Aesthetics Flashcards
An isolated upper blepharoplasty performed in the presence of brow ptosis can over time worsen that problem,why?
as frontalis tone decreases with the elimination of the compensatory stimulus provided by hanging upper lid skin, resulting in increased brow ptosis
fashion, it may be more desirable for the brow to reach its vertical peak closer to the lateral canthus
T
the temporal branch of the facial nerve, and this is the only motor nerve at risk during a brow lifting procedure
T
Staying in the subcutaneous plane while dissecting the forehead avoids any possibility of motor nerve injury
T
The supratrochlear nerve plays a far more significant role in brow innervation than the nerve supraorbital
F. supraorbital
Fat play major role in brow aesthetic T or F
f. There is minimal adiposity in the brow. Therefore, fat plays little role in the aging process of the brow
Temporal hollowing can indeed play a significant role in aging the face,
T
the sentinel vein, a structure that lies 1.5 cm superior and lateral to the lateral canthus
T. resents an important landmark, as it can be used to establish the position of the temporal branch of the facial nerve (1 cm lateral and inferior to the sentinel vein) as well as the temporal line of fusion at the temporal crest.1
The presence of compensated brow ptosis must also be ruled out prior to performing an upper blepharoplasty.
T
Neuromodulators are indicated in the treatment of isolated static rhytids of the brow.
Neuromodulators are indicated in the treatment of isolated dynamic rhytids of the brow.
efficacy is more rapidly lost in males.regarding botox
T
endoscopic brow lift effectively addresses central forehead and glabellar rhytids, lateral ptosis and crow’s feet are not as readily addressed with this procedure
T
a high hairline or an acutely sloped forehead can considered an aesly approached with endoscope
a high hairline or an acutely sloped forehead can make this procedure technically difficult to perform
Which potion of the orbiculares responsible for brow ptosis in upper eyelid and festoon in the lower eyelid
The orbital portion of the orbicularis can cause brow depression in the upper lid, and attenuation of this muscle can contribute to festoons in the lower lid
What the analogue in lower eyelid to the levator and Muller muscle of the upper eyelid?
The lower eyelid retractors include the capsulopalpebral fascia and inferior tarsal muscle,
The tear trough ligament is an osteocutaneous ligament between the palpebral and orbital portions of the orbicularis oculi muscle
T
The lacrimal sac located between anterior and posterior limp of the lateral canthus
F. Medial canthus
Patients with unrealistic self-image or who are not capable of understanding the limitations of the procedure are poor surgical candidates in blepharoplasty
T
lower eyelid blepharoplasty is generally reconstractive in nature
F lower eyelid blepharoplasty is generally cosmetic.
A safe rule of thumb is that skin resection should preserve a brow to margin distance of at least 10 mm
A safe rule of thumb is that skin resection should preserve a brow to margin distance of at least 20 mm
Central orbital fat pad typically requires debulking more often than the medial pad
medial orbital fat pad typically requires debulking more often than the central pad
If patient’s has significant lower lid laxity they are at higher risk for ectropion with any skin resection and a lateral canthal tightening procedure should be performed
T. Skin
We need to make lateral canthal support even in case of transconjectival approach
F. Lateral canthal support is generally not needed in a transconjunctival approach, as the orbicularis is not weakened by division
In case of subseptal hematoma after blepharoplasty high-dose IV steroids should be initiated to maximize visual recovery
F. Steriod should be given only in case of vision loss to maximize the vision recovery
Chronic UVA exposure, smoking, radiation, and chronic diseases are extrinsic factors that accelerate skin aging
T
Facelifting techniques have big effect on skin texture, elasticity, and discoloration, but they improve folds resulting from tissue shifting and descent.
F. Facelifting techniques have little effect on skin texture, elasticity, and discoloration, but they improve folds resulting from tissue shifting and descent.
Why the retaining ligaments is considered important?
Retaining ligaments are landmarks for facial rejuvenation procedures as they separate facial fat compartment, are intimately related to the branches of the facial nerve,
The branches of the facial nerve exit after getting out form parotid gland
F. With in parotid gland
The main blood supply to the soft tissues of the face comes from branches of the external carotid artery and external jugular vein
F.internal jugular vein
The infraorbital artery, another branch of the external carotid artery (from the facial artery)
The infraorbital artery, another branch of the external carotid artery (from the maxillary artery)
The volume and position of tissues will define the need for asymmetrical undermining and SMAS elevation, or a combination of a facelift with fat grafting
T
Perioperative pneumatic compression pump and early ambulation
are useful for all facelift patients.
T.
In short scar face lift the laxity of the neck can be addressed
F , not addressed
The elevation vector of the SMAS is usually posterolateral.
The elevation vector of the SMAS is usually superolateral, and the vector of the skin redraping is usually posterolateral
In SMAS flap at least partial transection of the zygomatic and masseteric-cutaneous ligaments for full mobilization of the cheek and jaw line.
T
Nanofat is a fat grafting derivate from emulsification of macrofat
F. Nanofat is a fat grafting derivate from emulsification of microfat
Some facelift procedures will have some effect on the neck
F. all facelift procedures will have some effect on the neck
The facial artery and vein and the marginal mandibular branch of the facial nerve crosses the gland superficially inside its capsule.
F. The facial artery and vein and the marginal mandibular branch of the facial nerve crosses the gland superficially outside its capsule.
the anterior belly of the digastric can be partially or totally excised without noticeable loss of function
T
In an anterior neck, the superficial and deep planes of the neck can be resected
T
Drains have shown to prevent hematomas or seromas but are advocated by many authors to help decrease the amount of swelling and bruising after a facelift and help the patient return quickly to social activitie
F. Drains have not shown to prevent hematomas or seromas but are advocated by many authors to help decrease the amount of swelling and bruising after a facelift and help the patient return quickly to social activitie
quilting sutures is a strategy in prevention of hematoma in the face by reducing the rate of hematoma to zero
T
Rohrich shows that at least 4 weeks of abstinence from smoking reduces respiratory and wound-healing complications.in face lift
T
What the difference between the nasl vien and other system ?
The nasal veins do not have valves
□ The nasal venous system has direct communication to the cavernous sinus, thus making nasal infections potentially a life-threatening event
The vestibule is lined by hair-bearing squamous epithelium up to the level of the upper lateral cartilage,
F. The vestibule is lined by hair-bearing squamous epithelium up to the level of the caudal margin of the alar cartilage,
What is the scroll area in the nose ?
Scroll area: The area where the cephalic edge of the lower lateral cartilage interlocks with the caudal edge of the upper lateral cartilage.
more anterior position of the nasal frontal angle can make the nasal tip look less projecting while a more posterior or deeper position for the nasal frontal angle can make the nasal tip look relatively more projecting
T
The degree of rotation of the nasal tip is assessed by evaluating the nasolabial angle.
T
The alar-columellar relationship can relay on for collemular show evaluation
T
modern rhinoplasty techniques they prefer to do nose before tip. T. F
T
the revision surgeon must be prepared to use all tools available to make the anatomical structures as normal as possible to achieve satisfactory appearance and function
T
Most otoplasty procedures are best performed e:3 years old when most ear growth is completed.
T
All of newborns have an auricular deformity that persists in 33% by 1 month old ; 1 as many as 84% of deformities continue to improve over the first year of life
About 50% of newborns have an auricular deformity that persists in 33% by 1 month old ; 1 as many as 84% of deformities continue to improve over the first year of life
Half of children have a bilateral ear deformity, and when deformity is unilateral, the right and left sides are affected equally.
T
A helical anomaly/constricted ear is the most common disorder at birth (15%)
T
The ears are particularly not tolerance to asymmetry.
The ears are particularly tolerant of asymmetry because of their lateral position over the temporal bones.
Ideally, molding is started between 4 and 6 weeks
F. Ideally, molding is started between 1 and 3 weeks
After 6weeks old, ear molding is not effective
F. After 12 weeks old, ear molding is not effective
The ear deformity that is most amenable to molding is a stahl ear.
F. The ear deformity that is most amenable to molding is a prominent ear.
Simple excisions of excess of abnormal ear structures can be performed during infancy with local anesthesia at 4-6 week
T
The best time to do surgical correction for otopalsty is at 7 years
F. Above 3 years because the ear has reache dher 85%. Of it growth
long-term memory and self-esteem begin to form at approximately 4 year old
T
Approximately 15% of the population has a prominent ear
F. Approximately 5% of the population has a prominent ear
Most patients will require recreation of the antihelical fold and setback of the concha. Rarely, a patient will have a normal antihelix and only require a procedure on the concha
T
all patients will need to have the upper and/or middle third of the ear and lobule set pack as well
F. all patients will need to have the upper and/or middle third of the ear setback, 25% of patients in my practice will benefit from having their lobule set � ack as well
Three-fourths of patients in my experience undergo bilateral setback otoplasty, whereas one-fourth of individuals have prominence of only one ear.
T
skin excision in prominent ear is preferred because it facilitates the procedure by enhancing exposure
T
scapha-concha sutures because it gives greater control and more predictability compared to scoring the cartilage
T. scoring the cartilage can cause damage to the cartilage and contour abnormalities
On front view, the antihelix should have a gentle curve and the helix should be visible behind the antihelix
T
It preferable to make cartilage excision because it reduces the risk of recurrence and weakens the area to facilitate the antihelix contour provided by the scapha-concha sutures in correction of the middle third of the ear
T
An approximately 2.0 to 2.5 cm long piece of superior conchal cartilage is removed just above the scapha-concha sutures
An approximately 2.0 to 2.5 cm long piece of superior conchal cartilage is removed just below the scapha-concha sutures
If more than a 7 mm width of cartilage is removed, then it is possible that the excess skin anteriorly might be bothersome to the patient and require excision
T
Stahl ear can cause cause psychosocial morbidity. F. Or. T
F. does not cause psychosocial morbidity.
Always , stahl patients have a prominent ear deformity
Occasionally, stahl ear patients may have a prominent ear deformity
In cleft lope The scar can be repierced 3 months later when it has achieved its maximal strength.
T
After rcsccting the keloid, the patient wears a pressure earring beginning immediately following the procedure at night
F. After rcsccting the keloid, the patient wears a pressure earring beginning 2 weeks following the procedure at night
Rarely, a skin abrasion or full-thickness wound can occur with ear molding;
T
The most common problem is an unfavorable “cosmetic” outcome. Infection, hematoma, extrusion of sutures, or wound dehiscence is uncommon
T
The most common problem is an unfavorable “cosmetic” outcome. Infection, hematoma, extrusion of sutures, or wound dehiscence is uncommon
T
The sub muscular plane is typically preferred for implant placement.
F. The subperiosteal plane is typically preferred for implant placement.
Skeletal augmentation can be viewed as a substitute for soft tissue suspension
Skeletal augmentation should not be viewed as a substitute for soft tissue suspension
An ideal implant material is one that is biocompatible and has minimal interaction with the surrounding tissues
T
Porous implants typically result in less robust capsule formation compared to smooth implants. Implant migration and adjacent bone erosion also tend to be lower in porous implants
T
Implant migration and adjacent bone erosion also tend to be lower in smooth implants
F. Implant migration and adjacent bone erosion also tend to be lower in porous implants
Solid silicone implants offer several advantages over other materials ?
Easily molding to take the shape and size we want
Easily fixated by screw or suture
Less infection
Screw fixation provides for more freedom in pocket dissection and thus greater exposure at the time of implant insertion
T
In patients with a relatively abnormal occlusion, deficient midface projection can be corrected with facial implants
In patients with a relatively normal occlusion, deficient midface projection can be corrected with facial implants
Malar implants can simulate the visual effect ofLeFort I advancement.
F. paranasal implants can simulate the visual effect ofLeFort I advancement.
Paranasal augmentation is don by placing the implant directly over the piriform operator
F. Lateral to piriform operator
Compromise ofthe nasal airway can occur ifimplants are positioned over the piriform aperture
Better exposure of the midface skeleton can be obtained by incorporating an intraoral sulcus incision.
T
Prior to closure, malar soft tissue should be resuspended over the secured implant.
T
In Temporal Augmentationthe implant placed under the muscles
F. the PMMA is placed over the deficient muscle
If patients have not had surgery or have had the temple used as a remote access to other regions of the face (i.e., subperiosteal facelift), then the implant is placed beneath the temporalis muscle though an incision in the temporal hair-bearing
T
Chin implant insertion better to approached through intra oral. T. F
F. submental incision exclusively
Bone resorption of adjacent areas has been reported and is associated with porous. implants
F. Bone resorption of adjacent areas has been reported and is associated with solid implants
If implant infection does occur, antibiotic treatment alone is usually sufficient.
F. If implant infection does occur, antibiotic treatment alone is usually not sufficient.
The horizontal genioplasty remains as the most commonly performed osteotomy of the facial skeleton,
F The horizontal genioplasty remains as the second most commonly performed osteotomy of the facial skeleton, after rhinoplasty
Alloplastic augmentation with chin implants can be effective in correcting mild to moderate volume deficiencies in the vertical plane
F. Alloplastic augmentation with chin implants can be effective in correcting mild to moderate volume deficiencies in the sagittal plane
Major limitations of alloplastic methods occur when trying to correct vertical excess or any asymmetries of the anterior
T
Genioplasty can be seen as a replacement to orthognathic surgery
F. should not be seen as a replacement to orthognathic surgery
Th e lower lip, determines the extent to which the chin should be advanced
Th e lower lip, and not the other structures in the mid and upper face, determines the extent to which the chin should be advanced
vertical lengthening softens the labiomental crease
T
Sagittal advancement or vertical shortening of the symphyseal segment would result in deepening of the labiomental groove
T
The majority of individuals requesting aesthetic enlargement of the chin have class II malocclusion secondary to mandibular retrognathia
T
There is no role for orthodontic treatment to correct the malocclusion T. F
F. Although prior orthodontic treatment can convert class II malocclusion into type I, it corrects the underlying skeletal problems
Alwas need to detach the anterior belly of the digastric muscles from the lingual surface.in case we want to move the chin segment
F. If extensive anterior movement of the chin segment is anticipated, it might be necessary to detach the anterior belly of the digastric muscles from the lingual surface.
Wound dehiscence and infection are common after osseous genioplasty.
F. Wound dehiscence and infection are rare after osseous genioplasty.
Tooth devitalization is probably one of the most serious complications after osseous genioplasty and can be avoided by placing the osteotomy at least 3mm caudal to the occlusal edge of the mandibular canines
F. Tooth devitalization is probably one of the most serious complications after osseous genioplasty and can be avoided by placing the osteotomy at least 30 mm caudal to the occlusal edge of the mandibular canines
Tooth devitalization is probably one of the most serious complications after osseous genioplasty and can be avoided by placing the osteotomy at least 3 mm caudal to the occlusal edge of the mandibular canines
F. Tooth devitalization is probably one of the most serious complications after osseous genioplasty and can be avoided by placing the osteotomy at least 30 mm caudal to the occlusal edge of the mandibular canines
