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Biomedical subjects

Norman J Pastorek

Publications and source records attributed to Norman J Pastorek.

5 recordsLinked to original sources

Preventing complications in facial plastic surgery.

PURPOSE OF REVIEW: The demand for cosmetic procedures has increased dramatically over the past few years, in part fueled by the prevalence of cosmetic 'makeover shows', increased media coverage on television and easy accessibility to the Internet. This growing social acceptance of aesthetic surgery has caused an increasing number of women and men to undergo elective noninvasive and invasive procedures to enhance their appearance. As the number of patients interested in cosmetic surgery increases and the number of physicians performing these procedures increases, the risk of complications invariably also rises. An article focusing on the prevention of complications in facial plastic surgery, therefore, is clearly appropriate in the current era. RECENT FINDINGS: One of the recurring themes in the literature is preventing complications before they occur. Proper patient selection, a thorough understanding of the anatomy and adhering to proper techniques are some of the methods mentioned to avoid unfavorable outcomes. SUMMARY: The literature is replete with articles that focus on the newest techniques for facial rejuvenation. Only through careful analysis of the pitfalls of cosmetic procedures, however, can the facial plastic surgeon adopt principles to help prevent complications.

Blepharoplasty↗

Blepharoplasty update.

The author's current perspective of blepharoplasty is a product of a 30-year evolution in treating the aging eyelid. A review of the literature highlighting the most recent techniques can provide the reader with state of the art thinking by many authors on the subject. Some-times, however, a single surgeon's lifetime experience with a surgical procedure also can be insightful. The article details the author's experience with blepharoplasty.

Blepharoplasty↗

Correction of the soft tissue pollybeak using triamcinolone injection.

OBJECTIVE: To describe the technique for correction of the soft tissue pollybeak deformity using intralesional injection of triamcinolone acetonide. METHODS: We discuss our philosophy, regimen, and technique for treatment of the soft tissue pollybeak using triamcinolone injection. We include results from a series of 173 patients who underwent rhinoplasty performed by one of us (N.J.P.). RESULTS: Triamcinolone was injected at 1 week after surgery in 127 patients (73%). A second injection was performed in 92 (72%) of the 127 patients at 4 weeks after surgery. One hundred eight (85%) of the 127 patients had an acceptable result, as judged by the surgeon, with good supratip definition. Nineteen (15%) of the 127 patients had a less than optimal result, with residual supratip fullness, as judged by the surgeon. There were no complications caused by triamcinolone injection. CONCLUSIONS: Because revision surgery is difficult and may be associated with complications, intralesional triamcinolone injection is the first-line treatment for the soft tissue pollybeak deformities caused by subdermal scarring. Should intralesional steroid injection fail to satisfactorily treat the deformity, revision rhinoplasty can subsequently be performed.

Adolescent↗

Long-term results of lower-lid suspension blepharoplasty: a 30-year experience.

BACKGROUND: Muscle suspension blepharoplasty remains a reliable method to tighten the loose skin and muscle of the lower eyelid. OBJECTIVE: To evaluate the 30-year experience of the senior author (N.J.P.) with the skin-muscle suspension technique for lower-lid blepharoplasty. PATIENTS AND METHODS: Of 4395 patients who underwent lower-lid blepharoplasty, 3988 had muscle suspension blepahroplasty performed with adequate follow-up. RESULTS: Results of the 30-year review showed that most patients were very satisfied with the procedure. There were 67 complications (2 hematomas, 1 poor scar, 24 cases of scleral show <1 mm, and 40 cases of chemosis). Chemosis resolved in 2 to 8 weeks, and there were no cases of ectropion, scleral show greater than 1 mm, dry eye, or vision loss. Revision surgery was needed in 41 patients, all of whom were satisfied after the secondary procedure. CONCLUSION: Despite the recent drift toward orbital fat preservation for lower-lid blepharoplasty, conventional lower-lid muscle suspension offers the surgeon a reliable method to tighten the loose skin and muscle of the lower eyelid and give the patient a more attractive, youthful appearance.

Blepharoplasty↗

The extended columellar strut-tip graft.

The extended columellar strut-tip graft is a structural unit used in endonasal rhinoplasty that combines the attributes of the columellar strut and the tip graft. It is used to provide projection and contour to the nasal tip. Our goal with this study was to evaluate a 15-year experience with 155 patients who underwent rhinoplasty with the extended columellar strut-tip graft. Of these, 110 underwent secondary rhinoplasty, and 45 underwent primary rhinoplasty. There were 6 patients in the secondary rhinoplasty group who experienced complications: in 3, the graft became visible postoperatively, and 3 patients had graft placement asymmetry. These 6 patients underwent surgery in the initial years of graft development. One patient with graft edge visibility and 1 patient with graft asymmetry underwent revision surgery with satisfactory results. The extended columella strut-tip graft is a reliable method to provide nasal tip projection and contour. The successful use of the graft requires precise diagnosis and surgical technique.

Adult↗