Plastic & Reconstructive Surgery

Rosen, Harvey M.

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These findings support the credibility of maxillary advancement as the procedure of choice in selected individuals with mandibular prognathism. Indications and an aesthetic rationale for this surgical approach are presented.

Jacobs, Jonathan S.

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Rosenstein, Sheldon ; Kernahan, Desmond ; Dado, Diane ; Grasseschi, Mitchell ; Griffith, B Herold

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This report may serve as a baseline for others who wish to report on the incidence and type of orthognathic surgery in their cleft palate centers.

Pasnick, Jeffrey C.

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Markowitz, Bernard L.; Manson, Paul N.; Sargent, Larry ; Vander Kolk, Craig A.; Yaremchuk, Michael ; Glassman, Dean ; Crawley, William A.

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All comminuted fractures require transnasal wiring of the bones of the medial orbital rim (medial canthal tendon-bearing or “central” bone fragment). If the fracture does not extend through the canthal insertion, the canthus should not be detached to accomplish the reduction.

Liu, Don

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This paper discusses the use of gold weight lid load as a secondary procedure. By using three representative patients, I emphasize the following points: First, the dominance of the eye must be determined so that postoperative changes in the eyelid height can be anticipated. Second, in order to obtain an accurate weight of implant needed, the restrictive effect on the eyelid from the previous surgery (a tarsorrhaphy or an encircling band) must first be eliminated. Third, to ensure the best result and the patient's comfort, lacrimal function, Bell's phenomenon, and levator function must be assessed.

Habal, Mutaz B.

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Achauer, Bruce M.; Vander Kam, Victoria M.

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Ten female infants were referred for symptomatic hemangiomas in the anogenital area. (One had had steroid treatment prior to consultation.) The natural history of these lesions is well known. Virtually all will spontaneously involute over a period of years. However, the lesions reported were particularly troublesome because of repeated ulcerations and subsequent pain. Prior treatment had been local wound care with antibiotic ointment and Telfa-type dressings. After referral from a family practitioner or pediatrician, argon laser treatment was performed in an outpatient setting. Eight of the 10 patients were treated with local anesthesia, and 2 had general anesthesia. All lesions healed in 1 to 5 weeks. No patients referred during this period were excluded from this series. All who received treatment were included. All the lesions involuted following treatment. In our estimation, the final result is identical to what may be expected after spontaneous involution of an ulcerated or infected hemangioma. The major difference is that involution occurred in a few weeks in laser-treated patients rather than a period of months or years. Ulcerated hemangiomas of the anogenital area have significant morbidity that can be efficiently avoided with the use of argon laser therapy. Lesions of the anogenital area have a strong predilection for females.

Apfelberg, David B.

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Hayashi, Reiko ; Matsuo, Kiyoshi ; Hirose, Takeshi

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Utilizing Langer's technique for skin tension lines, we punctured the auricular cartilage of 10 human cadavers and 2 mature rabbits and 24 immature rabbits with a conical awl to determine their tension lines. Deformation of the holes into straight lines indicated the direction of maximum tension. A regular pattern was observed in adult rabbits and humans: Tension was at right angles to the long axis at the auricular base and parallel at the apex. This pattern was not present at birth, but developed at 1 to 2 weeks of age in rabbits. It is felt that these tension lines are responsible for the clinical results of auricular reconstruction. In children less than 1 week of age, tension lines are disorganized so that nonsurgical correction will be successful as long as hypoplasia is not present. In older children, correction will be successful when the deformity is parallel to the tension lines.