Correction of chin underprojection has a significant effect on facial
symmetry. Alloplastic chin implants and sliding genioplasty are the currently
accepted methods of chin augmentation. While both procedures may be used for
retrognathia or microgenia, the sliding genioplasty can also be used in chin
asymmetry, prognathia, and vertical height discrepancies. Edward W. Chang, MD, DDS, and colleagues present a 5-year review of
their experience with the sliding genioplasty in 43 patients. Their technique
and cephalometric results are described. Forty-two of the 43 patients were
extremely or very satisfied with the results. One was dissatisfied because
of an occlusal problem.
Large zone-2 defects of the nose are commonly repaired with a forehead
flap. Timothy W. Wild, MD, DDS, and C. Patrick Hybarger,
MD, performed a cadaver study to identify the blood supply of the dorsal
nasal flap in relation to the medial canthal tendon, and the superior melolabial
flap in relation to the alar crease. Using this information, reconstruction
was performed successfully in 10 patients with large nasal defects using a
triple-flap technique. Frederick J. Menick, MD, discusses
this article and compares this technique with the forehead flap with refinements
that he and Gary Burget, MD, have described so well.
Article and Article
Outcomes research attempts to evaluate the results of medical interventions
in terms of patient satisfaction and quality of life as well as the costs
of obtaining these results. The use of standardized outcomes instruments would
allow more objective comparisons of both reconstructive and cosmetic surgery
results. The primary author, Ramsey Alsarraf, MD, MPH,
describes the cost and frequency of cosmetic facial plastic surgery procedures
across the United States. Both continue to rise, and there appears to be an
association between increased prices and increased frequency of procedures.
The maintenance of a normal temporal and frontal hairline is an important
consideration for many patients undergoing upper facial rejuvenation. J. David Holcomb, MD, and E. Gaylon McCollough, MD, describe
their results in 99 consecutive patients undergoing these procedures. Depending
on the preoperative anatomical deformities, their patients fell into 1 of
6 treatment groups, and they used their trichophytic incisional approach in
4 of these groups. These trichophytic incisions were acceptable to a large
percentage of the patients and present an excellent option, particularly in
Diego Velázquez (1598-1660), Philip IV at Fraga,
1644, Spanish. Oil on canvas, 133 × 98 cm.
Courtesy of the Frick Collection, New York, NY.
Highlights of Archives of Facial Plastic Surgery. Arch Facial Plast Surg. 2001;3(1):5. doi:10.1001/archfaci.3.1.5