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[Esthetic pinching of the globular nasal tip. Technical note].

A conservative technique designed to simple reduce the width of nasal tip is presented. It consists of approximation of the anterosuperior segments of alar lateral crus after their elevation on median pedicles. A marginal inferior band of alar cartilage is left adherent to the nasal mucosa. The procedure is completed without cartilaginous excision. We tried this technique in ten rhinoplasties and the results were satisfactory. The nasal tip narrowing obtained has no significant effect on either tip projection and position or nostril shape.

Esthetics↗

[Permanent expanders in esthetic, corrective and reconstructive surgery of the breast].

Since 1986 we used the permanent expandable implant (PEI) as the first choice of prosthesis in breast surgery. The possibilities offered by multiple over-expansions and deflations have been explored: 224 PEI were utilized in 162 patients for aesthetic (38 with bilateral hypoplasia), corrective (20 with asymmetry, tubular breasts or Poland's Syndrome) and reconstructive breast surgery (104 patients for immediate and delayed reconstruction following radical, modified radical, partial and subcutaneous mastectomy). All implants were positioned submuscularly; a latissimus dorsi flap was transposed when pectoralis major was absent or damaged. Either the Becker or the Gibney implant was used. All PEI were immediately or progressively overinflated by 25-80% and then deflated to the planned volume. Twenty-two patients developing capsular contracture were treated by overinflations and deflations with subjective and objective improvement. Many of augmentation mammaplasty patients refused implant deflation to the planned preoperative volume. The over-expansion/deflation process proved to be effective in obtaining ptosis, in maintaining permanent volume symmetry and in keeping the base of tubular breast unfolded.

Adult↗

Advances in pediatric esthetic dentistry.

The introduction of low-shrinkage composite and no-rinse conditioners has created an opportunity for pediatric dentists to change their standard operative regimen. The low-shrink composite solves many of the problems that have discouraged clinicians from routinely providing posterior composites for their patients. The reduction in polymerization shrinkage decreases problems with contraction stresses, sensitivity, microleakage, recurrent caries, and negative pulpal sequelae. No-rinse conditioners simplify the process and shorten the time required for bonding procedures. Liquid polish reduces the tedious finishing previously required with resin-based composites. The combination of the easier bonding and more user-friendly composite could add a new operative technique to the pediatric dentist's armamentarium. A study of low-shrink, resin-based composite restorations was performed to determine the effectiveness of these new materials for pediatric dental practice. The restorations were placed in primary molars to allow for their retrieval when exfoliated. The preparation and restorative techniques were standardized to match a similar study that used the "open-sandwich" method. The modified US Public Health Service ranking was used to evaluate marginal integrity at 6-month intervals for the 40 restorations placed in primary molars as a pilot study. TESCERA ATL restorations and prostheses were also evaluated for clinical effectiveness.

Acid Etching, Dental↗