Cosmetic and Facial Plastic Surgery Flashcards
Depression at the root of the nose corresponding to the nasofrontal suture
Nasion
What is the soft tissue equivalent of the nasion?
Sellion
Incision over the caudal edge of the lateral crura of the lower lats
Marginal
Where are lateral osteotomies performed after bony hump is removed in rhinoplasty?
Pyriform aperature on the ascending process of the maxilla at the level of the lateral attachment of the interior turbinate
Major tip support mechanisms
- Strength of the lower lateral cartilage
- Attachment of the medial crura of the LLC to the septum
- Attachment of the upper to the lower lateral cartilage
What are the minor tip support mechanisms?
- Dorsal septum
- Intermodal ligaments
- Membranous septum
- Nasal spine
- Surrounding skin and soft tissues
- Alar sidewalls
What is a lateral crural steal?
Recruiting the lateral crura into the tip with horizontal mattress, making the medial crura relatively longer and the lateral crura shorter, increasing tip projection
What kind of patient is at increased risk for inverted V deformity?
Short nasal bones with long ULCs
What is the etiology of inverted V deformity?
Medial displacement of the ULCs with respect to the nasal bones–leads to the caudal border of the nasal bones becoming visible
Internal nasal valve borders
Septum
Caudal ULC
Inferior turbinate
Floor of the nose
Idea brow position in men vs women
Men: at the level of the orbital rim
Women: 1 cm superior to the orbital rim
What is the term for excess skin in the upper or lower eyelids
Dermatochalasis
Where is the inferior oblique found during blephroplasty?
Between the lower medial and central adipose pads
What are the layers of the epidermis
Stratum corneum Stratums lucidum Stratum granulosum Stratum spinosum Stratum basale
What is the difference between ablative and non-ablative lasers?
Ablative: Damage and remove skin like peels
Nonablative: Target the dermis and stimulate collagen remodeling, leaving the stratum corneum intact
What is the difference between traditional non-fractional and newer fractional lasers?
Non-fractional: affect all of the skin in the treatment area
Fractional: Treat microcolumns called microthermal treatment zones (MTZ) and spare skin between mircocolumns
What is the respective depth of skin affected by the following peels?
- Very superficial
- Superficial
- Medium
- Deep
- Stratum corneum of the epidermis
- Epidermis
- Papillary dermis
- Reticular dermis
Ablative lasers target ___ within the skin as a chromophore
Water
What does fluence describe?
Energy per unit area of a laser beam–higher fluence has more energy and deeper penetration
How does Fitzpatrick type affect absorption of laser light?
Melanin can absorb laser light, increasing risk of laser burn
More conservative parameters should be used in patient with higher Fitzpatrick score
What particular peel has systemic risks and shouldn’t be used in patients with pre-existing cardiac, renal, or hepatic disease?
Phenol
How long after accutane is used are peels contraindicated?
6-12 mo, as it downregulates the adnexal structures in the dermis required for regeneration
What should be started 1 mo prior to skin resurfacing in a patient with a history of hyperpigmentation or a higher fitzpatrick type
Topical hydroquione
Prior to skin resurfacing, when should HSV 1 and 2 ppx be initiated?
2 days prior to procedure, regardless of infection hx
