Facial Plastics

Question 1

Define trichion

Answer 1

Trichion – hairline.

Question 2

Define glabella

Answer 2

Glabella – most prominent part of forehead (in profile).

Question 3

Define nasion, sellion, radix

Answer 3

Nasion – deepest part of forehead in between the eyes; also is where the nasofrontal suture line is and where the nasal dorsum begins. Sellion and radix are interchangeable and is the soft tissue equivalent of the nasion.

Question 4

Define rhinion

Answer 4

Rhinion – where the bony and cartilaginous dorsum meet and is where the skin is thinnest.

Question 5

Define pogonion

Answer 5

Pogonion – most anterior part of the chin.

Question 6

Define menton

Answer 6

Menton – most inferior part of the chin.

Question 7

Describe the Norwood classification type 2 for hair loss

Answer 7

Frontotemporal area starting to recede. 6 – bald spot now continuous with the bald area anteriorly. 7 – horseshoe (there is only hair at the temples wrapping posteriorly (nothing on top)

Question 8

Describe Norwood hair loss classification type 3

Answer 8

Deep frontotemporal recession. 3 vertex includes a bald spot starting to form.

Question 9

Describe Norwood hair loss classification type 4

Answer 9

The hairline recession is more severe, and there is sparse hair or no hair on the vertex. The two areas of hair loss are separated by a band of hair that connects to the hair remaining on the sides of the scalp.

Question 10

Describe Norwood hair loss classification type 5

Answer 10

The two areas of hair loss are larger than in stage 4. They are still separated, but the band of hair between them is narrower and sparser.

Question 11

Describe Norwood hair loss classification type 6

Answer 11

The balding areas at the temples join with the balding area at the vertex. The band of hair across the top of the head is gone or sparse.

Question 12

Describe Norwood hair loss classification type 7

Answer 12

Horseshoe

Question 13

Describe the Dedo classifications 1-6 for cervical abnormalities

Answer 13

1. youthful neckline
2. skin laxity
3. excess adipose tissue
4. platysmal banding
5. retrognathia / microgenia
6. low hyoid

Question 14

Plane of dissection for superficial facelift. , SMAS, sub-SMAS, subperiosteal

Answer 14

Skin only; only lasts ~6 months.

Question 15

Plane of dissection for SMAS facelift.

Answer 15

Subcutaneous layer; plication of the SMAS only (ie no cutting).

Question 16

Plane of dissection for sub-SMAS facelift.

Answer 16

sub-SMAS – elevate SMAS off the parotidicomasseteric fascia, then excise/imbricate 1-2 cm and suture up; good for taking care of mesolabial folds and jowls.

Note: “Deep plane” facelift is actually also a sub-SMAS facelift but you keep going to the zygomaticus minor muscle to take care of the midface.

Question 17

Plane of dissection for subperiosteal facelift.

Answer 17

Subperiosteal = composite facelift, which is basically a deep plane + orbicularis oclui to address bagging.

Note: the deeper and further medial you go, you will be able to get longer lasting results and better address the midface, but with longer recovery time, edema, and risk to FN.

Question 18

Unilateral left lip deformity: displacement of the ala? displacement of the columella? displacement of the caudal septum?

Answer 18

Ala is inferior, posterior, and lateral. Columella is to noncleft side. Caudal septum to noncleft side.

Question 19

What is lateral steal phenomenon in cleft lip?

Answer 19

Lower lateral cartilage is the same length but more length contributes to lateral than medial crura