Facial Plastic Surgery Clinics of North America RSS feed: Current Issue. Facial Plastic Surgery Clinics of North America updates you on the latest trends in patient management; keeps you up to date on the newest advances; and provides a sound basis for choosing treatment options. Each issue focuses on a single topic in facial plastic surgery and is presented under the direction of a guest editor with a highly regarded facial plastic surgery practice experienced in clinical and scientific aspects of the latest cosmetic and reconstruction techniques and materials.http://www.facialplastic.theclinics.com/?rss=yesElsevier Inc.en © 2009 Published by Elsevier Inc. All rights reserved. Facial Plastic Surgery Clinics of North America1064-7406181February 2010 © 2009 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.facialplastic.theclinics.com/article/PIIS1064740610000131/abstract?rss=yesContributors10.1016/S1064-7406(10)00013-1Facial Plastic Surgery Clinics of North America 18, 1 (2010)2010-02-01Facial Plastic Surgery Clinics of North America2010-02-01181S1064-7406(10)X0002-5iiiivhttp://www.facialplastic.theclinics.com/article/PIIS1064740609001539/abstract?rss=yesIn the November 2009 issue of Facial Plastic Surgery Clinics of North America on facelift, Dr David A. Caplin's affiliations were incorrectly published. Dr Caplin is Clinical Instructor at Washington University, St Louis, and in private practice at Parkcrest Plastic Surgery, 845 North New Ballas Court, Suite 300, St Louis, MO 63141, USA. His e-mail address is: Gfts27@aol.com.ErratumDavid A. Caplin10.1016/j.fsc.2009.12.001Facial Plastic Surgery Clinics of North America 18, 1 (2010)2010-02-01Facial Plastic Surgery Clinics of North America2010-02-01181S1064-7406(10)X0002-5vvhttp://www.facialplastic.theclinics.com/article/PIIS1064740610000143/abstract?rss=yesContents10.1016/S1064-7406(10)00014-3Facial Plastic Surgery Clinics of North America 18, 1 (2010)2010-02-01Facial Plastic Surgery Clinics of North America2010-02-01181S1064-7406(10)X0002-5viixihttp://www.facialplastic.theclinics.com/article/PIIS1064740610000155/abstract?rss=yesForthcoming Issues10.1016/S1064-7406(10)00015-5Facial Plastic Surgery Clinics of North America 18, 1 (2010)2010-02-01Facial Plastic Surgery Clinics of North America2010-02-01181S1064-7406(10)X0002-5xiixiihttp://www.facialplastic.theclinics.com/article/PIIS1064740609001515/abstract?rss=yesThe makeup of today's facial plastic surgery patient is as diverse as ever with a larger percentage of patients from various ethnicities seeking cosmetic enhancement. This edition of Facial Plastic Surgery Clinics focuses on a broad range of non-White groups, including African, Hispanic, Asian, and Middle Eastern individuals, with coverage of important topics ranging from cultural considerations, rejuvenation of the aging face, ethnic lip reduction, hair restoration, to rhinoplasty techniques. In-depth discussion of the management of difficult-to-treat ethnic skin is covered with an introduction to a new paradigm for ethnic skin and safe and effective treatment strategies using advanced lasers and traditional peels.PrefaceSamuel M. Lam10.1016/j.fsc.2009.11.017Facial Plastic Surgery Clinics of North America 18, 1 (2010)2010-02-01Facial Plastic Surgery Clinics of North America2010-02-01181S1064-7406(10)X0002-5xiiixiiihttp://www.facialplastic.theclinics.com/article/PIIS1064740609001357/abstract?rss=yesFat transfer has become the primary method for facial rejuvenation in my clinical practice for all ethnicities. This technique can be effectively used to address panfacial volume loss so long as artistry, technical skill, and an in-depth understanding of fat grafting changes over the years are well applied and understood. Fat grafting can replace many traditional facial rejuvenation techniques or serve as an important adjunct to excisional and lifting procedures to temper the degree of excision and lifting that are required.A New Paradigm for the Aging FaceSamuel M. Lam10.1016/j.fsc.2009.11.001Facial Plastic Surgery Clinics of North America 18, 1 (2010)2010-02-01Facial Plastic Surgery Clinics of North America2010-02-01181S1064-7406(10)X0002-516http://www.facialplastic.theclinics.com/article/PIIS1064740609001369/abstract?rss=yesThe goal would be similar to Caucasian patients in that all patients would like to have maximum improvement with minimal detectability of the surgical procedure. With regard to scars, the incisions must be no longer than necessary to accomplish the desired goal, and should be carefully placed so that color matches are ideal and there is no objectionable hair shift. In addition, the technique of making an incision for male patients should be made so that hairs will grow through the scars whenever possible. For non-Caucasian patients it is essential that attention be made to all of the known details and techniques, to avoid detection that surgery has been performed.Lower Facial Rejuvenation in the Non-Caucasian FaceBruce F. Connell10.1016/j.fsc.2009.11.002Facial Plastic Surgery Clinics of North America 18, 1 (2010)2010-02-01Facial Plastic Surgery Clinics of North America2010-02-01181S1064-7406(10)X0002-5717http://www.facialplastic.theclinics.com/article/PIIS1064740609001497/abstract?rss=yesThe non-Caucasian face has many unique attributes, including skin tone, texture, elasticity, skin thickness, and subcutaneous fat content. These differences may place the patient at increased risk for scarring and pigmentation issues. In this paper, the authors discuss treatment options, surgical and nonsurgical, for rejuvenation of the upper face and midface, including the periorbital region. The selection of the proper treatment must be coupled with a thorough understanding of the age-related changes that occur in the non-Caucasian face to meet and hopefully exceed the patient's expectations.Upper and Midfacial Rejuvenation in the Non-Caucasian FaceRami K. Batniji, Stephen W. Perkins10.1016/j.fsc.2009.11.015Facial Plastic Surgery Clinics of North America 18, 1 (2010)2010-02-01Facial Plastic Surgery Clinics of North America2010-02-01181S1064-7406(10)X0002-51933http://www.facialplastic.theclinics.com/article/PIIS1064740609001503/abstract?rss=yesSuperior hair restoration requires the application of universal principles along with variations that apply to specific ethnic populations. This article serves as a primer on basic tenets of hair restoration, with additional attention given to the uniqueness and differences in technique and design that are warranted for a wide range of races and ethnicities. This article also gives prospective surgeons an insight on how to undertake further study and shore up their deficiencies so as to refine knowledge gaps and ensure patient safety and excellent surgical outcomes.Hair Restoration in the Ethnic Patient and Review of Hair Transplant FundamentalsSamuel M. Lam, Emina Karamanovski10.1016/j.fsc.2009.11.016Facial Plastic Surgery Clinics of North America 18, 1 (2010)2010-02-01Facial Plastic Surgery Clinics of North America2010-02-01181S1064-7406(10)X0002-53542http://www.facialplastic.theclinics.com/article/PIIS1064740609001382/abstract?rss=yesSupratarsal crease fixation in the Asian patient can provide a more open-eyed, awake look without compromising their ethnic appearance. A conservative supratarsal crease height and conservative to no removal of postseptal fat help to ensure this natural-appearing result. With the full-incision method, consistently excellent results have been achieved with durable crease fixation despite a prolonged recovery time. The supratarsal crease fixation provides an excellent method for the younger patient seeking cosmetic eyelid enhancement. However, for the aging Asian patient, the complexity of the strategy is greater.Supratarsal Crease Creation in the Asian Upper EyelidSamuel M. Lam, Amir M. Karam10.1016/j.fsc.2009.11.004Facial Plastic Surgery Clinics of North America 18, 1 (2010)2010-02-01Facial Plastic Surgery Clinics of North America2010-02-01181S1064-7406(10)X0002-54347http://www.facialplastic.theclinics.com/article/PIIS1064740609001394/abstract?rss=yesThe population of the United States is becoming increasingly more diverse as there is an ever expanding influx of various ethnic groups and races that comprise the general population. As a result, the singular concept of Nordic beauty that dominated the United States media throughout the middle of the twentieth century has given way to a more diverse multiracial aesthetic. There is also a growing trend in aesthetic surgery toward ethnic feature preservation and avoidance of a “westernized” look that was more popular in previous years. Today's facial plastic surgeon must be familiar with these trends and aesthetic goals within this rapidly growing patient population. This article describes the anatomy of the Asian and Latino face and describes the techniques of midface alloplastic augmentation.Midface Alloplastic Augmentation in the Asian and Latino PatientA. Joshua Zimm, William J. Binder10.1016/j.fsc.2009.11.005Facial Plastic Surgery Clinics of North America 18, 1 (2010)2010-02-01Facial Plastic Surgery Clinics of North America2010-02-01181S1064-7406(10)X0002-54969http://www.facialplastic.theclinics.com/article/PIIS1064740609001400/abstract?rss=yesMethods of alloplastic forehead augmentation using soft expanded polytetrafluoroethylene (ePTFE) and silicone implants are described. Soft ePTFE forehead implantation has the advantage of being technically simpler, with better fixation. The disadvantages are a limited degree of forehead augmentation and higher chance of infection. Properly fabricated soft silicone implants provide potential for larger degree of forehead silhouette augmentation with less risk of infection. The corrugated edge and central perforations of the implant minimize mobility and capsule contraction.Forehead Augmentation with Alloplastic ImplantsJoseph K. Wong10.1016/j.fsc.2009.11.006Facial Plastic Surgery Clinics of North America 18, 1 (2010)2010-02-01Facial Plastic Surgery Clinics of North America2010-02-01181S1064-7406(10)X0002-57177http://www.facialplastic.theclinics.com/article/PIIS1064740609001412/abstract?rss=yesThis article discusses and presents options related to the cosmetic reduction of enlarged lips, primarily in ethnic populations. No formal study is performed. The author presents a literature review and discusses his personal 26-year experiences in lip surgery. When basic tenets are followed, cosmetic lip reduction is a predictable procedure with very little morbidity. Although lip augmentation is a popular cosmetic procedure, a certain percentage of the population desires smaller lips. Reduction cheiloplasty is a safe and predictable procedure that has been performed over a half century. This procedure is relatively simple and has a moderate learning curve. Cosmetic lip reduction is safe and effective, and has a high level of patient acceptance when certain diagnostic and treatment criteria are fulfilled.Lip Reduction Surgery (Reduction Cheiloplasty)Joe Niamtu10.1016/j.fsc.2009.11.007Facial Plastic Surgery Clinics of North America 18, 1 (2010)2010-02-01Facial Plastic Surgery Clinics of North America2010-02-01181S1064-7406(10)X0002-57997http://www.facialplastic.theclinics.com/article/PIIS1064740609001424/abstract?rss=yesRacial genetics play a significant role in determining a patient's response to any skin treatment. Contrary to traditional skin classifications, the new genetico-racial classification takes into consideration the racial origins of patients, as manifested in both their skin color and their feature contour characteristics, rather than their skin color alone. According to this new classification, patients may belong to 1 of 6 categories, originating from the 3 ancient continents: Africa, Europe, and Asia. In this article the Asian category, as well as its subcategories, are approached in a radically different way. This new geneticoracial classification ushers in a “paradigm shift” in the way Asian patients are perceived before, during, and after skin treatments. The new geneticoracial classification advances that Asians are excellent candidates to most peels and laser treatments, as long as their genetic disposition and their anticipated responses to those treatments are understood and respected.The New “Genetico-Racial” Skin Classification: Maximizing the Safety of Skin Treatments for AsiansValérie Côté, Nabil Fanous10.1016/j.fsc.2009.11.008Facial Plastic Surgery Clinics of North America 18, 1 (2010)2010-02-01Facial Plastic Surgery Clinics of North America2010-02-01181S1064-7406(10)X0002-599104http://www.facialplastic.theclinics.com/article/PIIS1064740609001436/abstract?rss=yesWith the growth of new technology and products over the last 10 years, there has been an increased ability to improve a patient's appearance with procedures that can be performed in an office setting, including laser procedures. Demand for these procedures has grown among all ethnic groups. Patients with ethnic skin can have varying response to lasers. This factor should be considered when planning their treatment. After laser treatment, Patients with ethnic skin are at greater risk for laser energy absorption by melanin, postinflammatory hyperpigmentation, and loss of pigment due to laser effects on melanin production leading to hypopigmentation. Therefore, any laser therapy should be planned carefully, especially in the treatment of patients with darker skin types.Laser Treatment for Ethnic SkinPaul J. Carniol, Heather Woolery-Lloyd, Alice S. Zhao, Kim Murray10.1016/j.fsc.2009.11.009Facial Plastic Surgery Clinics of North America 18, 1 (2010)2010-02-01Facial Plastic Surgery Clinics of North America2010-02-01181S1064-7406(10)X0002-5105110http://www.facialplastic.theclinics.com/article/PIIS1064740609001448/abstract?rss=yesThis article focuses on chemical peels for darker skin types. All races comprise a range of Fitzpatrick skin color types: light skin types in African Americans, Asians, Middle Easterners, and Latinos and dark skin types in whites. With the focus on Fitzgerald skin types IV to VI, this article discusses chemical peels, providing current information on types of peels, detailed techniques, preoperative and postoperative care, complications, hazards, and nuances of management.Chemical Peels for Darker Skin TypesPeter Rullan, Amir M. Karam10.1016/j.fsc.2009.11.010Facial Plastic Surgery Clinics of North America 18, 1 (2010)2010-02-01Facial Plastic Surgery Clinics of North America2010-02-01181S1064-7406(10)X0002-5111131http://www.facialplastic.theclinics.com/article/PIIS1064740609001485/abstract?rss=yesBotulinum toxin A is a highly efficacious and cost-effective, nonsurgical option for reducing the width and shape of the lower face and jawline. The results can vary from the subtlest thinning of the face to an extremely thin, cachectic appearance. Many nuances can be achieved. The administration is simple, and the process takes barely 5 minutes in an office setting. Botulinum toxin A can also be effectively used to reduce the bulk of an enlarged parotid gland without affecting saliva production.Botox Facial Slimming/Facial Sculpting: The Role of Botulinum Toxin-A in the Treatment of Hypertrophic Masseteric Muscle and Parotid Enlargement to Narrow the Lower Facial WidthWoffles T.L. Wu10.1016/j.fsc.2009.11.014Facial Plastic Surgery Clinics of North America 18, 1 (2010)2010-02-01Facial Plastic Surgery Clinics of North America2010-02-01181S1064-7406(10)X0002-5133140http://www.facialplastic.theclinics.com/article/PIIS106474060900145X/abstract?rss=yesTraumatic injury resulting in nasal deformity poses unique challenges to the surgeon. Optimal management requires careful preoperative analysis and thoughtful surgical planning. The goals of rhinoplasty are to correct both cosmetic and functional problems that may not have otherwise been an issue prior to the injury. Although it is overly simplistic to group all individuals from one ethnicity as having one type of nose, the rhinoplasty surgeon must understand the common variations of nasal anatomy seen in various races of individuals. This article discusses ethnic anatomic differences in the non-Caucasian nose in the context of posttraumatic nasal deformity. The various rhinoplasty techniques and strategies to address these issues are reviewed.Traumatic Rhinoplasty in the Non-Caucasian NoseDavid W. Kim, Harry S. Hwang10.1016/j.fsc.2009.11.011Facial Plastic Surgery Clinics of North America 18, 1 (2010)2010-02-01Facial Plastic Surgery Clinics of North America2010-02-01181S1064-7406(10)X0002-5141151http://www.facialplastic.theclinics.com/article/PIIS1064740609001527/abstract?rss=yesAsian rhinoplasty is one of the most challenging ethnic rhinoplasties that plastic surgeons perform because of the thick skin and soft-tissue envelope. There are three goals: pleasing the patient, achieving an aesthetically appealing result, and preserving a natural look. Of these goals, the most arduous is to satisfy the patient, as many patients have unrealistic goals and may desire an extremely narrow Western nose. Furthermore, patients may bring in celebrity or model photographs and expect that outcome, even though it may not be suitable for their face or appear over-resected and pinched. The surgeon's most important task is to attempt to persuade the patient that this result is nonfunctional, esthetically unfit, and difficult to achieve with their skin. For ethnic surgery, a clear and thorough grasp of nasal anatomy, function, and surgical techniques is paramount. An extensive preoperative discussion, including expectations, outcomes, and a detailed list of potential complications with the patient can prevent physician-patient miscommunication. Before surgery, it is essential to review the office examination, previous operative summary, photographs, nasal analysis sheet, problem list, and plan before proceeding with the surgical treatment.Asian RhinoplastyPaul S. Nassif, Kimberly J. Lee10.1016/j.fsc.2009.11.018Facial Plastic Surgery Clinics of North America 18, 1 (2010)2010-02-01Facial Plastic Surgery Clinics of North America2010-02-01181S1064-7406(10)X0002-5153171http://www.facialplastic.theclinics.com/article/PIIS1064740609001370/abstract?rss=yesRhinoplasty is one of the most common facial plastic procedures performed in the Hispanic/mestizo ethnic group. Today, emphasis is placed on ethnic and cultural backgrounds, definition of facial and nasal characteristics, and a clear understanding of patients' desires. This article highlights the different types of problems encountered in mestizo patients. It describes a graduated approach to the nose whereby support structures of the nose are strengthened by careful placement of sutures and grafts, trying to achieve greater definition and support without necessarily making the nose look bigger.Hispanic/Mestizo RhinoplastyRoxana Cobo10.1016/j.fsc.2009.11.003Facial Plastic Surgery Clinics of North America 18, 1 (2010)2010-02-01Facial Plastic Surgery Clinics of North America2010-02-01181S1064-7406(10)X0002-5173188http://www.facialplastic.theclinics.com/article/PIIS1064740609001461/abstract?rss=yesWe are in the midst of truly changing times, as patients of African descent actively embrace facial cosmetic surgery. Gaining surgical consistency in patients of African descent has proven to be elusive and unpredictable for many rhinoplasty surgeons. Surgical success relies on the surgeon's ability precisely to identify anatomic variables and reconcile these anatomic realities with the patient's expectations for aesthetic improvement and ethnic identity. An appreciation for underlying heritage provides a link culturally to connect with prospective patients and serves as a tool for establishing realistic aesthetic goals. This article highlights the significance of exploring ancestry in the rhinoplasty consultation; identifies key anatomic variables in the nasal tip, dorsum, and alar base; and reviews surgical logic that has facilitated the achievement of consistent, balanced aesthetic outcomes.Rhinoplasty in the Patient of African DescentMonte O. Harris10.1016/j.fsc.2009.11.012Facial Plastic Surgery Clinics of North America 18, 1 (2010)2010-02-01Facial Plastic Surgery Clinics of North America2010-02-01181S1064-7406(10)X0002-5189199http://www.facialplastic.theclinics.com/article/PIIS1064740609001473/abstract?rss=yesThe ethnic appearance of the Middle Eastern nose is defined by several unique visual features, particularly a high radix, wide overprojecting dorsum, and an amorphous hanging nasal tip. These external characteristics reflect distinct structural properties of the osseo-cartilaginous nasal framework and skin–soft tissue envelope in patients of Middle Eastern extraction. The goal, and the ultimate challenge, of rhinoplasty on Middle Eastern patients is to achieve balanced aesthetic refinement, while avoiding surgical westernization. Detailed understanding of the ethnic visual harmony in a Middle Eastern nose greatly assists in preserving native nasal-facial relationships during rhinoplasty on Middle Eastern patients. Esthetic alteration of a Middle Eastern nose follows a different set of goals and principles compared with rhinoplasties on white or other ethnic patients. This article highlights the inherent nasal features of the Middle Eastern nose and reviews pertinent concepts of rhinoplasty on Middle Eastern patients. Essential considerations in the process spanning the consultation and surgery are reviewed. Reliable operative techniques that achieve a successful aesthetic outcome are discussed in detail.Middle Eastern RhinoplastyBabak Azizzadeh, Grigoriy Mashkevich10.1016/j.fsc.2009.11.013Facial Plastic Surgery Clinics of North America 18, 1 (2010)2010-02-01Facial Plastic Surgery Clinics of North America2010-02-01181S1064-7406(10)X0002-5201206http://www.facialplastic.theclinics.com/article/PIIS1064740610000167/abstract?rss=yesIndex10.1016/S1064-7406(10)00016-7Facial Plastic Surgery Clinics of North America 18, 1 (2010)2010-02-01Facial Plastic Surgery Clinics of North America2010-02-01181S1064-7406(10)X0002-5207221