By Paul J. Carniol, Gary D. Monheit
Each practitioner of aesthetic drugs and surgical procedure will have already got a chain of textbooks educating on the way to deal with the normal sufferer. regrettably, each practitioner also will have sufferers who don't agree to the common – who're of a distinct age, or intercourse, or ethnicity, or clinical background, or who've specific social specifications. This publication appears to be like at these complex parts that have a tendency to be missed within the extra regular textbooks, yet are of severe curiosity to these practitioners who're faced by way of a sufferer no longer conforming to the traditional remedy; it swimming pools the services of best aesthetic practitioners to aid indicate the parts of detailed problem that come up in medical perform and the way to set approximately tackling and fixing them.
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Additional resources for Aesthetic Rejuvenation Challenges and Solutions: A World Perspective (Series in Cosmetic and Laser Therapy)
In patients with insufficient volume, it is necessary to use injectables. There are a great number of fillers, artificial and endogenous, temporary and permanent. Discussion of injectables is beyond the scope of this chapter. Suffice it to say, they are an essential component of the facial plastic surgeon’s armamentarium, but conservative technique is necessary to maintain a natural appearance. Areas which are essential to recognize and treat include the nasojugal groove, the melolabial groove, and commissure-mandibular groove.
The ability to nonsurgically elevate the brow allows a quick, low-risk treatment with a temporary effect. With careful injection technique, elevation can be fairly localized, something which is more difficult surgically. Touch-up injections can be easily performed as needed. Botox® can also be used adjunctively after surgical brow elevation for asymmetry. Whatever the approach used, the surgeon must bear in mind that conservative rather than dramatic elevation is preferable, and that the intended brow position is patient-specific.
Over-resection of skin in the upper lid can lead to ectropion, lid retraction, and a skeletonized orbit with a high degree of lid show. Recently, research by Knoll et al. (3) Thus, conservative skin resection without a high supratarsal crease will preserve a natural, youthful appearance. In the event that both the surgeon and patient feel that an inadequate amount of skin was removed, a revision under local anesthesia is easily performed. 3 Preoperative photo of patient with orbicularis hypertrophy.