of these various procedures. During the study period, there was a 38% reduction in standard grafts performed, a 31% increase in minigrafts performed, and a 48% increase in micrografts performed. There was a 31% overall decrease in complication rate with the minigraft procedure as compared with the standard graft procedure and a 29% reduction in complications with the micrograft procedure as compared with the minigraft procedure. There was a 59% overall decrease in the complication rate with the strip harvesting procedure compared with the punch harvesting procedure. This historical study demonstrates the advantages of current hair replacement techniques and the improved patient satisfaction that results. Article

Feedback-Controlled Laser-Mediated Cartilage Reshaping

Much nasal and auricular surgery involves reshaping the cartilaginous structure. This is usually done with mechanical methods such as excisions, incisions, morselization, or suture techniques. In this article, Brian J. F. Wong, MD, and colleagues demonstrate in an animal model the ability to reshape flat cartilage into carved configurations using a laser with feedback control. The ability to shape cartilage precisely with "forcing it" into the desired configuration or damaging its structural integrity would add an important tool to the armamentarium of the facial plastic surgeon. Article