Kneeling Girl in Orange-Red Dress (Kniendes Mädchen im orangeroten Kleid), by Egon Schiele (1890-1918).Article
Alexander Berghaus, MD, Kerstin Neumann, MD, and Thomas Schrom, MD, performed a study comparing the outcomes of 33 upper-lid gold implants for facial palsy with 30 flexible platinum chain implants. With gold implants some patients develop complications such as asymmetries, migration, bulging, and extrusion. Because the newly developed platinum chain implant has a higher density than gold, somewhat smaller implants can be used. The more flexible implants adapt better to the changing radius of the tarsus with movement. The flexible platinum chain implants had better outcomes, with fewer complications, than the standard rigid gold implants.
John D. Rachel, MD, and Jasmin J. Jamora, MD, performed a quantitative, prospective study to evaluate various skin rejuvenation regimens using profilometry and histopathologic analyses. A combination of therapeutic agents are often used to treat photodamaged and aged skin. In this study changes in skin surface topography were evaluated in patients treated with a combination of 0.05% tretinoin emollient cream, topical ascorbic acid lotion, and superficial trichloroacetic acid peels. Healthy volunteer subjects were placed into 4 treatment groups with combinations of topical treatments and superficial trichloroacetic acid peels. Although all treatment groups showed improvement from baseline, trichloroacetic acid peels in combination with topical treatments improved skin topography to a greater degree than less aggressive regimens. The study concludes that a combination of trichloroacetic acid peels, 0.05% tretinoin emollient cream, and ascorbic acid lotion is well tolerated and superior to any component alone as part of a comprehensive skin care and sun protection program.
Matthew A. Kienstra, MD, and his colleagues from the Mayo Clinic in Rochester, Minn, have developed a uniform grading system for nasal deformities. In spite of the popularity of rhinoplasty among both surgeons and the lay public, there is no consistent terminology to describe or quantitate contour deformities of the nasal dorsum. A common term such as "saddle nose" does not, for example, differentiate between bony and cartilaginous deficits. This new classification quantitates changes in 4 general areas: width, deviation, convexity, and projection. To examine the utility of their system, 2 of the authors independently graded 100 patient photographs. Results showed excellent correlation between observers. This system, if widely adopted, would provide a good basis for discussion among surgeons for surgical planning and outcome evaluation.
Thomas Romo III, MD, Kyle S. Choe, MD, and Anthony P. Sclafani, MD, describe the use of porous high-density polyethylene implants in cleft lip nasal reconstruction. They used multiple implants, including columellar struts, premaxillary and prealveolar plumper grafts, dorsal tip implants, and unilateral nasal valve batten grafts in 18 patients with a unilateral cleft lip deformity and without a previous history of formal rhinoplasty. Follow-up ranged from 6 months to 7 years, with an average of 20 months, and all the patients had favorable aesthetic results. There was 1 infectious complication, which occurred 6 months postoperatively. This favorable experience may lead surgeons to consider these implants as a replacement or supplement to autogenous materials for cleft lip/nose repair.
Highlights of Archives of Facial Plastic Surgery. Arch Facial Plast Surg. 2003;5(2):137. doi:10.1001/archfaci.5.2.137