Biomedical subjects
Publications and source records attributed to R A Younger.
A technique of transoral screw fixation mentoplasty is described for management of facial disproportion due to microgenia. One hundred and fifty-two patients followed for an average of 5.3 years revealed that screw fixation mentoplasty serves well to reduce perioperative morbidity and ensure a long-term improvement in facial balance and aesthetics.
A good rhinoplasty surgeon attempts to enhance nasal performance through airway and appearance improvement. The great rhinoplasty surgeon routinely improves not only nasal performance but endeavors to achieve a higher level of overall facial aesthetic enhancement by manipulating the surgical illusions of the face. This cohesive interplay of science between the eyes, cheeks, nose, lips, and chin is known all to well by the master facial plastic surgeon who defines the art of rhinoplasty.
The deviated external nose remains a difficult technical challenge to even the most masterful rhinoplastic surgeon. The classic septorhinoplasty approach to the deviated nose demonstrated a 9.8% revision rate in this study. During a 2-year period, the conservative subtraction-addition rhinoplasty procedure was developed, which subsequently reduced the revision rate to 1.3%. Conservative subtraction-addition rhinoplasty foregoes aggressive septal surgery and equalizes and enhances the airway through asymmetric turbinate volume reduction. Minimal bony and upper lateral work through rasping, soft tissue removal, and/or cartilage grafting allows for external nasal alignment. Both internal and external conservative subtraction-addition rhinoplasty components thus maintain perioperative structural stability and ensure long-term nasal symmetry.
The melolabial flap is a versatile technique for reconstruction of defects of the central face. Variations of this flap may be used to reconstruct the lower eyelids, the nose, the upper and lower lip, chin, and malar regions. Regional anatomy, indications, technical considerations, and avoidance of complications are discussed on the basis of 10 bilateral cadaver dissections of the melolabial area, in conjunction with 70 reconstructive cases that used this flap. Statistical analysis of the results reveals that flap viability is compromised by previous radiation and smoking. Consequently, alternate methods of reconstruction of the central face should be used in patients who have a history of these problems.
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