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At least 19 recordsLinked to original sources
PubMedDate not supplied

Follicular transplantation for the correction of various stigmas after rhytidoplasty.

BACKGROUND: Rhytidoplasty may cause permanent and unwanted stigmas, such as dislocation of the temporal and cervical hairline. Widened scars inside the hairline may cause considerable social embarrassment. Furthermore, pretrichial incisions, even if well placed, may widen or become hypochromic, thus revealing that an aesthetic procedure has been performed. Various procedures for the correction of these undesirable telltale signs of a face-lift have been published. This report aims to present the results of correction for postrhytidoplasty stigmas using follicular transplantation. Patient assessment is discussed, and relevant technical aspects are detailed and illustrated. METHODS: A prospective study at the Ivo Pitanguy Clinic investigated patients who underwent hair transplantation to correct unaesthetic signs secondary to rhytidoplasty from January 2001 to December 2004. The aesthetic results and complications were evaluated, as well as the patients' satisfaction rate. The patients presented in this series either were referred from another service or had their rhytidoplasty originally performed in the authors' service. RESULTS: A total of 33 female patients were included in this study. Two patients were lost to follow-up evaluation and not included. The complications were minor. In the late follow-up assessment, 24 patients classified the result as excellent, 4 as satisfactory, and 3 as unsatisfactory. Only the patients who classified the results as unsatisfactory requested a second procedure (i.e., another follicular transplantation). CONCLUSIONS: When performed by an experienced surgical team, the follicular unit transplantation technique is a simple, safe, and efficient way to correct stigmas secondary to a rhytidoplasty, such as a visible scar or a displaced hairline, with satisfactory results and a very low complication rate.

Adult↗
PubMedDate not supplied

Endoscopically assisted forehead-brow rhytidoplasty: theory and practice.

Forehead-brow rhytidoplasty has evolved from a procedure primarily advocated for brow ptosis, to one in which a group of deformities are routinely addressed. It has also become evident that the surgical results stem from wide undermining with release of the periosteum and the concomitant alteration of the forehead muscles and not necessarily from skin lifting using elevation/excision ratios. Therefore, with the introduction of endoscopically assisted techniques to plastic surgery, the indications for a long forehead incision and its untoward sequelae have to be reconsidered. The anatomic basis for minimally invasive forehead-brow rhytidoplasty and three types of procedures are discussed. These include Type I--complete, endoscopically assisted forehead-brow rhytidoplasty; Type II--segmental, in conjunction with facelift surgery; and Type III--isolated, frown-muscle modification. The role of fixation (external support, internal suspension, or excision techniques) is described. Results suggest that these options provide a worthwhile alternative to traditional "open" techniques in certain circumstances, although some relevant questions remain unresolved.

Endoscopy↗
PubMed1990

Rhytidoplasty in the "pseudo-obese" patient: a group with specific characteristics and management.

Among candidates for rhytidoplasty there is a group with special features. These patients are called "pseudo-obese" because they look obese since they have flaccid faces. They present deep nasolabial sulcus, a prominent nasogenian region, and large cervicofacial flaccidity, all of which contribute to a look of anxiety or depression. These problems are not resolved by a classic rhytidoplasty alone. The author has applied standard procedures to this group of patients, including: (1) extensive undermining up to the nasogenian sulcus and across the cervical midline; (2) facial liposuction associated with fat injection under the nasogenian and laterobucal sulcus; (3) submentonian and cervical lypectomy performed without visual aid by curettage below the undermined skin; (4) traction on the border of the platisma muscle. Associated procedures were also used, such as treatment of micrognatism, rhinoplasty, perioral chemical peeling, and thickening of the upper lip. Special emphasis is placed on a surgical maneuver of introducing both hands beneath the undermined skin and crossing the fingers over the cervical midline in order to eliminate residual adherences, to verify the symmetry of the undermining on both sides, and to provide rapid trans-surgical skin expansion. Among the 159 patients who underwent rhytidoplasty by the author in 1987 and 1988), 74 (47%) presented "pseudo-obese" features. The author concluded that this group would not present good results if the associated procedures were not applied. This article presents anatomic and technical details, statistical data, and final results of these procedures.

Adult↗
PubMedDate not supplied

Repeating rhytidoplasty with SMAS, malar fat pad, and labiomandibular fold treatment: the NO primary procedure.

To repeat a rhytidoplasty means to do it again, with the exclusive aim of correcting the consequences on the facial aging. A short historic outline of the SMAS evolution is made. When the rhytidoplasty is repeated, the following aspects have to be taken into consideration: 1. The preoperative study, that includes analyzing previous rhytidoplasties; satisfaction or nonsatisfaction; sideburn, its location; hairline, its location; scars, their location and aspects; irregularities, their characteristics; nerve injuries, their detection; flaccidity, its evolution. 2. The surgical method to be practiced, which consists of skin dissection, subcutaneous fatty tissue treatment; SMAS treatment, and skin treatment. The types of surgical methods are: how the inferior third of the face and neck are corrected through the great mobility of the SMAS in this region, while in the medium third of the face the "nasolabial fold" and the midface flaccidity are corrected by treating the "malar fat pad." 3. In the chin region, the formation of a "labiomandibular fold" and how it is liberated and treated is described.

Adipose Tissue↗
PubMed2005

Quality of life and self-esteem outcomes following rhytidoplasty.

To evaluate improvement in patients' quality of life and self-esteem as a result of rhytidoplasty, 32 Caucasian female patients with facial rhytidosis, aged 46 to 68, were selected consecutively from a waiting list and underwent rhytidoplasty. The widely used health evaluation tool Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), and the Rosenberg Self-esteem Scale, a specific tool for self-esteem assessment, were used. Evaluations were carried out preoperatively and in the second and sixth months postoperative. Significant improvements were observed in 4 out of 8 aspects evaluated through SF-36, as well as in self-esteem, 2 and 6 months after surgery. The results presented here indicate that rhytidoplasty confers substantial improvement in health status and psychologic functioning of patients by increasing both quality of life and self-esteem.

Adult↗
PubMed1994

Forehead-brow rhytidoplasty: reassessing the goals.

Forehead-eyebrow rhytidoplasty traditionally has been advocated for senile brow ptosis. As the procedure became more widely accepted, it became a routine consideration in facial rejuvenation surgery. Indeed, over time, forehead-eyebrow rhytidoplasty also has withstood the initial criticism that was lodged against it of limited longevity, and it is realized that as with all other lifting procedures, it will gradually succumb to time, gravity, and the aging process. Moreover, refinements in techniques have added versatility to the procedure so that a variety of problems encountered in the upper face in addition to brow ptosis can be addressed. Consequently, an eclectic population with a range of deformities benefits from the procedure. Recently, though, it has seemed that the pendulum is swinging back, and that some surgeons are hesitating to incorporate forehead surgery because patients are voicing dissatisfaction with it. In order to assess the goals and indications for surgery, we reviewed a series of 350 patients who had a variety of aesthetic complaints in the upper face. Traditionally, patients' "other" indications for surgery, exclusive of brow ptosis, have been referred to as secondary (minor) indications. Now, with closer scrutiny, it appears that such problems, including forehead rhytids, frown muscle imbalance, upper eyelid aesthetics, lateral temporal laxity, and an abnormal expression, as a newly defined group, may actually be more frequent reasons than brow ptosis alone for performing a forehead-brow rhytidoplasty. As evaluated by the authors and supported by independent reviewers, low brow position alone should now account for less than half the forehead-brow surgery candidates. Furthermore, it is recognized that in considering the benefits achieved for patients with brow ptosis, often the results were due to "ancillary" surgical maneuvers routinely employed for the secondary indications. On balance, surgeons are advised to avoid adhering to traditional formulas for skin excision/brow elevation when operating on the brow; these can ultimately be the source of unsatisfactory outcomes. We believe that this philosophy will ultimately account for improved outcomes in forehead surgery. In addition, objective guidelines for the upper face have been reviewed and visual criteria defined which can be used in supplementing established brow spatial relationships for determining the ideal normal criteria for the upper third of the face.

Adult↗
PubMedDate not supplied

Forehead rhytidoplasty: endoscopic approach.

The difficulty in determining how much skin must be resected to achieve an adequate forehead and eyebrow lift through the coronal approach led the author to search for another forehead rhytidoplasty procedure. The endoscopic approach yields a natural lift of the eyebrows without skin excision through a minimal incision. It has been useful for patients who have a prominent forehead or have had a forehead rhytidoplasty. In addition, this technique provides a smooth forehead that is achieved by breaking the continuity of the forehead and glabella muscles. Despite the fact that the endoscopic approach is in the early stages of development, the results obtained from its use allow it to be an alternative procedure for treating the aging forehead and glabella.

Adult↗
PubMed1992

Secondary rhytidoplasty.

Secondary rhytidoplasty has become a very popular procedure. Of the 100 most recent patients presenting for rhytidoplasty, 19% asked for a second face-lift. In this article, we discuss particulars of second face-lifts.

Adult↗
PubMed1998

Simultaneous rhytidoplasty and lipoinjection: a comprehensive aesthetic surgical strategy.

Fat autografting is an accepted technique in the treatment of depressions or augmenting thin soft tissues. Aging soft tissues become thin, among them the subcutaneous fat layer, muscles, and fasciae, and these tissues in addition become flaccid. Therefore, to get better results in rejuvenation plastic surgery, a good alternative is the combination of lifting the flaccid tissues and thickening the thin soft tissues with a lack of contour and definition, which enhances the aspect of the entire face and neck. For 10 years in our practice, we have been combining rhytidoplasty (which includes systematizing superficial musculoaponeurotic system and platysma plication) with lipoinjection, placing thin rolls of autologous fat into the facial and cervical muscles, or at least under the fasciae. The results reveal a very high success rate with few minor complications. Proper diagnosis, patient selection, and adequate surgical technique produce predictable and favorable aesthetic results. A concurrent retrospective study of 357 consecutive patients who underwent simultaneous rhytidoplasty and lipoinjection was conducted over a 10-year period (1985 to 1995). The purpose of this article is to show our experience with this method, including long follow-up observations.

Adipose Tissue↗
PubMed1981

Importance of cervicomental complex treatment in rhytidoplasty.

The classic rhytidoplasty does not resolve the problems of excessive submental fat and muscular flaccidity with ptosis of the supporting muscles of the bottom of the mouth associated with facial aging. Therefore, we have used a technique of submental fat curettage followed by total undermining of the platysma muscle, submental medial myoraphy, and suspension of the submental soft parts in association with rhytidoplasty. Seventy-five patients have undergone this combination technique. Some patients reported constriction in the neck and some difficulty in swallowing for about 2 weeks after surgery, but there were no late or long-term complications.

Adipose Tissue↗
PubMed1979

Platysma muscle in rhytidoplasty.

Surgical alteration of the platysma muscle improves the results of cervicofacial rhytidoplasty. The operative technique indicated for an individual patient is determined, in part, by the anatomy of the platysma deformity. Many questions regarding the late results of platysma muscle surgery can only be answered by long-term follow-up. This paper presents the results in 75 patients who had platysma muscle flap cervicofacial rhytidoplasty. The 8 most common platysma deformities are discussed. Undesirable results and pitfalls in technique are noted.

Face↗
PubMed1987

Routine use of a suction drain in facial rhytidoplasty.

The effectiveness of a suction drain in facial rhytidoplasty was evaluated in 46 women ranging in age from 41 to 78 years. The drain was placed on the left side of the face in 16 and on the right in 14, and no drain was used in 16 patients. The drain was removed in 24 hours regardless of the amount aspirated, which varied between 0 and 25 ml, with an average of 7.8 ml. Although none of these patients developed a hematoma while the drain was in place, a hematoma did occur in 1 patient on the drain side following its removal. Despite the variable quantities of fluid aspirated, there was no clinical difference in swelling noted around the face and neck area when the two sides were compared. Similarly, one could not distinguish this group of patients from those 16 who did not receive the drain. The routine use of continuous suction drains for patients undergoing rhytidoplasty is therefore probably unnecessary.

Adult↗
PubMed1987

[Rhytidoplasty: perioperative guidelines. Particular technical basic details].

The authors present their philosophy of rhytidoplasty and the basic technical details of this kind of operation. The aging face often causes psychological as well as social problems that make patients go to a facial plastic surgeon. The authors stress the importance of an intensive preoperative information. Basic details of preoperative preparation, surgical technique and postoperative care are emphasised because they represent decisive steps in terms of the aesthetic results obtained. These details proved to be mostly important in the course of about 5000 rhytidoplasties.

Face↗
PubMedDate not supplied

Chemical peeling: an alternative to rhytidoplasty.

Phenol chemical peeling is a well known ancillary procedure for facial rejuvenation. It may be used as an adjuvant to rhytidoplasty or may be an alternative in selected patients or in patients who refuse to undergo both procedures and prefer a single stage and scarless procedure. The results are very gratifying and long lasting.

Chemexfoliation↗
PubMedDate not supplied

Custom-made rhytidoplasty.

The necessity to provide a particular surgical plan for each patient who seeks surgery for facial rejuvenation is stressed in this paper. The constant evolution of surgical procedures for rhytidoplasty have introduced several new procedures to attain the same goal. The pitfalls of using the same technique for each patient and also the utilization of very extensive procedures are discussed.

Aged↗
PubMed1995

Anatomy of the forehead muscles: the basis for the videoendoscopic approach in forehead rhytidoplasty.

The musculoaponeurotic system that performs mime for the upper third of the face is composed of the subcutaneous fascia and the occipitofrontalis, corrugator supercilii, and procerus muscles. Perfect understanding of the activity of these muscles provides for correction of horizontal furrows on the forehead, horizontal lines on the root of the nose, and glabellar frown lines. An anatomic gap in the deep layer of the subcutaneous fascia provides for the wide mobility of the scalp and forehead. A natural eyebrow lift is achieved by interrupting the restrictive forces of the corrugator supercilii and procerus muscles against the upward action of the occipitofrontalis muscle. The forehead rhytidoplasty through the endoscopic approach can achieve these results with small incisions and without skin resection.

Adult↗
PubMed1976

Relative hypoxemia during rhytidoplasty.

The results of blood gas analyses in 24 patients who had a rhytidoplasty under local anesthesia indicated that a moderate degree of hypoxemia can be elicited in these patients when they have had standard doses of the usual sedatives. While the acid-base abnormalities were generally corrected spontaneously, the extent of the hypoxemia can be aggravated further by the additional use of diazepam during the operation. Therefore, over-sedation of such a patient during the operation, without a secured airway, must be avoided. Additionally, we recommend deep breathing at frequent intervals, with or without supplemental oxygen through a high flow system.

Adult↗
PubMedDate not supplied

Quadrangular rhytidoplasty.

A four-angled incision for the performance of rhytidoplasty has been utilized for the past 2-1/2 years. This approach has provided excellent results and is suggested as a flexible, cosmetic incision providing easy access to the temporal, malar, mandibular, and cervical integument.

Dermatologic Surgical Procedures↗