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Biomedical subjects

B C Mendelson

Publications and source records attributed to B C Mendelson.

At least 19 recordsLinked to original sources
PubMed2001

Surgery of the superficial musculoaponeurotic system: principles of release, vectors, and fixation.

The SMAS was described more than 25 years ago, yet its full potential in face-lift surgery has become appreciated only more recently. A reappraisal of the various aspects of SMAS surgery is now appropriate. These include aspects of its release from the deep fascia, the several considerations underlying the vectors of flap redistribution, and the rationale underlying the methods of flap fixation. These are unique, compared with the traditional considerations in subcutaneous face lifts and en bloc subperiosteal lifts.

Adipose Tissue↗
PubMed2000

Surgical anatomy of the ligamentous attachments in the temple and periorbital regions.

This study documents the anatomy of the deep attachments of the superficial fasciae within the temporal and periorbital regions. A highly organized and consistent three-dimensional connective tissue framework supports the overlying skin and soft tissues in these areas. The regional nerves and vessels display constant and predictable relationships with both the fascial planes and their ligamentous attachments. Knowledge of these relationships allows the surgeon to use the tissue planes and soft-tissue ligaments as intraoperative landmarks for the vital neurovascular structures. This results in improved efficiency and safety for aesthetic procedures in these regions.

Aged↗
PubMed1997

SMAS fixation to the facial skeleton: rationale and results.

The trend in modern facial rejuvenation surgery is to reposition the ptosis of the superficial soft-tissue mass relative to the facial skeleton. The logical method of supporting the superficial tissue is to reattach it to the underlying skeleton, thereby replicating the function of the retaining ligaments. Five hundred consecutive face lifts involving deep fixation of the submucosal aponeurotic system flap to the periosteum of the zygoma were reviewed for complications and side effects. Expected complications, such as irregularities, dimpling, and palpable sutures, occurred in fewer than 1 percent of cases, confirming the safety of this method. The conclusion from this experience is relevant to all methods of deep-layer facial rejuvenation surgery, including the endoscopic approach.

Humans↗
PubMed1995

Anatomy of the midface.

Surgical procedures for the midface and nasolabial fold demand that the surgeon possess a magnified knowledge of the facial anatomy and its structural relationships. With this knowledge, the surgeon limits complications while achieving better results. This article reviews the anatomy of the midfacial subcutaneous soft tissues.

Adipose Tissue↗
PubMed1995

Extended sub-SMAS dissection and cheek elevation.

The extended SMAS facelift techniques gave plastic surgeons the ability to correct the nasolabial fold and medial cheek. Retensioning the SMAS transmits the benefit through the multilinked fibrous support system of the facial soft tissues. The effect is to provide a recontouring of the ptotic soft tissues, which fills out the cheeks as it reduces nasolabial fullness. Indirectly, dermal tightening occurs to a lesser but more natural degree than with traditional facelift surgery. Although details of current techniques may be superseded, the emerging surgical principles are becoming more clearly defined. This article presents these principles and describes the author's current surgical technique.

Adult↗
PubMed1993

Herniated fat and the orbital septum of the lower lid.

The bulging fat of aging eyelids has always been described as a hernia; yet, the treatment has not been that of a true hernia. Rather, the contents (orbital fat) have been excised and the hernia wall left unrepaired. It is possible to treat bulging lower eyelids as a hernia by replacing both the fat and the sac into the original location within the orbital cavity, and then repairing the retaining wall.

Adipose Tissue↗
PubMed1992

Cosmetic surgery for the ageing face.

Cosmetic surgery is unique in that the results are qualitative. Recent technical advances now allow the skilled and artistic surgeon to achieve the degree of change requested by most patients, without the obvious operated look. General practitioners should extend their professional relationship with cosmetic surgery patients. Preliminary counselling can reduce patient's anxiety by clarifying their objectives and by providing relevant information and support. The relationship of trust so engendered is helpful for post operative support and allows the practitioner to share in the satisfaction experienced by the patient as a result of surgery.

Body Image↗
PubMed1992

Correction of the nasolabial fold: extended SMAS dissection with periosteal fixation.

The nasolabial fold has defied satisfactory correction with the face lift operation. This is despite variations of the SMAS technique over the last 20 years. In this study, the nasolabial fold is shown to be part of the overall aging deformity that affects the cheek and perioral region. The key to surgical correction, not previously appreciated, is the complete release of the anterior SMAS from the zygoma and zygomaticus major muscle. This allows a dramatic mobilization of the nasolabial fold without tension. The advanced SMAS is then reattached to the zygomatic periosteum by a series of permanent sutures. Each suture, by its location and direction of lift, corrects one of the four nasolabial regions including the jowl. The relevant anatomy is reviewed and the safety of the procedure is assessed in a personal series of 135 patients. It is concluded that the two principles of this technique, i.e., complete SMAS release and reattachment to the zygoma, safely and effectively achieve a natural-appearing rejuvenation of the cheek and nasolabial fold.

Adult↗
PubMed1984

Breast reconstruction after mastectomy. What the family physician should know.

The most common female malignancy, cancer of the breast, affects one in 15 women in Australia. A significant number of those who have had a mastectomy seek the advice of their general practitioner about breast reconstruction. The counsel of the past--that they should think themselves fortunate to have survived the mastectomy and 'leave well enough alone'--is no longer valid. This article discusses the need for reconstruction, its worth and the procedures available.

Adult↗
PubMed1983

Latissimus dorsi breast reconstruction--refinement and results.

The surgical objectives for an improved breast reconstruction are defined. In 30 latissimus dorsi flap breast reconstructions only 1 major flap complication occurred. There were 7 lesser complications involving the donor wound on the back (n = 4), the flap (n = 2) and the mastectomy skin (n = 1). Several refinements in the technique provide for a more accurate replacement of the missing breast yet minimize complications on the back. A one-stage reconstruction (with immediate insertion of the prosthesis) is shown to be safe, except in the presence of recognizable damage to the thoracodorsal vascular pedicle. It is concluded that refinements in the use of the flap allow for a better breast reconstruction and that major complications are avoidable.

Adult↗
PubMed1983

Results of nipple areola reconstruction.

Reconstruction of the nipple-areola complex is being performed for about a quarter of postmastectomy breast reconstruction patients. The methods used and results achieved in thirteen reconstructions were reviewed. Full thickness skin grafts from the upper inner thigh were used for the areola, with 100% success. For the nipple proper, most (eight) had a composite graft from the opposite nipple, with 100% take if the dressing was kept in place for 10-12 days. Earlobe tissue made an excellent nipple reconstruction for bilateral cases (four). It is concluded that nipple-areola reconstruction is safe, simple and predictable. A second operation is recommended for this surgery to ensure symmetry of nipple position, a fundamental requirement for a good result.

Adult↗
PubMed1982

Breast reconstruction.

This paper reviews a series of 40 consecutive breast reconstructions. Women of all ages, even many years after mastectomy, are seeking this form of rehabilitation. Breast reconstruction is now a practical proposition because of the low rate of complication and the minimal stay in hospital required.

Adult↗
PubMed1982

Local recurrence of breast cancer: its significance in relation to breast reconstruction.

Questions regarding local recurrences are a major concern in considering mastectomy patients for breast reconstruction. A critical analysis of the literature on local recurrences indirectly provides answers to several of these concerns. Local recurrence is a relatively predictable event, and is uncommon in those with a favourable breast cancer. Its presence reflects concurrent systemic disease which is usually lethal within a short time. Concern over subsequent local recurrences should not be a contraindication to breast reconstruction in selected patients.

Breast↗
PubMed1982

Submuscular mammary prostheses in reconstructive breast surgery.

The anatomical basis and operative technique for insertion of mammary prostheses in the completely submuscular position are described. The results of 38 completely submuscular prostheses used for reconstructive breast surgery form the basis of this report. The two major advantages of the method, freedom from major complications, and a reduced incidence of deforming fibrous capsular contracture, have important implications in reconstructive breast surgery.

Breast↗