Biomedical subjects
Publications and source records attributed to R Ellenbogen.
The small septal perforation has been a particular problem with regard to its symptoms. One author even recommended its conversion into a large septal perforation to decrease the symptoms. A simple technique using autologous nasal cartilage is presented in 4 cases with follow-up for one year.
A technique for eyebrow lift is presented which employs the eyebrow arch used by makeup artists to add subjectively to the operation and prevent the aesthetically displeasing result of a too highly arched brow. The marking technique to achieve the proper life is outlined. A concomitant blepharoplasty technique and its indications are presented.
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Platysma regrowth after platysma cervical lift is a new complication. We postulate that the platysma reestablishes itself by hypertrophy of muscle fibers contained in its posterior SMAS sheath as well as by muscle regrowth along the posterior sheath. We now routinely cut both platysma and posterior sheath. We also recommend excision of anterior platysma not connected to the posterior sheath. Closure of platysma should be from the mentum to the upper thyroid cartilage utilizing nonabsorbable sutures.
We have suggested visual criteria for achieving and assessing success in platysma cervical lift. We believe it is now possible to satisfy these criteria in most patients, even those with a low-lying hyoid. Anterior adjustment of the platysma is more important for desirable results than posterior adjustment or posterior closure alone. If present in a heavy neck, the subplatysma fat pocket must be excised. A posterior submental incision as well as a more radical submental lipectomy with platysma sling (submental neck lift) is helpful for patients who are not yet candidates for an upward lift. The cutting of the platysma and fashioning of the sling, as well as defatting, may possibly add to the longevity of the lift, but this can be ascertained only by long-term follow-up.
This report presents and 18 1/2-year-old patient with clinical features of Down syndrome and severe mental retardation due to partial trisomy 21. Cytogenetic studies using Giemsa banding chromosomes revealed translocation of the 21q21 qter segment onto the short arms of chromosome #8 (46,XY,--8, + t(8qter 8p23::21q21 21 qter)). It is recommended that patients with features of Down syndrome whose chromosome analysis was done prior to introduction of banding studies undergo repeat karyotyping.
With the increasing popularity of platysmal face lifts, the anatomy of the cervical branch of the facial nerve should be noted. The postoperative appearance of lack of ability to retrude the corner of the mouth, in someone who had a "full denture" smile preoperatively, could possibly be due to severance or stretching of the rami of the cervical branch of the facial nerve--rather than an injury of the facial nerve of the marginal mandibular branch.
There is a gray zone in specific communication about what size a woman's breasts will be after surgery. I have devised a clear plastic shell which accurately simulates a bra cup size of a breast in the upright position. This can be used for preoperative demonstration under clothes, intraoperatively with inflatable implants, preoperatively with gel implants, and in pexis. I have used these with great success for two years in my practice.
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Four patients who had received silicone injections had the following complications: migration, hepatic disease manifested as granulomatous hepatitis (previously undescribed, to our knowledge), hypopigmentation, and death. Silicone should now be considered as a possible cause of hepatic granulomas in an appropriate host.