Complications in Minimally Invasive Facial Rejuvenation

 

Description:

Expert guidance on minimizing and managing risks for a wide array of facial procedures

The demand for minimally invasive facial procedures has increased exponentially over the past 20 years. In fact, an AAFPRS survey estimated that 80% of cosmetic facial procedures performed by their surgeons in 2019 were minimally invasive. Given the vast number of patients and underqualified practitioners administering facial surgery treatments, complications and poor outcomes are a significant issue. Complications in Minimally Invasive Facial Rejuvenation: Prevention and Management by internationally prominent facial plastic surgeon Paul J. Carniol, renowned dermatologists Mathew M. Avram and Jeremy A. Brauer, and esteemed colleagues fills a gap in the literature.

Organized in five sections and 19 chapters, the book starts with discussions of appropriate patient selection, anesthesia considerations, relevant anatomy, and potentially toxic smoke plumes generated by laser treatments and electrocautery. Section two details fillers and fat transfers for volume restoration, neuromodulators to reduce the appearance of wrinkles, and deoxycholic acid to treat submental fat. Section three covers high-energy devices and procedures such as laser resurfacing, chemical peels, vascular and pigment laser and light sources, radiofrequency, and microneedling. The final two sections feature discussion of liposuction and cryolipolysis, followed by the minimally invasive procedures threadlifting, face and neck lifts, hair transplantation, and blepharoplasty.

Key Highlights:

Important insights on avoidance and management of adverse complications such as diplopia, ptosis, deformities, and asymmetry, as well as potentially life-threatening cerebrovascular accidents, visual loss, skin loss, and infection

Extensive detailed illustrations and surgical photographs improve visual understanding of anatomical topography

High-quality videos enhance knowledge of surgical nuances, potential pitfalls, and preventive measures to avoid problems

This is an essential reference for dermatology, plastic surgery, and otolaryngology residents and fellows. Practitioners who specialize in cosmetic dermatology and facial plastic surgery will also find this an invaluable surgical companion.

 

Table of Contents:

Section I: Complications Prevention Essentials

1 General Approach: The Consultation—Patient Evaluation

1.1 Introduction

1.2 Assessment of Expectations

1.3 Assessment for Body Dysmorphic Disorder

1.4 Accurate History Taking

1.5 Preoperative Counseling

1.6 Conclusion

2 Anesthesia for Minimally Invasive Facial Aesthetic Surgery

2.1 The Office-Based Surgery Setting

2.2 Preprocedure Preparation

2.3 Local Anesthesia

2.3.1 Topical Local Anesthesia

2.3.2 Subcutaneous or Tissue Infiltration

2.3.3 Regional Nerve Blocks

2.3.4 Tumescent Anesthesia

2.3.5 Cryoanesthesia

2.3.6 Oral Sedation

2.3.7 Monitored Anesthesia Care

2.4 Laser-Anesthesia Complications

2.4.1 Fire

2.5 Recovery and Discharge

2.6 Conclusion

3 Anatomy

3.1 Introduction

3.2 Skin Anatomy

3.2.1 Epidermis

3.2.2 Dermis

3.3 Forehead Anatomy

3.3.1 Central Forehead and Glabella

3.3.2 Temporal Fossa

3.4 Periorbital Anatomy

3.4.1 Upper and Lower Eyelids

3.4.2 Eyebrows

3.5 Midface

3.5.1 Lid/Cheek Junction

3.5.2 Cheek

3.6 Nasal Anatomy

3.6.1 Skin–Soft Tissue Envelope

3.6.2 Deep

3.7 Facial Nerve Branches

3.7.1 Frontal Branch

3.7.2 Zygomatic Branch

3.7.3 Buccal Branch

3.7.4 Marginal Branch

3.7.5 Cervical Branch

4 Plumes, Laser/Cautery

4.1 Introduction

4.2 Inorganic Contents of the Plume

4.3 Organic Contents of the Plume

4.4 Protective Strategies

Section II: Injectables: Avoiding and Managing Complications

5 Fillers

5.1 Introduction

5.2 General Principles

5.2.1 Patient-Related Factors

5.2.2 Product-Related Factors

5.2.3 Technique-Related Factors

5.2.4 Pretreatment Prophylaxis

5.3 Adverse Reactions and Complications

5.4 Early Adverse Reactions and Management of Complications

5.4.1 Bruising

5.4.2 Edema

5.4.3 Placement Related: Inappropriate Placement and Depth, Overcorrection

5.4.4 A Tool for Management of Early Adverse Events: Use of Blunt-Tip Cannula

5.5 Inflammatory Reactions

5.5.1 Allergic Reactions and HA Hypersensitivity

5.5.2 Acute Infection

5.6 Vascular Events

5.6.1 Anatomic Considerations and Mechanisms

5.6.2 Technique

5.6.3 Identification

5.6.4 Treatment and Management of Vascular Compromise

5.7 Specific Considerations

5.7.1 Blindness

5.8 Delayed Adverse Reactions and Management of Complications

5.8.1 Noninflammatory Nodules

5.8.2 Inflammatory Reactions Including Infection and Granuloma Formation

6 Fat Transfers

6.1 Introduction

6.2 Risks and Complications

6.3 Vascular Occlusion

6.4 Atypical Infections

6.5 Fat Necrosis

6.6 Treatment of Facial Fat Necrosis

6.7 Conclusion

7 Neuromodulators for Muscle Induced Wrinkles

7.1 Introduction

7.2 Upper Face

7.3 Midface

7.4 Lower Face

7.5 Neck

8 Deoxycholic Acid

8.1 Description of Technology/Procedures

8.1.1 Introduction

8.1.2 Mechanism of Action

8.2 Optimizing Use and Avoiding Complications

8.2.1 Clinical Trials

8.2.2 Determination of Ideal Patient

8.2.3 Assessing Preplatysmal Fat

8.2.4 Proper Injection Technique

8.2.5 Common Complications

8.2.6 Complications: Nerve Injury

8.2.7 Complications: Skin Ulceration and Necrosis

8.2.8 Complications: Dysphagia

8.2.9 Complications: Alopecia

8.3 Early Identification of Complications

8.4 Managing Complications

8.5 Conclusion

Section III: High Energy Devices: Avoiding and Managing Complications

9 Laser Resurfacing

9.1 Introduction

9.2 Key Points for Maximizing Safety with Lasers and Other Energy Devices

9.3 Key Points for Maximizing Safety with Shallower-Penetrating Lasers and Energy Devices

9.4 Fractional Laser Systems

9.4.1 Nonablative Fractional Laser Systems

9.4.2 Microneedling and RF Pins/Needles

9.5 Nonfractional Ablative Treatment

9.6 Key Points for Maximizing Safety in the Eye Area

9.7 Key Points for Maximizing Safety in the Perioral/Cheek Area

9.8 Key Points for Maximizing Safety in Different Skin Types

9.9 Ethnic Skin

9.10 Tanned/Solar-Damaged Skin

9.11 X-Irradiated Skin

10 Chemical Peels

10.1 Background

10.2 Patient Selection

10.3 Preoperative Guidelines

10.4 Complication Prevention

10.5 Infection Prophylaxis

10.6 Complication Management

10.6.1 Delayed Reepithelialization

10.7 Scarring

10.7.1 Infection

10.7.2 Erythema and Hyperpigmentation

10.7.3 Hypopigmentation

10.7.4 Cardiac Arrhythmia

10.8 Conclusion

11 Vascular and Pigment Laser and Light Sources

11.1 Vascular and Pigment Laser and Light Sources

11.1.1 Laser Treatment of Vascular Lesions

11.1.2 Choice of Device—Wavelength and Pulse Duration

11.1.3 Enhancing Outcomes in the Treatment of Vascular Lesions

11.2 Laser Treatment of Pigmented Lesions

11.2.1 Nanosecond and Picosecond Lasers (1,064 nm, 755 nm, 532 nm)

11.2.2 Long-Pulsed Lasers (532 nm, 595 nm, 755 nm, 800–890 nm, 1,064 nm)

11.2.3 Light Sources

11.2.4 Pigment Nonspecific Lasers

11.2.5 Combination of Lasers

11.3 Managing Complications from Laser Treatment of Vascular and Pigmented Lesions

11.4 Conclusion

12 Radiofrequency and Microneedle Radiofrequency

12.1 Introduction

12.2 Science of RF

12.3 Neocollagenesis

12.4 Methods of RF Delivery

12.5 Safety Measures

12.6 Patient Selection

12.7 Complications

12.7.1 Prolonged Swelling, Erythema, Discomfort

12.7.2 Postinflammatory Hyperpigmentation (PIH)

12.7.3 Second-Degree Burn

12.7.4 Fat Loss

12.7.5 Textural Abnormalities

12.7.6 Acne Flair/Infection

12.7.7 Dysesthesia/Neuropraxia

12.7.8 Seroma/Cyst

12.8 Conclusion

13 Complications of Platelet-Rich Plasma and Microneedling

13.1 Platelet-Rich Plasma—An Introduction

13.2 Platelet-Rich Plasma—Avoiding, Identifying, and Managing Complications

13.3 Microneedling—An Introduction

13.4 Microneedling—Avoiding, Identifying, and Managing Complications

Section IV: Lipo Reduction: Avoiding and Managing Complications

14 Liposuction

14.1 Background

14.2 Preoperative Evaluation

14.2.1 Physical Examination and Laboratory Evaluation

14.2.2 Anesthetic Planning

14.2.3 Selecting the Right Tools to Optimize Aesthetic Results

14.3 Procedure

14.3.1 Cannulas

14.3.2 General Principles of Surgical Technique

14.3.3 Malar Fat Pad and Cheek Contouring

14.3.4 Treatment of the Nasolabial Fold and Pretragal Sulcus

14.3.5 Treatment of the Jowl

14.3.6 Submental Liposuction

14.3.7 Facial and Periorbital Autologous Fat Transfer

14.3.8 Liposuction of Other Body Sites

14.4 Postoperative Considerations

14.5 Minimizing Risks

14.6 Management of Complications

14.6.1 Pain and Edema

14.6.2 Vascular Complications

14.6.3 Suboptimal Aesthetic Outcomes

14.6.4 Perforation Injury

14.6.5 Intravascular Volume Redistribution

14.6.6 Nerve Injury

14.6.7 Infection

14.6.8 Seroma

14.6.9 Delayed Improvement

14.6.10 Lidocaine Toxicity

14.7 Conclusions

15 Cryolipolysis

15.1 Introduction

15.2 Cryolipolysis Mechanism of Action

15.3 Safety Profile of Cryolipolysis

15.4 Paradoxical Adipose Hyperplasia in Cryolipolysis

15.5 Delayed Post-treatment Pain in Cryolipolysis

15.6 Miscellaneous Complications in Cryolipolysis

15.7 Introduction to ATX-101

15.8 Safety Profile of ATX-101

15.9 Marginal Mandibular Nerve Injury with ATX-101

15.10 Vascular Complications in ATX-101

15.11 Conclusion

Section V: Minimally Invasive Surgery: Avoiding and Managing Complications

16 Thread Lift

16.1 Introduction

16.2 Complications

16.3 PDO Threads

16.4 Prevention of Complications Utilizing PDO Threads

16.4.1 Patient Selection

16.4.2 Patient Informed Consent

16.4.3 Treatment Protocols

16.4.4 Posttreatment Instructions and Protocols

16.5 Management of Complications

16.5.1 Bruising

16.5.2 Mild-to-Moderate Puckering/Irregularity

16.5.3 Severe Puckering/Irregularity of Superficial Placement of Threads

16.5.4 Infection

16.6 Conclusion

17 SMAS Lift

17.1 Introduction

17.2 Indications and Patient Selection

17.3 Surgical Technique

17.3.1 Procedure Details

17.3.2 Optimizing Results

17.4 Complications

17.4.1 Minimizing Risk and Complications

17.4.2 Early Identification of Complications

17.4.3 Management of Complications

18 Hair Transplantation

18.1 Introduction

18.2 Current Hair Transplantation Technique

18.3 Unfavorable Results in Hair Transplantation

18.3.1 Hairline that is Too Low and/or Too Straight.

18.3.2 Grafts Too Large (Too Many Hairs Per Graft) Giving a Clumpy (Pluggy) Appearance

18.3.3 Scarring Alopecia of the Donor Site

18.3.4 Poor Hair Growth After Hair Transplantation

18.4 Conclusion

19 Blepharoplasty

19.1 Introduction

19.2 Patient Evaluation

19.3 Common Postoperative Problems: Their Avoidance and Correction

19.3.1 Upper Eyelid Blepharoplasty Complications

19.3.2 Lower Eyelid Blepharoplasty Complications

19.3.3 Uncommon/Catastrophic Blepharoplasty Complications

19.4 Conclusion

Index

Additional MedOne Information

 

An aparitie	2021
Autor	Paul J. Carniol, Mathew M. Avram, Jeremy A. Brauer
Dimensiuni	25.4 x 17.78 cm
Editura	Thieme
Format	Hardcover
ISBN	9781684200139
Limba	Engleza
Nr pag	244
Versiune digitala	DA