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The facial proportions used by facial plastic surgeons are based on the neoclassical canons and were derived from the white population. As facial cosmetic surgery becomes more common among people from various ethnic backgrounds, the concept of a single aesthetic standard of beauty is inadequate. Jennifer Parker Porter, MD, and Krista L. Olson, MD, Article studied a volunteer sample of African American women (n = 108) and compared their results with the standards for North American white women. African American women differ in significant ways that are discussed in this important article.
Long-term follow-up in a large patient series is crucial to the evaluation of rhinoplasty techniques. Stephen W. Perkins, MD, and colleagues Article review their extensive experience with 386 patients who underwent endonasal double-dome tip rhinoplasty. They discuss the technical refinements they have developed over the years. Their results at 1 year show high rates of supratip (94%), dome (95%), and nostril (88%) symmetry. There was an overall high rate of patient satisfaction (92%) and a low revision rate (7%).
Facial laser resurfacing and chemodenervation with botulinum toxin are 2 independent techniques for nonsurgical facial rejuvenation. Laser resurfacing is excellent for fine to medium rhytids but is a less optimal treatment for such areas as the crow's feet and forehead, where there is dynamic muscle activity. In this blinded study, patients had one side of their face injected with botulinum toxin, at specific anatomic sites, and then the entire face was resurfaced using a carbon dioxide or erbium laser. Ten female patients were enrolled in this study. All sites pretreated with botulinum toxin showed statistically significant improvement compared with the side not treated with botulinum toxin. Marc S. Zimbler, MD, and associates Article recommend pretreatment of movement-associated rhytids with botulinum toxin prior to laser resurfacing.
Nasal tip support is one of the most important variables in rhinoplasty surgery. Holger G. Gassner, MD, and colleagues Article have developed a new device to measure nasal tissue resilience. The normative values established in their study allow one to identify areas of inadequate tip support prior to surgery. Measured postoperative changes correlate well with the placement of structural grafts during rhinoplasty. For the first time, a reproducible quantitative technique is available to measure nasal tip support.
See Figure 1 and Figure 2 below Article .ArticleArticle
Woodcut, plate 22, lateral view of skeleton. From Vesalius A. De Humani Corporis Fabrica.
Woodcut, plate 26, anterior view of muscular system. From Vesalius A. De Humani Corporis Fabrica.
Highlights of Archives of Facial Plastic Surgery. Arch Facial Plast Surg. 2001;3(3):155. doi: