Cosmetic Surgery (Strauss) Flashcards
Most cosmetic procedures are to do what?
Reverse the aging process
What are 2 things that aide the aging process?
- Sun
2. Gravity
What are 2 kinds of facial deformities?
- Quantity
2. Quality
What is the term for a facial deformity where something is too big or too small relative to the rest of the face?
Quantity
What is the term for facial deformity where something is just not right, but not a definite thing?
Quality
Which is easier to fix: quality or quantity?
Quantity
How long does a face lift last?
Forever, but it sets the clock back 10 yrs, as soon as the facelift is complete, the pt begins to age again
What are 3 goals of esthetic surgery?
- Improve appearance
- Improve self-image
- Improve function
Can a dentist give BOTOX in Virginia?
No
What are 2 functional goals of a Septo-Rhinoplasty?
- Improve breathing
2. Fix a septal deformity
What are 2 surgical approaches for rhinoplasty?
- Open (most universal)
2. Closed (has a darted incision)
What is the risk when does an osteotomy on the nasal bones?
Creating an open roof deformity
What cartilage forms the tips of the nose?
Lower lateral cartilage
What cartilage attaches to the nasal bones?
Upper lateral cartilage
What is the term for the removal of skin, fat, or muscle from around the eyes?
Blepharoplasty
What does fat herniation from aging do to the eyes?
Causes prolapse
What is dermatochalasis?
Skin laxity, can be a reason for blepharoplasty
How many pieces of fat are in the lower eyelid?
3
What is done before incision is made when doing an upper elyeli
Forceps test. Bunch up tissue to be excised until the lid closes naturally over the eyeball
What is the diagnosis when there is lateral brow ptosis and hooding, horizontal and vertical forehead rhytids(wrinkles), visual disturbances, crow’s feet and what surgery is indicated?
Unesthetic brow with endoscopic brow and forehead lift indicated
What are 4 advantages over endoscopic surgery over open surgery?
- Less swelling
- Less bleeding
- Decrease healing time
- Minimal scarring
What are 2 basic things to do in a brow lift?
First: release the brow from the bone
Second: elevate brow and fix in place
Will skin resurfacing remove muscle creases?
No. Can remove small rhytids and smooth deep rhytids
What are 3 reasons Laser Collagen Skin Resurfacing is good for smoothing wrinkles / rhytids?
- Flattens skin via vaporization of epithelium and some dermis
- Collagen contraction by 1/3 tightens skin
- Collagen welding
Suction lipectomy is indicated in what patient demographic?
Younger patient with good skin
What is otoplasty?
Pinning the ears back
What is a procedure used in older patients to remove excess skin, flatten muscle creases, deep wrinkles and improve skeletal outline?
Rhytidectomy / facelift
What is SMAS plication?
SMAS = superficial musculoaponeurotic system plication = folding
Why should OMFS’s due cosmetic surgery?
- Best suited by dental, surgical, and anesthesia training
- Only surgeons with esthetic training
- Hard and soft tissue surgeons
- Modifications of pervious surgery done by OMFS-natural evolution
- Needed for complete orthognathic and reconstructive surgery
How did the goal of orthognathic surgery change from the 60s to the 70s?
Switched from a hard to a soft tissue analysis for cosmetic reasons
What is the advantage of using a laser in cosmetic surgery?
- Faster surgery
- Bloodless surgery
- Less swelling
- Less ecchymosis
- Faster recovery
- Patient perception
What are the advantages of using endoscopy in cosmetic surgery?
- Less invasive
- Less scarring
- Less swelling / bleeding
- Faster function
Where should the eyebrows be for males?
Right on the bony rim
What are some effects of aging on the eyes?
- Fat herniation (really prolapse)
- Dermatochalasis (skin laxity)
- Hyerptrophic orbicularis muscles
- Lower lid laxity
- Prolapsed lacrimal gland
- Eyebrow ptosis
- Blepharoptosis
What are indications for blepharoplasty?
- Bulging fat (“bags”)
- Excess skin
- Visual disturbances
- Remove fat, skin and muscle
What must you be extremely careful of when doing an upper blepharoplasty?
Lacrimal gland
How many fat pads are present on the lower eyelids?
Three (with inferior oblique muscle between two of them)
How many fat pads are present on the upper eyelids?
Two (with the superior oblique muscle between them)
What are 4 features of the unesthetic brow?
- Medial or lateral brow ptosis and hooding
- Horizontal and vertical forehead rhytids
- Visual disturbance
- Crow’s feet
What are the advantages of endoscopic surgery?
- Less swelling
- Less bleeding
- Decreased healing time
- Minimal scarring
What is the basic concept of the brow lift?
- Release brow from bone
2. Elevate brow and fix
What are 3 components to the endoscopic brow lift?
- Decide the magnitude of pull medial, central and lateral
- Decide the vector of pull
- Choose muscles to disrupt
What are the main steps of the endoscopic brow lift?
- Create optical cavity
- Release Brow
- Elevation and Suspension
What are three steps to the release of the brow?
- Incise periostium at marcus arginalis medial and lateral to nerves
- Connect lateral area to temporal
- Sharp upturned periosteal or laser
What is an advantage of cutting the muscles under the brow?
Deactivate the hyperactive muscle that may be causing the problem in the first place.
What are some key points with skin resurfacing?
- Removes small rhytids
- Smooths deep rhytids
- May work with acne scars
- Does not remove muscle creases
- Essentially the same as dermabrasian or chemical peel
- Does not replace a facelift
- Small vs large areas
What three main effects dose a laser CSR have on wrinkles?
- Physical vaporization of epithelium and some dermis (flattens skin)
- Collagen contraction by 1/3 (tightens skin)
- Collagen welding
What group is preferable for lipectomy?
Young patient with good skin
