Biomedical subjects
Publications and source records attributed to F M Kamer.
Many materials have been used for augmentation mentoplasty with varying degrees of success. In our experience with the silicone bag-gel implant in 50 cases over the past 18 months the results have been quite satisfactory and there were no untoward complications.
Satisfactory treatment of alopecia following rhytidectomy is discussed using the punch graft technique. In spite of the presence of scar tissue following rhytidectomy, this procedure has been quite successful because of the rich blood supply in that area.
Gelfilm is a nonporous, rigid, cellophane-like absorbable gelatin. Its use in preventing adhesions in neurosurgery and ophthalmic, otologic, and chest surgery has been well described. It has not been previously reported for nasal surgery. It incorporates many characteristics of an ideal absorbable implant. The material has been used clinically as a dorsal nasal implant either alone or as a vehicle for autogenous cartilage grafts. Its main function is to diminish adhesions between the nasal bones and dorsal skin after surgery on the nasal pyramid. Its benefits seem most applicable in traumatic or revisionary rhinoplasty. Its use has been well documented in 40 cases with a one-year follow-up. The only disadvantage is a slight prolonged dorsal edema until the implant resorbs. The results have been impressive in both early and late postoperative follow-up because the nasal dorsum appears smoother and the skin nonadherent.
The advantages of the Fomon technique modifications in rhinoplasty are outlined. The importance of these adaptations is emphasized.
A method of chin augmentation employing a newer synthetic material (Proplast) is presented. The characteristics and biocompatibility of Proplast are detailed. Technical considerations and results of short term clinical trials in 20 patients are discussed. One implant necessitated removal secondary to trauma four months after surgery. All other implants including over 30 additional cases have been without incident.
The infrabrow lift is presented as a specific method to correct skin redundancy between the eyebrow and upper lid. Indications are outlined which differentiate this technique from the suprabrow surgical approach. The surgical technique is discussed. Esthetic results have proven most satisfactory.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A modification of an absorbent, non-adherent material (Telfa) is described for use as an anterior nasal packing. The ideal nasal packing should fulfill certain criteria. It should be easy to introduce and remove, contour to the nasal cavity to exert a tamponade effect, and should not prolapse or react unfavorably with the mucous membranes of the nose. The advantages of Telfa as a nasal packing is discussed and compared to previously described materials in this regard. During the past three years this pack has been used in over 800 patients for anterior epistaxis, septal and rhinoplastic surgery. The results have been extremely satisfactory, and the authors suggest their use in these cases.
The difficulties in obtaining an adequate result in the Negroid nose have been elucidated by other authors. Paucity of lobular cartilage; the flat dorsum; short columella; wide flaring nares; and skin that tends to keloid formation have led many surgeons to attempt radical surgical techniques to obtain rather limited results. To circumvent the complications in the more radical procedures, a more conservative concept of an entirely intranasal operation without external skin incisions is outlined. This technique consists of tip rotation andlobular cartilage trimming; the use of a non-absorbable basal bunching suture, and the placement of a dorsal implant without performing osteotomies. A comparison with other techniques is made, as well as surgical aims, limitations and a discussion of results. Pertinent illustrations and photographs are presented.
Explore the source record for details and available documents.
Upper blepharoplasty remains a valuable procedure in rejuvenating the upper eyelid. An innovative technique was recently reported whereby medial fat is removed through a transconjunctival approach. This is a preliminary report of our experience with 60 patients treated over the past 10 months using this technique. The technique will be described in detail and cases will be reported. There were no perioperative or postoperative complications. All of the patients are satisfied with the results of their surgical procedure. The technique has the advantage of avoiding an incision of the medial upper eyelid and the inherent risks of excessive scarring in this area. We have found the technique especially useful in secondary blepharoplasty with an isolated prominence of residual medial fat. Other advantages include the following: primary cases in which the surgeon is able to avoid medial extension of the cutaneous incision, patients who possess deep tarsal folds with prominent medial fat, or as an adjunct to eyebrow lifting techniques where in both cases cutaneous excision is unnecessary. No disadvantages have been noted.
Hematoma formation following rhytidectomy procedure is unfortunately common and one of the more devastating complications that can occur. Various reports have cited the incidence of hematoma formation using the superficial musculoaponeurotic system-platysma technique; but, to our knowledge, no report has specifically addressed the incidence of hematoma formation following deep plane rhytidectomies. We retrospectively reviewed the medical records and deep plane rhytidectomy worksheets of 451 consecutive deep plane rhytidectomies preformed at one institution by one surgeon. The incidence of major hematoma was 2.2% (10/451) and of minor hematoma was 6.65% (30/451). All hematomas that did occur did so in the subcutaneous plane of dissection. There were no facial hematomas. Arch Facial Plast Surg. 2000;2:240-242
The two-stage concept is a plan for the management of rhytidectomy patients. Preoperatively, all patients are told that they may need a minor secondary temporal tuck-up procedure 6 to 12 months after surgical treatment. Although only 20% of patients require this secondary surgical procedure, the possibility of its need encourages all patients to return for follow-up and removes a source of patient discontent. The indications for the secondary procedure are significant gravitational jowling and malar sagging developing 6 to 12 months after the primary surgical treatment. The technique is described in detail.
Over a two-year period, 258 rhytidectomy procedures were performed. Fifty-six patients (21.7%) required a secondary procedure. A thorough survey of these patients is in progress and will be reported at a later date. An early analysis shows that the secondary office surgery is neither time-consuming, difficult, nor disabling. It appears to be a relatively simple, painless, and effective method to minimize three causes of patient dissatisfaction with face-lifting surgery.