The biplane facelift: an opportunistic approach.
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Biomedical subjects
Publications and source records attributed to H A Tobin.
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A wide variety of surgical procedures and implant materials have been used to satisfy the growing demand of patients for lip augmentation. The authors describe our experience with Alloderm (LifeCell Corp, The Woodlands, TX). It has proven to be a safe and effective means of offering mild to moderate augmentation of the lips.
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A case of hemifacial atrophy affecting a young female is presented and the manifestations of this uncommon disorder are reviewed. The various methods employed in correcting the facial deformity including the relatively new technique of fat injection are described.
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A brief history of office based surgery as well as a guide to economic and practical considerations for new facility planning.
Just as surgical techniques have changed in rhinoplasty, there have been dramatic changes in the techniques of delivery of care. This article has emphasized concepts of outpatient operative technique and anesthesia, especially as they relate to an ambulatory facility incorporated in a surgical practice.
An analysis of patient response to less-than-ideal results in rhinoplasty reveals a marked discrepancy between the way patients react and the way in which surgeons think they would react. We feel that, by showing less-than-ideal results to prospective patients, we may be able to develop a method to predict the degree of dissatisfaction that a patient might show to a result that was less than ideal.
Traditional teaching on blepharoplasty surgery emphasizes the existence of several discrete fat compartments in the upper and lower lids. Surgical techniques are based upon removal of fat from each of the two or three so-called compartments within the upper or lower lid. Anatomically, there is little basis for assuming the existence of such compartments. They usually represent areas of weakness or dehiscence within the overlying muscle or septum. A technique of blepharoplasty using electrosurgical dissection is described which emphasizes wide incision of the orbital septum with abundant presentation of the entire fat pad. Removal of fat is carried out without clamping and with great assurance that there will be no subsequent bleeding. Since it is not necessary to pull on the fat pads, retraction of open vessels is avoided.
Two cases of almost complete stenosis of the hypopharynx occurred after laryngectomy, radical neck dissection, and postoperative radiation therapy. Successful reconstruction that utilized a tubed, deltopectoral flap was accomplished in each case. In the absence of evidence indicating increased long-term survival with combined surgery and postoperative radiation therapy, one must question the utilization of these methods. Decreased local recurrence or cervical metastasis may not be an adequate justification if the rate of complications is notably increased, especially when complications can be as severe as these.
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