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Biomedical subjects

Joseph Niamtu

Publications and source records attributed to Joseph Niamtu.

17 recordsLinked to original sources
PubMed2005

Simple technique for lip and nasolabial fold anesthesia for injectable fillers.

BACKGROUND: Minimally invasive cosmetic facial surgery procedures including injectable lip fillers are more popular than ever. Many of the newer fillers are more painful to inject than previous products and require a greater level of pain control. OBJECTIVE: The objective of this article is to describe a simple method of local anesthesia infiltration for pain control when injecting filler substances into the lips and perioral and nasolabial fold areas. MATERIALS AND METHODS: The preinjection topical anesthetic preparation, the actual infiltration techniques, and the author's experience are reviewed. RESULTS: These infiltration techniques are simple to perform and provide adequate anesthesia for the painless injection of filler substances in the lips and perioral, nasolabial regions. CONCLUSION: This simple intraoral infiltration technique is well tolerated and appreciated by patients and facilitates the experience of filler injection for both the patient and the doctor.

Anesthesia, Local↗
PubMed2005

Expanding hematoma in face-lift surgery: literature review, case presentations, and caveats.

BACKGROUND: Postoperative expanding hematoma is the most common complication seen in face-lift surgery. It has been described in 0 to 15% of all cases, and if not promptly recognized and treated, severe ischemic flap changes, with resultant necrosis, can occur. In addition, postoperative hematoma can frequently occur after normal office hours, and an organized plan of action needs to be established to effectively deal with this unpredictable complication. OBJECTIVES: The objective of this article is to review the current face-lift literature and the author's experience, to present the salient features of postoperative hematoma, and to alert surgeons to the prompt recognition and treatment of major hematomas following face-lift surgery. MATERIALS AND METHODS: A review of the face-lift literature concerning postoperative expanding hematoma and its causes and treatment is presented. In addition, the author's experience and hematoma rate are reviewed, along with several case presentations. RESULTS: It is well known that critical postoperative hematomas occur in face-lift surgeries. No predictable set of signs or symptoms has been identified to diagnose which patients present a risk of postoperative hematoma. Common themes in patients who have experienced hematoma following face-lift include male gender, preoperative medications that affect coagulation, perioperative and postoperative blood pressure spikes, postoperative activity, nausea, vomiting, and retching. The prompt recognition and treatment of postoperative face-lift hematoma are generally easily accomplished with common hemostatic techniques, and the surgical site most frequently heals without major complications. CONCLUSION: Major expanding hematomas have been reported in 0 to 15% of facelift surgeries, with an average of 2 to 4%. There do not appear to be any common recognizable screening factors to determine who is at risk. Close attention needs to be paid to the preoperative medical history, medication regimens, perioperative blood pressures, postoperative activity, and nausea and vomiting. Because most hematomas occur in the first 12 hours after surgery, their recognition and treatment may be after normal office hours, requiring a preemptive and organized plan of action. Significant complications are uncommon when hematomas are promptly recognized and treated. In 140 consecutive face-lifts, the author's hematoma rate was 1.4%.

Female↗
PubMed2004

Cosmetic blepharoplasty.

Cosmetic blepharoplasty is the hallmark of facial rejuvenation and is rewarding for the surgeon and patient. No other cosmetic procedure is more common in the 40- to 65-year age group. This procedure carries a steep learning curve, but the training of an oral and maxillofacial surgeon is adequate to begin learning this procedure. Proper diagnosis and adherence to strict preoperative, intraoperative, and postoperative protocols are paramount to avoiding complications that may be serious. The author, like many surgeons, enjoys this procedure and believes that its place in the contemporary scope of oral and maxillofacial surgery is well established.

Adipose Tissue↗
PubMed2004

The adjustable vector deep plane midface lift.

Midface lifting is valuable rejuvenative options for many patients and can provide a more youthful and balanced face. This procedure is well suited for the oral and maxillofacial surgeon because of familiarity with the intraoral and temporal surgical approaches, and it does not require any specialized equipment. This procedure has minimal postoperative recovery and a low complication rate. The results of this procedure have remained stable in the author's cohort of patients approaching 2 years. Contraindications include atrophic or minimal malar fat, in which case there is nothing to elevate. The midface lift can be performed as an isolated procedure or as part of multiple facial procedures. The astute surgeon considers midface rejuvenation in all cosmetic cases.

Adipose Tissue↗
PubMed2004

Image is everything: pearls and pitfalls of digital photography and PowerPoint presentations for the cosmetic surgeon.

BACKGROUND: Cosmetic surgery and photography are inseparable. Clinical photographs serve as diagnostic aids, medical records, legal protection, and marketing tools. In the past, taking high-quality, standardized images and maintaining and using them for presentations were tasks of significant proportion when done correctly. Although the cosmetic literature is replete with articles on standardized photography, this has eluded many practitioners in part to the complexity. A paradigm shift has occurred in the past decade, and digital technology has revolutionized clinical photography and presentations. Digital technology has made it easier than ever to take high-quality, standardized images and to use them in a multitude of ways to enhance the practice of cosmetic surgery. PowerPoint presentations have become the standard for academic presentations, but many pitfalls exist, especially when taking a backup disc to play on an alternate computer at a lecture venue. OBJECTIVE: Embracing digital technology has a mild to moderate learning curve but is complicated by old habits and holdovers from the days of slide photography, macro lenses, and specialized flashes. Discussion is presented to circumvent common problems involving computer glitches with PowerPoint presentations. CONCLUSION: In the past, high-quality clinical photography was complex and sometimes beyond the confines of a busy clinical practice. The digital revolution of the past decade has removed many of these associated barriers, and it has never been easier or more affordable to take images and use them in a multitude of ways for learning, judging surgical outcomes, teaching and lecturing, and marketing. Even though this technology has existed for years, many practitioners have failed to embrace it for various reasons or fears. By following a few simple techniques, even the most novice practitioner can be on the forefront of digital imaging technology. By observing a number of modified techniques with digital cameras, any practitioner can take high-quality, standardized clinical photographs and can make and use these images to enhance his or her practice. This article deals with common pitfalls of digital photography and PowerPoint presentations and presents multiple pearls to achieve proficiency quickly with digital photography and imaging as well as avoid malfunction of PowerPoint presentations in an academic lecture venue.

Documentation↗
PubMed2003

The aging forehead.

Explore the source record for details and available documents.

Biocompatible Materials↗
PubMed2003

The endoscopic brow and midface lift.

Improvements in technology have increased the level of patient care in all aspects of medicine and surgery. This is no less true in the area of cosmetic surgery. The use of endoscopy has led to improved aesthetics with respect to postoperative scarring, decreased healing time for patients, and an increase in overall patient satisfaction. Because the endoscopic brow and midface lift accomplishes the three primary goals of facial cosmetic surgery (restoration, rejuvenation, and enhancement) while adhering to the concepts of working from inside out and repositioning rather than excising, it could be concluded that there is no longer any indication for either the coronal or trichophillic brow lifts. An argument could be made that a direct brow lift may be indicated in cases of extreme brow ptosis with deep frontal rhytids to allow concealment of the scar; however, even moderate-to-severe brow ptosis can be corrected endoscopically when deep forehead rhytids are not present.

Bone Screws↗
PubMed2003

Botulinum toxin A: a review of 1,085 oral and maxillofacial patient treatments.

PURPOSE: Botulinum toxin A (Botox; Allergan, Inc, Irvine, CA) has been used safely and effectively for the management of rhytids and dynamic lines of the face. Much of the initial anecdotal experience with Botox has changed with experience and is reported by the author. PATIENTS AND METHODS: In a 56-month period, 439 vials of Botox were used for primarily cosmetic improvement of facial lines and rhytids. Four hundred seventeen patients underwent 1,085 treatment episodes with an estimated 17,000 injections that were tracked on a database and reviewed. RESULTS: Botox is a safe and effective treatment for the temporary improvement of facial lines and dynamic rhytids in selected anatomic regions. The techniques of reconstitution, storage, use, dose, and technique may not be as sensitive as originally described. CONCLUSION: When following minimal guidelines, the use of Botox for cosmetic facial applications is safe, predictable, and without serious complications and provides generalized patient satisfaction.

Blepharoptosis↗
PubMed2002

Eleven pearls for cosmetic earlobe repair.

Earlobe repair is a common request in cosmetic facial surgery. Earlobe tears result from a variety of traumatic situations. A resurgence in body piercing and multiple facial and ear piercings is occurring in college-aged individuals. This increase in piercing will bring more piercing-related complications to the cosmetic surgeon. The author has outlined 11 surgical pearls to provide improved cosmetic results in the repair of torn earlobes. Also described is immediate repiercing of the earlobe at the time of the surgical repair. Preventive practices to decrease earring and earlobe trauma are also reviewed.

Dermatology↗
PubMed2002

Techno pearls for digital image management.

BACKGROUND: The past decade has provided a paradigm shift in image management. Technological advances have enabled affordable, high-quality digital clinical photography. In addition, this technology has enabled doctors to easily compose and present multimedia lectures with programs such as Microsoft PowerPoint. Since most practitioners already possess large numbers of conventional slides and photographs, digitization is required to convert these to a usable format. Depending on the type of image and resolution, it can take anywhere from 30 seconds to several minutes to scan each slide. This drawback delays or prevents many practitioners from switching to digital technology. OBJECTIVE: Using a digital camera and the XP version of Windows, some common tasks associated with digital images and PowerPoint presentations may be simplified and facilitated. METHODS: Using common digital cameras and computer image editing software, slides, photographs, radiographs, and textbook images may be digitized in seconds with adequate quality for most common clinical and educational applications. In addition, the use of new dual monitor functionality is discussed. This new technology comes standard with Windows XP and allows the use of two monitors simultaneously, allowing the user to view thumbnail images on one monitor and the PowerPoint presentation on the other monitor. Images may be dragged and dropped into the presentation, thereby avoiding repetitive menu commands. RESULTS: The author shows several techniques and shortcuts to assist the clinical practitioner in digitizing slides and facilitating the management of these images in PowerPoint presentations. CONCLUSION: A digital camera can be used to adequately digitize most slide pictures, and these images can be managed in a more simple and direct manner utilizing the Windows XP operating system that is shipping with most new computers.

Dermatology↗