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Biomedical subjects

B L McGraw

Publications and source records attributed to B L McGraw.

8 recordsLinked to original sources
PubMed1992

The coronal forehead lift--modifications and results.

The coronal forehead lift has produced excellent results in the rejuvenation of the upper face. The problem of brow and glabellar ptosis, as well as the problem of frontoglabellar rhytids, are directly addressed with this procedure while producing no visible scars. In addition, the pretrichial modification of it can be used without alteration in the hairline. The success and low morbidity of the coronal forehead lift has made it the procedure of choice for upper facial rejuvenation in females, and many male patients. A review of 41 coronal forehead lifts performed by the senior author is presented, with emphasis placed on the results and the refinements brought to the surgical technique. A discussion comparing this procedure to other brow lift procedures is also presented, outlining their respective advantages and disadvantages.

Adult↗
PubMed1991

Extended blepharoplasty.

Extended blepharoplasty involves extending the dissection of the skin-muscle flap used in standard lower eyelid blepharoplasty to a level below the infraorbital rim. This technique is useful in the management of infraorbital, or malar, bags that are seen in as many as 10% of blepharoplasty candidates. A concomitant eyelid shortening procedure is frequently needed to treat horizontal eyelid laxity. Achievement of satisfactory results depends on the proper suspension of the skin-muscle flap to the lateral canthal periosteum. Extended blepharoplasty is an innovative way to improve infraorbital pouching, which is otherwise beyond the reach of the standard blepharoplasty procedure.

Adult↗
PubMed1991

Postblepharoplasty ectropion. Prevention and management.

Lower-eyelid malposition is one of the more serious complications encountered following lower-lid blepharoplasty, ranging in severity from mild lower-lid retraction to frank ectropion with marked lower-lid eversion. We define a grading system for postblepharoplasty lid malposition based on the severity of lower-lid retraction. In a critical review of 111 patients who underwent lower-lid blepharoplasty between January 1985 and January 1990, 15% were thought to have some degree of lower-lid retraction. Presence of lid laxity preoperatively and increasing amounts of skin excision at surgery were significant factors in the development of malposition. Placement of orbicularis suspension sutures tended to decrease the incidence of lid retraction. No patients had frank ectropion; however, three patients with grade 2 or 3 malposition required a secondary surgical procedure for correction. All three patients had resolution of their symptoms and good cosmetic results using standard treatment methods. A literature review and discussion of the causes, sequelae, and management of post-operative ectropion is presented as a reminder to surgeons performing blepharoplasty. Avoidance of this entity by appropriate preoperative assessment is emphasized, along with conservative operative technique. These factors combined are essential for the successful outcome of lower-lid blepharoplasty.

Adult↗
PubMed1991

Otoplasty: critical review of clinical results.

Although it is generally believed that otoplasty provides uniformly gratifying results, thorough patient follow-up reviews are quite rare. Otoplasty surgery performed on 119 ears was retrospectively reviewed to assess the results of our cartilage-sparing technique. This method of otoplasty relies on a conchal set-back and suture transfixation technique to improve the antihelical contour. Auricular medialization averaged 10.3 mm. Over-correction is required, particularly in the superior pole, as loss of correction with healing was approximately 40% of the initial medialization. Revision surgery due to loss of correction was necessary for 6.6% of the ears initially operated on by the senior author. Patients who presented following cartilage-cutting procedures tended to have a higher rate of revision and persistent postoperative stigmata. Complications in general were few; however, mersilene suture extrusion occurred in 8% of ears. Only one of these required revision surgery for associated loss of correction. Despite these drawbacks, over 95% of patients achieved satisfactory results using cartilage-sparing otoplasty techniques.

Adolescent↗
PubMed1990

Pediatric maxillofacial trauma. Age-related variations in injury.

Seventy-two children were treated for maxillofacial injuries by the otolaryngology service between January 1984 and June 1988. Patients were divided into three age groups on the basis of the development of paranasal sinuses and dentition. Differences in fracture characteristics, associated injuries, and treatment modalities were correlated to the maturational changes in the pediatric facial skeleton. The fracture site tended to shift from the upper to the lower aspect of the face with increasing age of the patient. Associated injuries were frequent, especially cranial injuries, and temporal bone fractures were notably more common in the youngest age group. Conservative treatment was found to be successful, particularly in the youngest age group, because of the unique remodeling potential of the pediatric facial skeleton.

Accidents, Traffic↗
PubMed1990

Cervicofacial liposuction: results and controversies.

Obtaining ideal results with cervicofacial rhytidectomy has long frustrated facial plastic surgeons due to the difficulty of removing local excesses of adipose tissue in the parotid, melolabial, submental and submandibular areas. Open and closed liposuction techniques are being developed in conjunction with the facelift to improve definition of the facial, mandibular and cervical contours. A review of the senior author's (PAA) cases of cervicofacial liposuction and rhytidectomy is presented with emphasis placed on surgical techniques and results. Current literature is reviewed. Recommendations are made regarding analysis, surgical techniques and postoperative management of patients presenting for rejuvenation of the lower face.

Face↗
PubMed1990

The hanging columella.

A hanging columella significantly detracts from otherwise pleasing nasal esthetics. Preoperative assessment of the nasal base is crucial to determine the etiology of a pre-existing hanging columella, and to assess the potential for creating such a deformity with rhinoplasty. Prevention or correction of a hanging columella requires surgical techniques that take into consideration the anatomic tip dynamic factors involved. We discuss the anatomy of the nasal base, define the hanging columella, and distinguish this entity from others with which it can be confused. We propose a methodical approach to the evaluation of the hanging columella, and recommend corrective techniques which we have found successful in achieving good cosmetic results.

Esthetics↗