Common Facial Plastic Surgery Procedures

Question 1

what is facial plastic surgery used for

Answer 1

aesthetic anxiety, combat effects of ageing, congenital problems, trauma, following tumour excision

Question 2

briefly describe what is involved in the assessment of a rhinoplasty

Answer 2

careful assessment of face, the nose and the person, NHS Scotland has strict cosmetic procedures

Question 3

what needs to be ruled out when considering a rhinoplasty

Answer 3

any contraindications, such as mental health issues of the patient

Question 4

describe the aesthetic protocol for otoplasty in the NHS

Answer 4

should have been dealt with as a child, simple cosmetic pinnaplasty not supported
normally consider from 6 onwards

Question 5

describe the 1-2-3 technique used for assessment of otoplasty

Answer 5

1cm from most superior part of pinna to mastoid
2cm from Frankfort posterior part of pinna to the mastoid
30 degrees mastoid and helix

Question 6

what are the 3 common problems that require otoplasty

Answer 6

underdeveloped antihelical fold, prominent concha, protruding lobe

Question 7

what is mentoplasty

Answer 7

jaw/chin plastic surgery

Question 8

describe what skin changes occur with age

Answer 8

skin thins, melanocytes decrease, skin flattens at dermo-epidermal junction, decreased collagen turnover and elastin

Question 9

what changes are there in fat distribution as we age

Answer 9

decreases in face, hands, feet and subcutaneous

incerases in thighs, waist and abdomen

Question 10

give some examples of aesthetic interventions that people get to combat the effects of ageing

Answer 10

botulinum toxin, skin rejuvenation, fillers

Question 11

what is blephroplasty

Answer 11

an operation to reshape the eyelids

Question 12

describe the effects of ageing on the eyelids

Answer 12

accumulation of skin forms deepening creases under eyelids, slackening of muscle around eyelid allowing fat to protrude forward giving “bags”

Question 13

briefly describe what blephroplasty involves

Answer 13

incision in creases of upper lids and just below lashes in lower, through these incisions extra far, excess skin and sagging muscle are removed

Question 14

describe the reconstructive facial surgery ladder, from bottom(first line) to the top

Answer 14

healing by secondary intention => delayed primary closure => skin grafts => tissue expansion => local/free tissue transfer

Question 15

when would delayed primary closure be used

Answer 15

for infected tissue/wound, for tumour unsure of margins

Question 16

what are the benefits of healing by secondary intention

Answer 16

can give better cosmetic outcome, less scarring/movement of tissue

Question 17

describe the characteristics of a split thickness skin graft

Answer 17

quick, covers large surface area, can’t go directly on bone or tendon, contrasts and colour match not good with loss of volume

Question 18

describe what a split thickness skin graft is

Answer 18

just take off top of skin, not any tissue underneath

Question 19

describe the characteristics of a full thickness skin graft

Answer 19

retains skin volume and pigmentation, hair retained and donor site morbidity