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Highlights of Archives of Facial Plastic Surgery
March 2006

Highlights of Archives of Facial Plastic Surgery

Author Affiliations

Copyright 2006 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2006

Arch Facial Plast Surg. 2006;8(2):83. doi:10.1001/archfaci.8.2.83
Long-term Viability and Mechanical Behavior Following Laser Cartilage Reshaping

Laser cartilage reshaping relies on generated heat to induce structural changes in the tissue matrix. Although several animal studies have demonstrated the feasibility of this method, the mechanisms underlying the reshaping process have yet to be entirely identified. Moreover, the laser dosimetry that results in effective reshaping remains undetermined. This study by Amir M. Karam, MD, and colleagues investigates the long-term in vivo effect of laser dosimetry on rabbit septal cartilage integrity, viability, and mechanical behavior. They conclude that laser irradiation of cartilage resulted in the loss of both structural integrity and chondrocyte viability for a wide range of laser parameters. The results of this elegant study stress the importance of spatially selective heating, which may prove to be essential to the clinical application of this modality.


Use of Radiesse in Combination With Restylane for Facial Augmentation

Facial contouring with injectable biofillers continues to be a growing part of any cosmetic practice. Because of their relatively short time on the market, newer injectables such as Radiesse (calcium hydroxylapatite) and Restylane (hyaluronic acid) have limited long-term data on patient satisfaction. Moreover, limited data have been published on the outcomes of using these 2 fillers in combination. Michael S. Godin, MD, and associates present the long-term results of 72 patients treated with Radiesse and 29 patients treated with Radiesse and Restylane in combination. The authors determined that the combination group had greater immediate and overall satisfaction than patients receiving Radiesse alone. They also address technical considerations in injecting these biofillers as well as recommendations to minimize complications.


Prophylactic vs Postoperative Antibiotic Use in Complex Septorhinoplasty Surgery

Septorhinoplasty (SRP) is by definition a contaminated procedure owing to the unavoidable contact with normal vestibular and intranasal flora. Postoperative infection rates of 2.5% have been reported for routine nasal surgery (SRP without grafting), and routine use of postoperative antibiotics has not shown a decrease in infection rates. However, reduced infection rates in complex nasal surgery (SRP with grafting or revision SRP) have been reported when compared with placebo. P. J. Andrews, FRCS, and colleagues report their randomized, prospective, single-blind study comparing the efficacy of prophylactic vs postoperative antibiotic use in complex SRP. In 164 patients, no significant difference existed in infection rates between the group that received 3 perioperative intravenous doses of antibiotics and the group given a 7-day course of postoperative oral antibiotics.


The Double Transposition Flap for Closure of the Extremely Wide Hard Palate Cleft

In an extremely wide cleft palate defect, the width of the palate defect is more than 60% of the width of the entire palate or the width of both palatal shelves is less than the width of the palatal defect. Attempts at closure of such clefts with traditional techniques can lead to excessive tension on the closure, which can result in an increased incidence of flap breakdown. Sivi Bakthavachalam, MD, and Yadranko Ducic, MD, FRCSC, report the double transposition flap for the closure of extremely wide cleft palates in 6 children. All children tolerated the procedure well. The authors believe this novel technique to be less technically demanding than other methods currently used.


Early Cycladic II period (ca 2800-2700 BC) reclining female figure with folded arms, Kapsala variety (displayed standing). Article


This issue's Highlights were written by Bryan Ambro, MD.