Ophthalmic Plastic Surgery of the Upper Face

 

Description:

 

The definitive resource on cutting-edge oculoplastic surgery of the upper face, eyelids, and eyebrows

While an estimated 1.5 million brow and upper eyelid surgery procedures are performed worldwide each year, this book is the first published ophthalmologic text with detailed coverage focused solely on this topic. Ophthalmic Plastic Surgery of the Upper Face: Eyelid Ptosis, Dermatochalasis, and Eyebrow Ptosis by distinguished oculofacial plastic surgeons and educators Michael A. Burnstine, Steven C. Dresner, David B. Samimi, Helen A. Merritt, and an impressive group of international experts fills a void in the literature. The succinct, richly illustrated text covers classification, anatomy, evaluation, and a wide spectrum of surgical approaches for each condition. Surgical videos are included.

Organized by 7 sections and 39 chapters, the book begins with clinical assessment of patients who present with upper eyelid and eyebrow conditions, followed by evidenced-based treatment protocols. All procedural chapters follow a consistent format, enabling readers to classify problems, review surgical steps, and consider key issues associated with each condition and corrective procedure. Mechanical, involutional, neurogenic, myogenic, and syndromic blepharoptoses detailed in Sections 2 to 6 include etiology, diagnosis, management, and diverse state-of-the-art resection, repair, lift, fill, and augmentation techniques.

Key Features

Each procedural chapter includes an introduction, risks, benefits, informed consent, indications, relative contraindications, a preoperative checklist, required instrumentation, a step-by-step approach for surgeons beginning their career, and refined tips for more experienced surgeons.

High quality full-color operative photographs enhance knowledge of the most salient operative steps, while before and after photos demonstrate the evidence-based efficacy of each surgery.

Chapters focused on brow surgery detail a full range of surgical and nonsurgical approaches—from contouring options and direct elevation to fillers and neuromodulators.

This is a must-have surgical resource for ophthalmology, otolaryngology, and plastic surgery residents and practitioners. The highly practical, reader-friendly text facilitates greater understanding of the clinical implications of each ophthalmic surgery approach, thereby helping surgeons achieve improved cosmetic results.

 

Table of Contents:

 

Section I Introduction

1 Ptosis Classification

1.1 Introduction

1.2 Ptosis Classification

1.3 Preoperative Assessment

1.3.1 History of Present Illness

1.3.2 Physical Examination

1.4 Upper Eyelid Ptosis Classification

1.4.1 Aponeurotic Ptosis

1.4.2 Myogenic Ptosis

1.4.3 Mechanical Ptosis

1.4.4 Neurogenic Ptosis

1.4.5 Pseudoptosis

1.5 Eyebrow Ptosis Classification

1.6 Clinical Decision-Making

1.7 Photographing the Patient

1.8 Informed Consent

1.9 Principles of Surgical Correction

1.10 When Not to Operate

1.11 Postoperative Complications

1.12 Aesthetic Concerns for Upper Eyelid and Eyebrow Rejuvenation

References

2 Aesthetic Anatomy of the Upper Face

2.1 Introduction

2.2 Skin

2.3 Subcutaneous Tissue and Fat Compartments

2.4 Superficial Musculoaponeurotic System

2.5 Retaining Ligaments, Canthal Tendons, and Orbital Septum

2.6 Mimetic Muscles and Eyelid Retractors

2.7 Deep Fat Compartments

2.8 Nervous Innervation to the Upper Eyelid and Forehead

2.8.1 Sensory

2.8.2 Motor

2.9 Blood Supply

2.9.1 Forehead

2.9.2 Eyelid

2.10 Lymphatic Drainage

2.10.1 Forehead

2.10.2 Eyelid

2.11 Unique Considerations for the Upper Facial Surgeon: Facial Danger Zones

2.12 Unique Anatomical Considerations for the Eyelid Surgeon

2.12.1 Anterior Lamella

2.12.2 Middle Lamella

2.12.3 Posterior Lamella

2.12.4 Eye Protective Mechanisms

References

3 Anatomic Considerations in the Aesthetic Surgery of the Upper Face

3.1 Introduction

3.2 Racial Differences

3.2.1 Eyelid Skin

3.2.2 Upper Eyelid Crease

3.2.3 Epicanthal Fold

3.2.4 Tarsal Plate

3.2.5 Eyebrow Height and Contour

3.3 Gender Differences

3.3.1 Eyelid Skin

3.3.2 Eyelid Dimensions

3.3.3 Eyebrow Height and Contour

3.4 Conclusions

References

Section II Mechanical Ptosis

4 Mechanical Ptosis: Etiology and Management

4.1 Introduction

4.2 Benign Eyelid Lesions

4.3 Malignant Eyelid Lesions

4.4 Orbital Lesions

4.5 Periorbital Infections and Inflammation

4.6 Other Considerations

4.7 Summary

References

5 Upper Blepharoplasty

5.1 Introduction

5.2 Goals of Treatment

5.3 Risks

5.4 Benefits

5.5 Informed Consent

5.6 Indications

5.7 Contraindications

5.8 The Procedure

5.8.1 Preoperative Checklist

5.8.2 Instruments Needed

5.8.3 Sutures Used

5.8.4 Operative Technique: Step by Step

5.8.5 Expert Tips/Pearls/Suggestions

5.8.6 Postoperative Care Checklist

5.9 Complications and Their Management

References

6 Double Eyelid Surgery

6.1 Introduction

6.2 Anatomical Considerations

6.2.1 The Eyelid Crease and Fold

6.2.2 The Medical Canthal Area

6.2.3 The Lateral Canthal Area

6.3 Goals of Intervention/Indications

6.4 Risks of the Procedure

6.5 Benefits of the Procedure

6.6 Informed Consent

6.7 Contraindications

6.8 The Procedure

6.8.1 Instruments Needed

6.8.2 Preoperative Checklist

6.8.3 The Operative Technique

6.8.4 Expert Tips/Pearls/Suggestions

6.8.5 Postoperative Care Checklist

6.9 Complications and Their Management

6.10 Alternative Approaches to Double Eyelid Surgery

References

7 A Guide to Eyebrow Contouring Options

7.1 Introduction

7.2 Evolving Trends in Brow Beauty

7.2.1 History of Eyebrow Aesthetics

7.2.2 Volume and Facial Aging

7.2.3 Eyebrow Height and Proportions

7.3 Patient Assessment

7.3.1 History

7.3.2 Physical Exam Checklist

7.4 Risks of Surgery

7.5 Choosing the Best Procedure/Physician Decision-Making

7.6 Expert Tips/Pearls/Suggestions

7.6.1 Upper Eyelid Considerations

7.6.2 The Role of Nonsurgical Adjuncts

7.6.3 Managing Asymmetry

7.6.4 Minimizing Hair Loss

8 Direct Eyebrow Elevation

8.1 Introduction

8.2 Relevant Anatomy

8.3 Goals of Intervention, Indications, and Benefits of the Procedure

8.4 Risks of the Procedure

8.5 Preoperative Considerations and Patient Selection

8.6 Informed Consent

8.7 Relative Contraindications

8.8 Procedure

8.8.1 Instrumentation

8.8.2 Preoperative Checklist

8.8.3 Operative Technique

8.8.4 Expert Tips/Pearls/Suggestions

8.8.5 Postoperative Care

8.9 Complications and Their Management

References

9 Internal Eyebrow Lift

9.1 Introduction

9.2 Anatomic Considerations of the Upper Facial Continuum

9.3 Goals of Intervention

9.4 Risks

9.5 Benefits

9.6 Informed Consent

9.7 Indications

9.8 Contraindications

9.9 Patient Assessment

9.9.1 Medical History

9.9.2 Ophthalmic History

9.9.3 Ophthalmic Examination

9.9.4 Anatomic Evaluation: The Eyelid and Eyebrow Subunits

9.10 Preoperative Checklist

9.11 The Procedure

9.11.1 Instrumentation Needed

9.11.2 Sutures

9.11.3 Operative Technique

9.12 Expert Tips/Pearls/Suggestions

9.13 Postoperative Care Checklist

9.14 Complications and Their management

9.14.1 Bleeding

9.14.2 Infection

9.14.3 Nerve Damage

9.14.4 Postoperative Lagophthalmos and Dry Eye

9.14.5 Residual Aesthetic Deformity

9.14.6 Skin Dimpling

9.15 Summary

References

10 Midforehead Browlift Technique

10.1 Introduction

10.2 Goals of Intervention/Indications

10.3 Risks of the Procedure

10.4 Benefits of the Procedure

10.5 Informed Consent

10.6 Contraindications

10.7 Preoperative Assessment

10.8 The Procedure

10.8.1 Instruments Needed

10.8.2 Operative Technique

10.9 Expert Tips/Pearls/Suggestions

10.10 Postoperative Care Checklist

10.11 Complications and Their Management

10.12 Conclusion

References

11 Open Coronal Pretrichial Browlift Surgery

11.1 Introduction

11.2 Unique Anatomical Considerations in Coronal Brow Lifting

11.2.1 The Eyebrow

11.2.2 The Anatomic Layers

11.2.3 The Muscles of Elevation and Depression

11.2.4 The Sensory Supply

11.2.5 The Facial Nerve

11.2.6 The Vascular Supply

11.3 Patient Evaluation

11.3.1 Forehead Length and Contour

11.3.2 Eyebrow Shape and Contour

11.3.3 Forehead Rhytids

11.3.4 Nasal Root

11.4 Goals of Intervention/Indications

11.5 Risks of the Procedure

11.6 Benefits of the Procedure

11.7 Contraindications

11.8 Informed Consent

11.9 The Procedure

11.9.1 Instruments Needed

11.9.2 Sutures Used

11.9.3 Preoperative Checklist

11.9.4 The Operative Technique

11.10 Expert Tips/Pearls/Suggestions

11.11 Postoperative Care Checklist

11.12 Complications and Their Management

11.12.1 Expanding Hematoma

11.12.2 Scarring

11.12.3 Postoperative Brow Asymmetry

11.12.4 Facial Nerve Damage

11.12.5 Scalp and Forehead Numbness

11.12.6 Alopecia

11.13 Alternative Approaches to the Open Browlift

References

Bibliography

12 Pretrichial Temporal Browlift

12.1 Introduction

12.2 Goals of Intervention/Indications

12.3 Risks of Procedure

12.4 Benefits of Procedure

12.5 Contraindications

12.6 Informed Consent

12.7 Preoperative Evaluation

12.8 The Procedure

12.8.1 Instrumentation

12.8.2 Preoperative Checklist

12.8.3 Surgical Technique

12.9 Expert Tips/Pearls/Suggestions

12.10 Postoperative Care Checklist

12.11 Complications

12.11.1 Scarring

12.11.2 Suture Granuloma

12.11.3 Undercorrection

12.11.4 Overcorrection

12.12 Conclusion

References

13 Minimally Invasive Su-Por–Suture Temporal Brow Suspension: The Lift and Fill Technique

13.1 Introduction

13.2 Goals of Intervention/Indications

13.2.1 Risks of the Procedure

13.2.2 Benefits of the Procedure

13.2.3 Informed Consent

13.3 Contraindications

13.4 The Procedure

13.4.1 Instruments Needed

13.4.2 Preoperative Checklist

13.4.3 Operative Technique

13.5 Expert Tips/Pearls/Suggestions

13.6 Postoperative Care Checklist

13.7 Complications and Their Management

References

14 Endoscopic Upper Face and Eyebrow Lifting

14.1 Introduction

14.2 Goals of Intervention

14.3 Risks

14.4 Informed Consent

14.5 Indications

14.6 Contraindications

14.7 The Procedure

14.7.1 Preoperative Checklist

14.7.2 Instruments Needed

14.7.3 Closure

14.7.4 Local Anesthetic

14.7.5 Fat Grafting

14.7.6 Incision Placement

14.7.7 Operative Technique

14.8 Postoperative Care Checklist

14.9 Expert Tips/Pearls/Suggestions

14.10 Complications and Their Management

14.11 Conclusions

References

15 Nonsurgical Management Techniques: Fillers and Neuromodulators

15.1 Introduction

15.2 Properties of Botulinum Toxins and Periocular Fillers

15.2.1 Botulinum Toxin Properties

15.2.2 Periocular Fillers Properties

15.3 Single Therapy and Combination Treatments in the Upper Face

15.3.1 Glabellar Frown Lines

15.3.2 Crow’s-Feet

15.3.3 Horizontal Forehead Lines

15.3.4 Brow Lifting and Shaping

15.3.5 Hypertrophic Orbicularis Oculi

15.3.6 Midface

15.3.7 Temple

15.4 Conclusion

References

16 Fat Augmentation of the Brow

16.1 Introduction

16.2 Goals of Intervention

16.3 Risks of Fat Grafting

16.4 Benefits of Fat Grafting

16.5 Informed Consent

16.6 Indications

16.7 Contraindications

16.8 Preoperative Checklist

16.8.1 Instrumentation

16.8.2 Operative Technique: Step by Step

16.9 Expert Tips/Pearls/Suggestions

16.10 Postoperative Care Checklist

16.11 Complications and Their Management

16.12 Conclusion

References

Section III Involutional Ptosis

17 Involutional Ptosis: Etiology and Management

17.1 Introduction

17.2 Etiology

17.3 Clinical Presentation

17.4 Evaluation

17.4.1 Evaluation of Eyelid

17.5 Management

References

18 External Levator Advancement with Orbicularis-Sparing Technique

18.1 Introduction/Goals of Intervention

18.2 Risks

18.3 Benefits

18.4 Informed Consent

18.5 Indications

18.6 Relative Contraindications

18.7 The Procedure

18.7.1 Preoperative Checklist

18.7.2 Instruments Needed

18.7.3 Sutures Used

18.7.4 The Operative Technique: Step by Step

18.8 Postoperative Care Checklist

18.9 Expert Tips/Pearls/Suggestions

18.10 Complications and Their Management

18.10.1 Undercorrection

18.10.2 Overcorrection

18.10.3 Lagophthalmos

18.10.4 Unsatisfactory Eyelid Contour or Eyelid Crease Asymmetry

18.10.5 Wound Infection

18.10.6 Retrobulbar Hemorrhage

18.11 Conclusion

References

19 Small Incision Anterior Levator Advancement

19.1 Introduction

19.2 Goals/Indications

19.3 Risks of the Procedure

19.4 Benefits of the Procedure

19.5 Contraindications

19.5.1 Absolute Contraindications

19.5.2 Relative Contraindications

19.6 Informed Consent

19.7 The Procedure

19.7.1 Instruments Needed

19.7.2 Preoperative Checklist

19.7.3 Operative Technique

19.8 Expert Tips/Pearls/Suggestions

19.9 Postoperative Care Checklist

19.10 Complications and Their Management

References

20 Müller’s Muscle–Conjunctival Resection

20.1 Introduction

20.2 Special Preoperative Considerations

20.2.1 Margin Reflex Distance 1

20.2.2 Phenylephrine Test

20.2.3 Determining the Amount of Müller’s Muscle–Conjunctival Resection

20.3 Risks

20.4 Benefits

20.5 Informed Consent

20.6 Contraindications

20.7 Instrumentation

20.8 Preoperative Checklist

20.9 Operative Technique

20.10 Expert Tips/Pearls/Suggestions

20.11 Postoperative Management

20.12 Complications and Their Management

20.13 Acknowledgment

References

21 Dresner’s Modification of Müller’s Muscle–Conjunctival Resection

21.1 Introduction

21.2 Indications

21.3 Risks

21.4 Benefits

21.5 Informed Consent

21.6 Contraindications

21.7 Instrumentation

21.8 Preoperative Checklist

21.9 Operative Technique

21.10 Expert Tips/Pearls/Suggestions

21.11 Results

21.12 Complications and Their Management

21.13 Conclusion

References

22 Posterior White Line Advancement

22.1 Introduction

22.2 Relevant Anatomy

22.3 Indications

22.4 Risks

22.5 Benefits

22.6 Informed Consent

22.7 Contraindications

22.8 Instrumentation

22.9 Preoperative Checklist

22.10 Operative Technique

22.10.1 The White Line Advancement for Aponeurotic Ptosis

22.10.2 Levatorpexy for Congenital Ptosis

22.11 Expert Tips/Pearls/Suggestions

22.12 Complications and Their Management

22.13 Conclusions

References

23 The Fasanella–Servat Procedure

23.1 Introduction

23.2 Indications

23.3 Risks

23.4 Benefits

23.5 Informed Consent

23.6 Contraindications

23.7 Instruments Needed

23.8 Preoperative Checklist

23.9 Operative Technique

23.10 Expert Tips/Pearls/Suggestions

23.11 Results

23.12 Complications and Their Management

23.13 Conclusion

References

24 Combined Upper Blepharoplasty and Ptosis Repair

24.1 Introduction

24.2 Clinical Evaluation and Indications for Surgery

24.3 Combined Müller’s Muscle–Conjunctival Resection and Blepharoplasty

24.4 Combined Fasanella–Servat and Blepharoplasty

24.5 Combined Levator Aponeurotic Advancement and Blepharoplasty

24.5.1 Indications

24.5.2 Contraindications

24.5.3 Instrumentation

24.5.4 Preoperative Checklist

24.5.5 Operative Technique

24.6 Expert Tips/Pearls/Suggestions

24.7 Postoperative Management

24.8 Complications and Their Management

25 Floppy Eyelid Syndrome Repair with Concomitant Ptosis Repair

25.1 Introduction

25.2 Goals of Intervention/Indications

25.2.1 Risks of the Procedure

25.2.2 Benefits of the Procedure

25.3 Informed Consent

25.4 Contraindications

25.5 Preoperative Assessment

25.6 Operative Technique

25.6.1 Instruments Needed

25.6.2 Surgical Technique

25.7 Expert Tips/Pearls/Suggestions

25.8 Postoperative Care Checklist

25.9 Complications

References

26 Management of Lacrimal Gland Prolapse

26.1 Introduction and Anatomy

26.2 Goals of Intervention

26.3 Risks

26.4 Benefits

26.5 Contraindications

26.5.1 Surgical Procedure

26.5.2 Instruments Needed

26.5.3 Operative Technique: Step by Step

26.6 Expert Tips/Pearls/Suggestions

26.7 Postoperative Management and Complications

References

Section IV Myogenic Ptosis

27 Myogenic Ptosis: Etiology and Management

27.1 Introduction

27.2 Static Myogenic Ptosis

27.3 Progressive Myogenic Ptosis

References

28 Static Myogenic Ptosis: Evaluation and Management

28.1 Introduction

28.2 Causes and Syndromic Associations of Static Myopathic Ptosis

28.2.1 Isolated Congenital Ptosis

28.2.2 Static Myopathic Ptosis with Associated Periocular Anomalies

28.2.3 Congenital Ptosis with Aberrant Innervation

28.2.4 Trauma

28.3 History

28.3.1 Personal History of Ptosis

28.3.2 Family History of Ptosis

28.4 The Physical Examination

28.4.1 The Eyelid and Adnexal Examination

28.4.2 The Eye Examination

28.5 Management

28.5.1 Observation

28.5.2 Timing of Surgical Intervention

28.5.3 The Surgical Approach

28.6 Conclusions

References

29 Surgical Management of Levator Function Less Than 4 mm

29.1 Introduction

29.2 History of Frontalis Sling

29.2.1 Patterns of Sling

29.2.2 Sling Materials

29.2.3 Fixation of Sling to Eyelid Tarsus

29.3 Indications

29.4 Consequences

29.5 Unique Considerations in Frontalis Suspension

29.5.1 Congenital Cases

29.5.2 Acquired Cases

29.6 Risks of the Procedure

29.7 Benefits of the Procedure

29.8 Relative Contraindications

29.9 Informed Consent

29.10 The Procedure

29.10.1 Surgical Supplies and Equipment

29.10.2 Preoperative Checklist

29.10.3 Operative Technique

29.11 Expert Tips/Pearls/Suggestions

29.12 Postoperative Care Checklist

29.13 Complications and Their Management

29.13.1 Early Complications

29.13.2 Late Complications

References

30 Surgical Management of Static Congenital Ptosis with Levator Function between 4 and 10 mm

30.1 Introduction

30.2 The Anatomy of the Eyelid Crease

30.3 Preoperative Assessment

30.3.1 Indications

30.3.2 Consequences of Levator Resection

30.3.3 Risks of the Procedure

30.3.4 Benefits of the Procedure

30.3.5 Relative Contraindications

30.3.6 Alternatives

30.4 Informed Consent

30.5 Instrumentation

30.6 The Levator Resection Procedure

30.7 Expert Tips/Pearls/Suggestions

30.8 Postoperative Care

30.9 Complications and Their Management

30.10 Conclusion

References

31 Progressive Myogenic Ptosis: Evaluation and Management

31.1 Introduction

31.2 Causes of Progressive Myopathic Ptosis

31.2.1 Oculopharyngeal Muscular Dystrophy

31.2.2 Chronic Progressive External Ophthalmoplegia

31.2.3 Myotonic Dystrophies

31.2.4 The Masquerader of Progressive Myopathic Ptosis

31.3 History and Physical Examination

31.3.1 The History

31.3.2 Physical Examination

31.4 Management of Progressive Myopathic Ptosis

31.4.1 Timing of Repair

31.4.2 Our Workhorse Procedure

31.5 Conclusions

References

32 Syndromic Blepharoptoses

32.1 Introduction

32.2 Aberrant Innervation Syndromes

32.3 Static Myopathic Ptoses Involving the Extraocular Muscles

32.4 Progressive Myopathic Ptoses that Affect the Levator and Other Muscle Groups Presenting in Childhood

32.5 Progressive Myopathic Ptoses Seen in Adulthood

32.6 Management and Conclusions

References

Section V Neurogenic Ptosis

33 Neurogenic Ptosis: Diagnosis and Management

33.1 Introduction

33.2 Neuroanatomic Considerations

33.2.1 Cortical and Supranuclear Pathways

33.2.2 Oculomotor Nerve

33.2.3 Oculosympathetic Pathway

33.2.4 Neuromuscular Junction

33.3 Localization

33.3.1 Supranuclear/Cortical Localization

33.3.2 Brainstem Localization

33.3.3 Spinal Cord and Paravertebral Ganglia Localization

33.3.4 Carotid Artery and Cavernous Sinus Localization

33.3.5 Nuclear Localization

33.3.6 Infranuclear Localization

33.4 Aberrant Innervation Syndromes

33.4.1 Compressive/Trauma

33.4.2 Marin-Amat’s Syndrome

33.4.3 Synkinesis

33.5 Diseases of the Neuromuscular Junction

33.5.1 Myasthenia Gravis

33.5.2 Lambert–Eaton Syndrome

33.6 Congenital Presentations

33.6.1 Third Nerve Palsy

33.6.2 Congenital Horner’s Syndrome

33.7 Summary

References

Section VI Pseudoptosis

34 Pseudoptosis: Evaluation and Management

34.1 Introduction

34.1.1 Dermatochalasis

34.1.2 Vertical Strabismus

34.1.3 Contralateral Eyelid Retraction

34.1.4 Enophthalmos

34.1.5 Ocular Abnormalities

34.1.6 Eyelid Protractor Overaction

References

Section VII Additional Considerations in Upper Facial Surgery

35 Eyelash Ptosis Management

35.1 Introduction

35.2 Anatomical Considerations

35.2.1 Eyelash Cilia

35.2.2 Levator Aponeurosis and Eyelid Crease

35.3 Goals of Intervention/Indications

35.4 Risks of the Procedure

35.5 Benefits of the Procedure

35.6 Informed Consent

35.7 Contraindications

35.8 Procedure

35.8.1 Instruments Needed

35.8.2 Preoperative Checklist

35.8.3 Operative Technique

35.8.4 Expert Tips/Pearls/Suggestions

35.8.5 Postoperative Care Checklist

35.9 Complications and Their Management

References

36 Blepharoptosis Reoperation

36.1 Introduction

36.2 Anatomical Considerations

36.3 Goals of Intervention/Indications

36.4 Risks of the Procedure

36.5 Benefits of the Procedure

36.6 Informed Consent

36.7 Contraindications

36.8 Procedure

36.8.1 Instruments Needed

36.8.2 Preoperative Checklist

36.8.3 Operative Technique

36.8.4 Expert Tips/Pearls/Suggestions

36.8.5 Postoperative Care Checklist

36.9 Complications and Their Management

References

37 Nonsurgical Management of Ptosis

37.1 Introduction

37.2 Mechanical Eyelid Elevation

37.2.1 Eyelid Crutches

37.2.2 Eyelid Taping

37.2.3 Haptic Contact Lens

37.3 Pharmacologic Eyelid Elevation

37.3.1 Topical Therapy

37.3.2 Neurotoxin Injections

37.4 Management of Ptosis in the Anophthalmic Patient

37.5 Management of Pseudoptosis with Filler Injection

References

38 Unique Considerations in Upper Facial Surgery

38.1 Introduction

38.2 Perioperative Medications

38.2.1 Blood-Thinner Considerations

38.2.2 Classes of Blood Thinners

38.2.3 Balancing Thrombotic Risks and Bleeding Risks

38.2.4 Time to Stop Blood Thinners Preoperatively

38.2.5 Supplements and Other Considerations

38.3 Perioperative Antibiotic Considerations

38.3.1 Current Practice Patterns in Oculofacial Plastic Surgery

38.3.2 Patterns and Rates of Surgical Site Infection

38.3.3 Preoperative Recommendations

38.3.4 Perioperative Recommendations

38.3.5 Postoperative Recommendations

38.4 Energy Devices

38.4.1 Types of Devices

38.4.2 Fire Risk and the Triad

38.4.3 Effects of the Plume

38.5 Conclusions

References

39 Staying Out of Trouble: Strategies Based on Recent OMIC Oculofacial Plastic Surgery Claims

39.1 Introduction

39.2 Particular Problem Areas in the Practice of Upper Facial Plastic Surgery

39.2.1 Blepharoplasty and Ptosis Repair

39.2.2 Brow Lifting

39.2.3 Invasive Skin Treatments

39.3 Fillers and Autologous Fat

39.4 Goals for the Upper Facial Surgeon

39.4.1 Establishing the Correct Diagnosis

39.4.2 Knowing When to Say No to Treatment

39.4.3 Effective Communication

39.4.4 Surgical Plan and Execution

39.4.5 Patient Follow-Up

39.4.6 Actively Manage Complications

39.4.7 Revisit Patient Expectations Frequently

39.5 The Unhappy Patient: Cosmetic Dissatisfaction and Patient Expectations

39.5.1 Refunds

39.5.2 I’m Sorry Laws

39.6 Expert Tips/Pearls/Suggestions

39.7 Coping with the Process of a Malpractice Claim

39.8 Conclusions

References

39.9 Appendix A

39.9.1 Informed Consent for Ptosis Surgery (Droopy Eyelid Surgery)

39.10 Appendix B

39.10.1 Patient Cosmetic Surgical Agreement

Index

Medone Additional Information

 

An aparitie	15 Nov. 2019
Autor	Michael Burnstine, Steven Dresner, David Samimi
Dimensiuni	221 x 284 x 20 mm
Editura	Thieme
Format	Hardcover
ISBN	9781626239210
Limba	Engleza
Nr pag	288