Facial plastic surgery : FPS
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The management of perioral injuries is a complex topic that must take into consideration the unique anatomy, histology, and function of the lips to best restore form and function of the mouth after injury. Basic reconstructive principles include three-layered closure for full-thickness lip lacerations. Additionally, special care is needed to ensure an aesthetic repair of the cosmetically complex and important vermillion border, philtrum, and Cupid's bow. ⋯ Hypertrophic scars are common in the perioral area after trauma. The mainstays of treatment for hypertrophic scars on the lips are silicone elastomer sheeting and intralesional steroid injections. For large perioral defects, a myriad of reconstructive options are available, ranging from primary closure, cross-lip flaps, and local tissue transfer, to free tissue transfers such as radial forearm free flaps, innervated gracilis free flaps, anterolateral thigh free flaps, and osteocutaneous free flaps.
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Studies show that patients seeking cosmetic surgery are more likely to suffer from depression than is the general population. Thus it behooves the cosmetic surgeon to be familiar with the diagnosis of depression and the unique challenges that it poses to a cosmetic practice. Does depression affect surgical outcomes? Could a surgical procedure improve or exacerbate depressive symptoms? When is referral to a mental health professional warranted? This article attempts to deal with these questions, and in doing so we suggest possible means for managing depression in the cosmetic surgery patient.
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Developing a successful Internet strategy can help attract new patients and take your practice to the next level. Today, as the Internet has evolved, it is more important than ever, especially as your competitors are likely pursuing more aggressive strategies themselves. ⋯ Behind such a strategy you will find a strong focus in many areas, including Web site development, search engine optimization, link building, content creation, blogs, video, choosing a vendor, patient conversion, Web 2.0, social networking, reputation management, and more. Understanding each of these areas, and the efforts required to tackle each effectively, can help you ensure that your own Internet strategy is functioning well and reaching its true potential.
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This article reviews common methods of reconstructive surgery in patients with wounds that involve the scalp, including primary wound repair, healing by secondary intention, and the use of skin grafts, local tissue flaps, regional myocutaneous flaps, and microvascular free flaps. Special attention is paid toward consideration of aspects of the reconstruction that affect the aesthetic outcome, including preservation of the hairline and hair follicle orientation, scar camouflage, avoidance of alopecia, and secondary restoration of alopecia.
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In this article we describe the first case of combined laryngotracheal and esophageal injury following blunt neck trauma in the otolaryngology literature and delineate appropriate management considerations. Successful reconstruction requires appropriate airway management, restoration of esophageal and laryngeal mucosal integrity, and reduction of tracheal and laryngeal fractures with appropriate stenting. ⋯ After the airway is secure, injury severity dictates repair and postoperative care. Immediate reconstruction with restoration of the laryngotracheal framework and mucosal integrity enables patients to recover a patent airway, functional voice, and normal swallow.