Botulinum neurotoxin A has become a widely used therapeutic agent to treat undesired facial lines and wrinkles. Andrew Blitzer, MD, DDS, and William J. Binder, MD, present a comprehensive review of the underlying science and historical development of this agent. They include an extended discussion of the risks and complications. These authors discuss their personal techniques for Botox injections in each specific anatomic site. In this rapidly evolving area, their scientific review and long experience should prove useful to all physicians utilizing the technique.
Though the endoscopic brow-lift has been widely accepted, there is still discussion as to which brow-lift technique is more effective long term to maintain brow position. Christine M. Puig, MD, and Keith A. LaFerriere, MD, performed a retrospective review of 84 brow-lift patients with more than 10 months' postoperative photodocumentation. The series included 34 patients with a coronal brow-lift, 32 patients with a trichophytic brow-lift, and 38 patients with an endoscopic brow-lift. After performing a detailed evaluation of the photographs, they found no statistical difference between the brow positions for these separate surgical approaches. The authors discuss their clinical technique and recommendations based on their experience.
There is no consensus as to the efficacy and safety of simultaneous rhytidectomy and full-face laser resurfacing. Brenton B. Koch, MD, and Stephen W. Perkins, MD, present a series of 30 patients treated in this fashion. This 30-patient series over a 2½-year period included resurfacing over the undermined portion of the flaps. They found no evidence of flap loss, skin slough, infection, or pigment changes. The authors also present a 463-patient meta-analysis data set, which shows a complication rate for the combined procedure that does not differ from that of rhytidectomy alone. The authors discuss their preferred techniques for rhytidectomy and laser resurfacing.
Stephen Prendiville, MD, and his coauthors developed a cadaver model to evaluate the effect of 4 widely used submental techniques on the cervicomental angle. The cervicomental angle in this study was significantly reduced after all of the procedures, which ranged from simple platysma plication to an interlocking mastoid-to-mastoid suture. The addition of the mastoid-to-mastoid suture had the greatest impact on the cervicomental angle. The authors note appropriately that this information from a cadaver study provides no information about the long-term effects of these various procedures in patients.
Primavera, by Sandro Botticelli.Article
Highlights of Archives of Facial Plastic Surgery. Arch Facial Plast Surg. 2002;4(4):213. doi: