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May 2019 - January 1999

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May/Jun 2011, Vol 13, No. 3, Pages 140-225 | Pediatric Facial Plastic Surgery

Editorial

An Introduction to the Pediatric Special Edition and to Our “Contemporary Review” New Regular Feature

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Arch Facial Plast Surg. 2011;13(3):144. doi:10.1001/archfacial.2011.24
Research Letter

Perceptions of Aesthetic and Reconstructive Facial Surgery Among Medical Students

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Arch Facial Plast Surg. 2011;13(3):215-217. doi:10.1001/archfacial.2011.27

Evolution in Nasal Tip Contouring Techniques: A 10-Year Evaluation and Analysis

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Arch Facial Plast Surg. 2011;13(3):217-219. doi:10.1001/archfacial.2011.25
Beauty

Symphony in Flesh Colour and Pink: Portrait of Mrs Leyland by James Abbott McNeill Whistler

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Arch Facial Plast Surg. 2011;13(3):224-225. doi:10.1001/archfacial.2011.20
Reviewers List

Thank You to Our Reviewers

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Arch Facial Plast Surg. 2011;13(3):142. doi:10.1001/archfacial.2011.17
Highlights of Archives of Facial Plastic Surgery

Highlights of Archives of Facial Plastic Surgery

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Arch Facial Plast Surg. 2011;13(3):143. doi:10.1001/archfacial.2011.22
Contemporary Review

Current Knowledge and Management of Vascular Anomalies: I. Hemangiomas

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Arch Facial Plast Surg. 2011;13(3):145-151. doi:10.1001/archfacial.2011.33
Original Article

The Spectrum of Isolated Congenital Nasal Deformities Resembling the Cleft Lip Nasal Morphology

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Arch Facial Plast Surg. 2011;13(3):152-160. doi:10.1001/archfacial.2011.26

A 2-Stage Ear Reconstruction for Microtia

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Arch Facial Plast Surg. 2011;13(3):162-166. doi:10.1001/archfacial.2011.30

A 6-Year Experience in Flat Helix Correction With a Simple Procedure

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Arch Facial Plast Surg. 2011;13(3):168-172. doi:10.1001/archfacial.2011.31
Techniques in Facial Plastic Surgery

The Autospreader Flap in Reduction Rhinoplasty

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Arch Facial Plast Surg. 2011;13(3):172. doi:10.1001/archfacial.2011.34

Mandibular Distraction Osteogenesis in Infants Younger Than 3 Months

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Arch Facial Plast Surg. 2011;13(3):173-179. doi:10.1001/archfacial.2010.114
ObjectivesTo examine the long-term outcomes and complications in infants with upper airway obstruction and feeding difficulty who underwent bilateral mandibular distraction osteogenesis (MDO) within the first 3 months of life and to identify any preoperative characteristics that may predict the long-term outcome following early MDO intervention for airway obstruction.MethodsAn institutional, retrospective medical chart review was performed. Inclusion criteria were bilateral MDO performed at an age younger than 3 months, with a minimum follow-up of 3 years. A quantitative outcome measures scale was developed, and patients were scored based on long-term postoperative complications as well as airway and feeding goals. Factors such as need for an additional surgical procedure were also considered.ResultsNineteen children were identified as having undergone MDO before 3 months of age and having more than 3 years of follow-up data. The mean age at distraction was 4.8 weeks (range, 5 days-12 weeks); the mean length of follow-up was 5.6 years (range, 37-122 months). Of these 19 patients, 14 had isolated Pierre Robin sequence (PRS) and 5 had syndromic PRS. All patients with isolated PRS had a good or intermediate long-term result. Infants with comorbidities such as developmental delay, seizures, or arthrogryposis had the poorest outcomes.ConclusionsBilateral MDO is a relatively safe and effective means of treating airway obstruction and feeding difficulty in infants with PRS. The effects of this procedure, which carries a relatively low morbidity, persist through early childhood in most patients.

Improving Aesthetic Outcomes in Pediatric Free Tissue Oromandibular Reconstruction

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Arch Facial Plast Surg. 2011;13(3):180-184. doi:10.1001/archfacial.2010.113
ObjectiveTo review our substantial favorable experience with oromandibular free tissue reconstruction in pediatric patients, emphasizing technical pearls, which seem to be associated with favorable long-term aesthetic and functional outcomes.MethodsRetrospective review of a consecutive series of all free tissue transfers performed from 1997 to 2010 by the senior author (Y.D.) in patients younger than 18 years. Demographic data, techniques used, and complications were examined.ResultsA total of 51 patients were identified, and their data were available for collection. Twenty-eight were female, and 23 were male; the mean age was 10 years (range, 4-17 years). Flaps performed included 43 fibula free flaps and 8 radial forearm free flaps with successful transplantation in each case. Twenty-six patients had temporomandibular joint reconstruction as part of their initial repair. The reasons for reconstruction were trauma (in 18 cases) and oncologic (in 33 cases). Functional and aesthetic results were improved with minimal access, maximal exposure approaches as outlined.ConclusionsPediatric free tissue oromandibular reconstruction is associated with excellent outcomes in most patients. Specific technical modifications allowing for minimal visible scarring and improved function, particularly at the level of the joint, allow for rewarding results in young patients.

Evaluating Revascularization and Flap Survival Using Vascular Endothelial Growth Factor in an Irradiated Rat Model

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Arch Facial Plast Surg. 2011;13(3):185-189. doi:10.1001/archfacial.2010.115
ObjectiveTo evaluate the role of vascular endothelial growth factor (VEGF) plasmid DNA (pDNA) in improving flap revascularization in a previously developed rat model. Our hypothesis was that the uptake and expression of VEGF pDNA in the wound bed would improve revascularization and flap viability.DesignTwenty-eight male Sprague-Dawley rats received a total dose of 40 Gy electron beam radiation to the ventral abdominal wall. After a recovery period, they underwent a ventral fasciocutaneous flap procedure with a 2-hour ischemia period. Group 1 (n = 14) received topical VEGF pDNA, in vivo cationic polymer, and fibrin sealant. Group 2 (n = 14) received topical cationic polymer and fibrin sealant only. Seven of the rats from each group underwent pedicle ligation at 8 or 14 days. The primary outcome measure was percentage of flap revascularization 5 days after pedicle ligation.ResultsRats receiving VEGF pDNA had a significantly higher rate of flap revascularization (90.8% vs 79.8%) after pedicle ligation at 14 days (P = .045). At 8 days, rats receiving VEGF pDNA (group 1) had an increased rate of flap revascularization (58.2% vs 42.8%) that approached significance (P = .11).ConclusionThis study demonstrates the potential of VEGF pDNA to improve revascularization and flap viability in previously irradiated tissue.

Free Gracilis Transfer for Smile in Children: The Massachusetts Eye and Ear Infirmary Experience in Excursion and Quality-of-Life Changes

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Arch Facial Plast Surg. 2011;13(3):190-194. doi:10.1001/archfacial.2011.29

Excision of Periorbital Hemangiomas to Correct Visual Abnormalities

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Arch Facial Plast Surg. 2011;13(3):195-198. doi:10.1001/archfacial.2011.32

Serial Excision of Facial Hemangiomas

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Arch Facial Plast Surg. 2011;13(3):199-202. doi:10.1001/archfacial.2011.23

1550-nm Nonablative Laser Resurfacing for Facial Surgical Scars

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Arch Facial Plast Surg. 2011;13(3):203-210. doi:10.1001/archfacial.2011.28
Ethics and Public Policy

Are You Ethical?That May Depend on Who You Are Asking

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Arch Facial Plast Surg. 2011;13(3):211-213. doi:10.1001/archfacial.2011.19

The Cephalic Tuck Procedure

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Arch Facial Plast Surg. 2011;13(3):213. doi:10.1001/archfacial.2011.35
Commentary

Ethical Behavior and the Practice of Medicine

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Arch Facial Plast Surg. 2011;13(3):214. doi:10.1001/archfacial.2011.21
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