Biomedical subjects

R T Farrior

Publications and source records attributed to R T Farrior.

At least 19 recordsLinked to original sources

PubMed1998

Management of malar folds in blepharoplasty.

OBJECTIVES/HYPOTHESIS: To define the anatomy and location of malar folds as distinguished from lower eyelid skin and orbital fat and to teach a new surgical technique for the management of the aging eye. STUDY DESIGN: Retrospective report of a surgical procedure designed to address the malar folds. METHODS: Analysis of preoperative and postoperative photographic documentation for surgical planning and long-term result. RESULTS: Patient satisfaction and lack of recurrence, without the requirement of direct excision, were noted in all patients studied. CONCLUSION: This presentation describes a new simple technique for the management of the folds and cutaneous and subcutaneous prominences that occur inferior to the lower eyelid skin. The operation addresses the correction by a combination of skin/muscle flap lower eyelid blepharoplasty with immediately subcutaneous (skin flap) elevations over the carefully delineated malar prominences; the removal of the deep fat that may or may not be associated with dehiscence of fat through the thin inferior fibers of the orbicularis muscle; and finally suspension of the remaining subcutaneous tissue and the muscle to the periosteum of the inferior orbital rim as well as suspension of the orbicularis muscle margin to the lateral orbital periosteum or the lateral canthal ligament area. The technique is designed to manage the more commonly found malar prominences but can be applied in the management of more pronounced festoons involving skin, muscle, and fat.

Adipose Tissue↗

PubMed1993

The cleft lip nose: an update.

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Cleft Lip↗

PubMed1985

Dermabrasion in facial surgery.

Surgical planing or dermabrasion has many uses in facial aesthetic and reconstructive surgery but often is an underutilized technique. The purpose of this paper is to familiarize the head and neck and facial plastic surgeon with some of these uses extending from trauma to rejuvenation of the aging face. Detail will be presented regarding analysis for conditions where dermabrasion is indicated and in dealing with modifications of surgical technique. The author feels that dermabrasion is the treatment of choice for scars and acne and favors it over chemabrasion or chemical peel even for fine rhytids because the depth of dermabrasion can be precisely controlled and varied according to the location of and the degree of scarring or facial wrinkles. It offers early and predictable healing without concern for the penetration and absorption of chemical elements (especially phenol). Dermabrasion may be combined with other procedures such as scar revisions, dermal shaves, and de-epithelization of flaps.

Acne Vulgaris↗

PubMed1983

Primary and late plastic repair of soft tissue injuries.

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Cicatrix↗

PubMed1981

Bilateral chylothorax. Rare complication of neck dissection.

Bilateral chylothorax is an extremely serious complication that affects the cardiorespiratory system and places the patient in serious danger of respiratory collapse. In cases of postoperative chyle fistula or chylomas, one should consider the possibility of chylothorax. Chest film and, subsequently, diagnostic thoracentesis can provide the diagnosis. Conservative treatment, such as repeated thoracentesis, low-triglyceride diet, and possibly closed thoracostomy tube drainage, should be used. The surgical approach for the ligation of the thoracic duct should be reserved for cases that do not respond to the previously mentioned conservative measures.

Chylothorax↗

PubMed1978

The osteotomy in rhinoplasty.

The purpose is to assist the surgeon in the selection of modifications for nasal osteotomies. Details of the technique include: 1. Incision for osteotomy made perpendicular to the pyriform rim and modified incisions, intraoral or through the Weir incision. 2. Rasping of the lateral nasal vault prior to any osteotomies. 3. Removal of a modified beveled wedge of bone prior to the medial osteotomy, unroofing the bony dorsum to a higher level. 4. The medial osteotomy done prior to either the lateral or the intermediate osteotomy. The intermediate osteotomy is performed prior to the lateral. 5. "Complete" and "fading" medial osteotomies are utilized as indicated. 6. The lateral osteotomy may be relatively straight and low depending then on a transverse fracture or may be high and curved meeting the fading medial osteotomy. 7. A sub-periosteal tunnel with the osteotome guard external to the bone is preferred to a submucosal tunnel.

Humans↗

PubMed1977

Management of lacerations and scars.

The purpose of this paper is to review and update the subject of management of scars and lacerations. The surgion who accepts responsibility for management of soft tissue injuries must be aware of fundamental surgical principles as well as detailed technique. Knowledge of basic anatomy and wound physiology is utilized and applied. Emphasis is placed on management of the total pateint. The specialist must accept the role of team captain and establish an order of priority in management and in wound analysis. By having a basic knowledge of wound healing and the lines of favorable contracture, one is better able to prognosticate the eventual healing of the wound after proper management. By being able to predict wound contracture and scar maturation, the patient can be better informed as to what to expect during the period of healing. With lacerations immediate repair is carried out. With scars there is more time for planning and photographic analysis. The contracting forces will by this time have identified themselves and the degree of release of the contracture or camouflage can be determined. Specific wound management emphasized meticulous closure in layers and the use of skin hooks with the interrupted subcuticular suture. Skin sutures with both the continuous subcuticular suture and interrupted sutures of monofilament nylon using the spring-loop are described. Emphasis is placed on the preparation of the skin margins with slight beveling of the skin edges and undermining with precise even thickness of the skin especially at the wound margin. For scar revisions a minimum time of six months should elapse, and 12-18 months is better. Complications include infection, hematoma, wound separation, and rejection of suture materials. Keloids are discussed briefly, particularly regarding the use of intralesional injection steroids. Broken line camouflage techniques are discussed with the regard to breaking up contracture without lengthening. Lengthening either existing or anticipated contractures is accomplished with Z-plasty. The multiple Z-plasty, W-plasty, and Zig-Zag plasty are aimed towards creating a less conspicuous scar and creating some diffusion of the forces of contracture. A technique for a "practical Z-plasty" is described. Both free grafts and skin flaps sometimes must be utilized to fill tissue defects and break up line of contracture. The materials presented and conclusions drawn are based on 25 years of active emergency room coverage and long term follow-up of treated patients. It is the responsibility of the physician to act within the first few hours and to take the time necessary for accurate approximation and realignment of both soft tissue and bone injuries. Minimal scarring depends on accurate approximation of skin margins without tension. The need for early meticulous repair, so that unsightly scars and disfigurements may be prevented, cannot be overemphasized.

Cicatrix↗

PubMed1976