Biomedical subjects

P Helton

Publications and source records attributed to P Helton.

5 recordsLinked to original sources

PubMed2001

The S-lift facelift featuring the U-suture and O-suture combined with skin resurfacing.

BACKGROUND: A short-flap S-lift may be helpful for minor jowling or submental laxity in cases of early facial ptosis, revision facelifts, or where skin resurfacing is combined with neck lifting. OBJECTIVE: To develop a safe and effective method to lift the jowl either as a single procedure or combined with other rejuvenation methods. METHODS: After the induction of monitored anesthesia care the skin resurfacing is completed, if necessary, and the submental and lateral S-lift incisions are marked next to the tragus. The submental area is hydrodissected with modified tumescent solution. After a 15-minute waiting period, the submental area is debulked with small spatula cannulas using reduced pressure liposuction. Often the platysma bands are tied together with a running locked suture. The right cheek area is hydrodissected and debulked in a similar fashion. A 3-4 cm flap is elevated. If necessary, further blunt dissection is passed through the anterior mandible ligament and the nasolabial fold. Care is taken to keep the skin trabeculae intact. The SMAS is plicated with a U-shaped and O-shaped purse-string suture. Following this tightening of the subcutaneous tissue, the skin is closed with a double-layer closure. The face is dressed in two layers of tube gauze. Sutures are removed in 7-9 days. RESULTS: This S-lift gives a pleasing rejuvenation of the jowl and submental area. It is also possible to combine this procedure with other procedures such as corset platysmaplasty, skin resurfacing, fat augmentation, a browlift, or blepharoplasty. CONCLUSION: The S-lift provides a safe and effective method for rejuvenation of the early sagging face or for revision facelift.

Chemexfoliation↗

PubMed2000

Lip rejuvenation.

BACKGROUND: The management of the senile lip remains a dilemma. Allogenic fillers often feel unnatural, lip resurfacing is not adequate, and fat transfers may disappear. OBJECTIVE: To develop a more reliable step-by-step approach to lip augmentation. METHOD: Lips were divided into types: (1) the simple senile lip that had lost its fullness-treated with fat augmentation; (2) the lip with rhagades-treated with fat augmentation and laser resurfacing; and (3) the duckbill lip-treated with lip advancement, fat augmentation, and laser resurfacing. Tattooing to increase the degree of redness was performed on all types of lips. RESULT: If there had been a previously full lip, it was possible to rejuvenate the lip by simple augmentation with autologous fat transfer. The average number of fat transfer sessions to generate this pleasing lip was two to three. The lip with rhagades required fat filling, with laser resurfacing to achieve a new contour. The duckbill lip required a lip advancement along with lipofilling and laser resurfacing. All types benefited from lip tattooing. CONCLUSIONS: It was possible with fat augmentation and/or laser resurfacing to generate a pleasing lip in type 1 and 2 lips. Lip type 3 required a lip advancement along with fat augmentation and laser resurfacing. Lip tattooing accentuated all the lip types.

Adipose Tissue↗

PubMed1999

Neck rejuvenation by combining Jessner/TCA peel, dermasanding, and CO2 laser resurfacing.

BACKGROUND: One of the greatest challenges facing facial cosmetic surgeons today is the simultaneous rejuvenation of the neck and face. Laser resurfacing of the face using the carbon dioxide (CO2) laser or the erbium:yttrium-aluminum-garnet (Er:YAG) laser has enjoyed widespread popularity, but the neck and chest are often avoided. It would be quite helpful to rejuvenate the neck at the same time the face is being resurfaced. This would diminish lines of demarcation and help reduce the signs of aging of the neck. There would be a better match between the new skin of the neck and face. OBJECTIVE: To develop a safe and effective method to rejuvenate the neck. METHOD: A step-by-step skin care program was instituted. The patients preconditioned their face and neck skin with vitamin A/glycolic skin conditioning lotions for 6-8 weeks prior to surgery. Following this the chest and neck area was treated with the Jessner-trichloroacetic acid (TCA) peel. Then the middle section of the neck was sanded with 150 grit sandscreen. Finally, the central area was resurfaced with the UltraPulse CO2 laser using reduced power settings. Usually two passes was adequate to shrink the skin of this central section of the neck. A petrolatum-based ointment was applied during the initial 7-day postoperative period. After reepithelialization a sunscreen-moisturizer was used during the day and hydrocortisone moisturizer was applied at night. RESULTS: The neck skin was able to tolerate this step-by-step skin rejuvenation. The blending from the décolleté area to the hairline produced a rejuvenation without a line of demarcation. There were no examples of scarring in the 12 cases that were evaluated for 6 months. Two cases developed persistent erythema that responded to silicone gel sheeting. Although no patients complained of hypopigmentation, a decrease in pigment was found using special UV photography. CONCLUSION: It is possible with this gradient, step-by-step method to produce a rejuvenation of the neck. An improved texture of the neck developed without visible scarring.

Chemexfoliation↗

PubMed1999

Modified tumescent liposuction.

BACKGROUND: Tumescent liposuction has been found to be safe and effective. However, there are still many refinements that may be possible, such as varying the size and tips of the cannulas, varying the types of infiltrate and associated anesthesia, and the method of compression. OBJECTIVE: To examine possible variables in tumescent liposuction techniques such as the most efficient liposuction cannulas, to determine an effective tumescent fluid, and to examine the extent of compression provided by different garments. METHODS: Patient markings, tumescent fluid formulas, methods of infiltration, types of cannulas, skin incisions, and compression garments were compared between the pure tumescent technique and modified tumescent liposuction. RESULTS: The most efficient cannulas were those with three staggered ports, such as the Mercedes, Cobra-keel, Giorgio Fischer, and Accelerator II tips. When these are combined with modified tumescent fluids and sedation, it is possible to perform total body liposuction in a safe and efficient manner. Multiple ports and compression garments are beneficial to reduce bruising and focal areas of inflammation. CONCLUSION: The tumescent liposuction technique will continue to be improved. So far, with more efficient cannulas and more efficient tumescent fluids, combined with sedation, it has been possible to increase the yield and decrease the required time for the technique. We call this modified tumescent liposuction.

Humans↗

PubMed1999

Disappointing results following resurfacing of facial skin with CO2 lasers for prophylaxis of keratoses and cancers.

BACKGROUND: With the development of the short-pulse CO2 laser it was hoped that this resurfacing would prevent recurrent actinic keratoses and basal cell cancers similar to resurfacing with dermabrasion, laser abrasion, and deep chemical peel. However, we have begun to see patients that are developing keratoses and cancers within months following laser resurfacing. OBJECTIVE: To document the problems of recurrent keratoses and basal cell cancers in patients following CO2 laser resurfacing. METHODS: Thirty-five patients with extreme sun damage were seen at 3, 6, and 12 months following CO2 laser resurfacing for repeat color and ultraviolet photography and clinical examination to look for erythematous dyskeratotic lesions or papules with pearly borders. RESULTS: Five of our patients (14.3%) who had undergone recent CO2 resurfacing developed actinic keratoses and basal cell cancers. CONCLUSION: CO2 laser resurfacing is not as effective as dermabrasion, chemabrasion, and deep chemical peel for the prophylaxis of actinic keratoses and basal cell cancers, especially in Fitzpatrick type I and II patients.

Adult↗