Facial Plastics Flashcards
What is the name of the area where the septum articulates with the nasal bones?
“Keystone”
At what vertebrae is the hyoid bone located?
C3-C4
Difference in nasofrontal angle between men and women?
Men tend to have a more acute NFA than do women.
A reconstructive surgeon plans on using a tissue expander for the scalp. What is the ideal layer of placement of the tissue expander?
Calvarium
This is because tissue expanders work best in locations with solid bony support under the expander balloon (ex. scalp, forehead)
What is an absolute contraindication to performing chemical peels?
Isotetinoin use within the last 6 months
Postpeel reepithelialization relies upon the epidermis within hair follicles and sebaceous glands. Isotetinoin prevents reepithelialization from these locations
What is the first stage of auricular reconstruction for microtia?
Harvest costal cartilage at age 6 or later.
Pogonian
Anterior most portion of the chin
Which three facial muscles are the exception and run deep to the course of the facial nerve?
- Levator anguli oris
- Buccinator
- Mentalis
These muscles are innervated on their superior surface
What forms the nasofacial angle?
Intersection of the line from the glabella and pogonion with the nasion to nasal tip.
Ideally 35 degrees
Name two areas that heal well by secondary intention?
- Temple
- Medial canthus
Heal better if wound is superficial and in a concave area
Frankfort horizontal plane
line from the superior aspect of the external auditory canal to the inferior aspect of the infraorbital rim on a lateral view.
For standardization for patient positioning for facial analysis
Menton (definition)
Lowest point of the chin
Nasofrontal angle
115-135 degrees
Nasofacial angle
36-40 degrees
Nasolabial angle
90-95 degrees
Nasomental angle
120-132 degrees
Mentocervical angle
80-95 degrees
What are the subunits of the face?
- Forehead
- Periorbital region
- Cheeks
- Nose
- Perioral region and chin
- Neck
Fitzpatrick Skin Classification System
Classifies degrees of skin pigmentation and ability to tan. Graded I - VI
-Forecasts sun sensitivity and susceptibility to photodamage
What is the significance of the Fitzpatrick Skin Classification System?
Provides important information related to the risk factors for skin resurfacing procedures
Which Fitpatrick Skin Classes are at higher risk for pigmentary dyschromia (hyper or hypo-pigmentation) after skin resurfacing procedures?
III and up
What are the main indications for skin resurfacing?
- Photo-damage
- Fine Wrinkles
- Pigmentary dyschomia
- Acne scars
Describe the 6 skin types in Fitzpatrick Skin Classification System
I - White or freckled, Always burns II - White, Usually burns III - White to olive, Sometimes burns * IV - Brown, Rarely burns * V - Dark Brown, Very barely burns * VI - Black, Never burns *
What are contraindications of skin resurfacing with chemical peels, dermabrasion, and lasers?
- Facelift surgery in last 6 months
- Isotretinoin (Accutane) in past 1 year
- Active HSV infection
- Active skin disorder (ex. psoriasis)
Describe the difference in pigmentary changes after skin resurfacing
Hyperpigmentation tends to occur sooner and can be successfully treated with topical therapy
Hypopigmenation tends to be a delayed phenomenon and is often permanent
Glogau Classification system
-Describes the amount of surface facial aging
Grades the severity of wrinkles
Grades the severity of photodamage
Glogau Scale: Group I
- Mild
- Typical age: 28-35
- Description: No wrinkles
- Early photo aging, mild pigment changes, no keratosis, minimal wrinkles, minimal or no make up
Glogau Scale: Group II
- Moderate
- Typical age: 35-50
- Description: Wrinkles in Motion
- Skin Characteristics: Early to moderate photo aging, early brown spots visible, keratosis palpable but not visible, parallel smile lines begin to appear, wears some foundation
Glogau Scale: Group III
- Advanced
- Typical age: 50-65
- Wrinkles at rest
- Skin characteristics: Advanced photo aging: obvious discoloration, visible capillaries, visible keratosis, wears heavier foundation
Glogau Scale: Group IV
- Severe
- Typical Age: 60+
- Description: Only wrinkles
- Skin Characteristics: Severe photo aging: yellow/grey skin color, prior skin malignancies, wrinkles throughout, no normal skin, cannot wear make-up because it cracks and cakes
Dedo Classification of the Neck
Class I - VI for characterizing the submental and anterior neck region
Dedo: Class I
Youthful neck
Dedo Class II
Only skin laxity
Dedo: Class III
excessive submandibular and submental adipose`
Dedo: Class IV
Anterior platysma banding
Dedo: Class V
Microgenia or retrognathia
Dedo: Class VI
Low positioned hyoid bone
