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Biomedical subjects

S W Perkins

Publications and source records attributed to S W Perkins.

15 recordsLinked to original sources
PubMed2000

Achieving the "natural look" in rhytidectomy.

Achieving the "natural look" in rhytidectomy and satisfying my aging face patient population are the primary motivating factors that have guided me to develop my personal philosophy and technique for facelifting. The following article will consider how to achieve the "natural look" in rhytidectomy using the modified deep plane-extended SMAS rhytidectomy technique, including the benefits derived from this efficient face-lift technique. It outlines how to give proper individualized consideration to each patient from the initial consultation, through the preoperative evaluation and workup, as well as anatomic indications for the type of face lift to be performed. In addition, the article covers possible postoperative complications and how to determine when secondary rhytidectomies or tuck-ups are indicated.

Bandages↗
PubMed2000

The incidence of sports-related facial trauma in children.

We conducted a survey of physician members of the American Academy of Facial Plastic and Reconstructive Surgery to determine the incidence and nature of facial traumas seen in their practices. We solicited information on the anatomic location of each injury, the severity of the trauma, and whether the injury occurred during a sports activity. According to the responses, 21% of facial fractures and 29% of nasal fractures were experienced by patients aged 17 years and younger who were participating in sports. We believe that many such injuries can be prevented with greater use of protective equipment.

Adolescent↗
PubMed1997

Prevention of seromas and hematomas after face-lift surgery with the use of postoperative vacuum drains.

OBJECTIVE: To evaluate the rate of hematoma and seroma formation in a series of rhytidectomies performed with and without the use of intrawound vacuum drains. DESIGN: Retrospective chart review of 222 consecutive face-lifts performed by a single surgeon using an identical surgical technique before and after the use of vacuum wound drains. The patients were divided into 2 groups of 111 patients each. Group 1 patients underwent surgery without drains, while group 2 patients had suction drains placed at the time of surgery. MAIN OUTCOME MEASURE: The occurrence of seromas and hematomas within the first 24 hours after surgery. RESULTS: In group 1, 41 patients (37%) developed seromas and 9 (8%) developed hematomas; the hematomas were small and were treated by aspiration alone. In group 2, 17 patients (15%) developed seromas and 8 (7%) developed hematomas. The decrease in the rate of seroma occurrence was statistically significant, while the decrease in hematoma formation did not reach statistical significance. CONCLUSIONS: The use of intrawound vacuum drains during the first 24 hours after surgery significantly decreases the rate of seroma formation. The occurrence of hematomas is also reduced, but less dramatically.

Exudates and Transudates↗
PubMed1996

Transconjunctival blepharoplasty.

Cosmetic blepharoplasty is directed at the surgical correction of undesirable changes of the eyelids that are usually of an acquired nature and caused by aging. The goals are to improve the appearance and, many times, the function of the eyelids. Just as important as attaining these goals is avoiding any complications or undesirable sequelae of a blepharoplasty procedure. In this article, the technique and application of transconjunctival blepharoplasty are reviewed. The differences in the preseptal and retroseptal approaches are discussed and illustrated. The transconjunctival technique can be expanded through the use of various other techniques in order to apply it to a wider variety of patients. These expanded techniques of transconjunctival blepharoplasty allow the surgeon to manage excess skin and rhytids more effectively. Transconjunctival blepharoplasty, therefore, represents a technique in the armamatarium of surgeons performing cosmetic blepharoplasty that has gained new popularity. The technique can be effectively applied to a wide variety of patients. Transconjunctival blepharoplasty allows the surgeon to accomplish many of the esthetic goals of blepharoplasty while reducing the incidence of many of the associated problems, i.e., lid malposition and a visible cutaneous scar.

Aged↗
PubMed1996

Prevention of facial herpetic infections after chemical peel and dermabrasion: new treatment strategies in the prophylaxis of patients undergoing procedures of the perioral area.

A proposed clinical strategy is offered for the prevention and treatment of facial herpetic infection associated with phenol chemical peel or dermabrasion of the perioral area. A retrospective evaluation of 181 consecutive patients undergoing perioral chemical peel or dermabrasion from 1983 to 1990 was performed. No patients were excluded and the minimum follow-up was 6 to 24 months. All procedures were done at a private practice ambulatory surgery center. Patients with any history of oral herpetic lesions were pretreated with oral acyclovir. The vast majority of these patients received dosages far exceeding previously described regiments. A subset of patients (n = 12) whose procedures predated acyclovir's commercial availability received no prophylactic treatment and allowed for a comparison group. The incidence of postoperative infection was measured to determine the effectiveness of prophylactic acyclovir treatment. In patients reporting previous herpetic infection, postoperative herpetic outbreaks were far more likely to occur (50 percent infection rate) in the absence of prophylactic acyclovir. An 8.3 percent infection rate was noted in patients with a similar history who received standard acyclovir prophylaxis. Once high dose prophylactic treatment was initiated, no further herpetic outbreaks were observed. Even among patients with a negative history of oral herpes (no treatment), 6.6 percent developed postoperative infections. Pretreatment with high dose acyclovir clinically minimizes the incidence and severity of postoperative herpetic infection in patients undergoing perioral chemical peel or dermabrasion. All patients should be treated preoperatively with acyclovir regardless of past history, because even those patients reporting no previous outbreaks of oral herpes may develop postoperative infections.

Acyclovir↗
PubMed1994

Transconjunctival approach to lower eyelid blepharoplasty. Experience, indications, and technique in 300 patients.

Despite the fact that transconjunctival approach to lower eyelid blepharoplasty is not a new technique, the indications, patient selection, technique, and results using this technique have not previously been widely reported. Specifically, we have compared the results of this blepharoplasty procedure in terms of the indications, expected results, postoperative complications, and patient satisfaction in 300 successive cases of skin-muscle flap approach with those in 300 cases in which the transconjunctival approach was used. The orientation and details of this approach for the facial plastic surgeon are well outlined. Associated adjunctive procedures such as simultaneous chemical peeling and the "pinch" technique for skin excess removal are discussed. Both short- and long-term complications are significantly reduced with the transconjunctival approach to lower lid blepharoplasty compared with the skin-muscle flap approach. Therefore, for the removal of pseudoherniation of orbital fat of the lower eyelid, the transconjunctival approach to lower lid blepharoplasty should have a significant place in the surgical armamentarium of the facial plastic surgeon.

Adipose Tissue↗
PubMed1993

Use of submentoplasty to enhance cervical recontouring in face-lift surgery.

A number of surgical techniques for recontouring the aging neck are available. Using liposuction and direct lipectomy, the surgeon can sculpt the jowl and submental contour. Posterior tightening of the ptotic platysma refines the submental area, while incisional or excisional techniques, along with midline plication, remove anterior banding. Despite these maneuvers, recurrent submental and cervical ptosis is noted in some patients. These individuals can benefit from a secondary submentoplasty, a submental tuck-up face-lift operation, usually within 6 to 18 months after their initial surgery. We have identified several reliable causes for a secondary submentoplasty. Submentoplasty as a planned second-stage surgery in certain patients allows achievement of more dramatic and long-lasting rejuvenation of the neck.

Adult↗
PubMed1989

SASMAS suspension rhytidectomy. Rationale and long-term experience.

Prudent surgeons who perform face-lifting operations continue to alter techniques to reduce morbidity and achieve lasting results. The philosophy and technique herein described arose from the premise that suspension of the superficial musculoaponeurotic system (SMAS) suspends the skin-adipose unit (SA). In turn, suspension of the skin-adipose unit (SA) suspends the SMAS. When proper suspension is achieved, both systems function in tandem as a single unit, ie, the SASMAS (skin-adipose superficial musculoaponeurotic system). The SASMAS technique has been performed in approximately 1200 patients with gratifying results and minimal complications.

Female↗
PubMedDate not supplied

Mersilene mesh chin augmentation. A 14-year experience.

During the past 20 years, a variety of alloplastic materials have been introduced for chin augmentation. Mersilene mesh (Ethicon, Sommerville, NJ), introduced in 1950, demonstrates many qualities that make it an ideal implant. This article reviews the senior author's (S.W.P.) successful 14-year experience using Mersilene mesh chin implants. Between 1983 and 1997, 264 patients underwent chin implantation procedures. The results show a low rate of infection (0.8%) and displacement (1.5%). There were 14 temporary paresthesias and no cases of permanent anesthesia. There were no incidences of absorption, rejection, or extrusion. Mersilene provides a soft, natural appearance to the chin, and it continues to be our choice for chin implantation.

Adult↗
PubMedDate not supplied

A successful 15-year experience in double-dome tip surgery via endonasal approach: nuances and pitfalls.

BACKGROUND: Endonasal double-dome techniques provide a reliable method to approach the nasal tip. OBJECTIVES: To review one surgeon's 15-year experience using a graduated method of endonasal double-dome tip surgery including patient selection, intraoperative techniques, and postoperative complications and to emphasize the nuances to achieve symmetry and consistent results. PATIENTS AND METHODS: Three hundred eighty-six patients who had adequate follow-up after undergoing endonasal double-dome tip rhinoplasty. RESULTS: Results at 1 year showed high rates of supratip (94%), dome (96%), and nostril (88%) symmetry. There was a high rate of patient satisfaction with a low rate of revision (7%). CONCLUSION: Endonasal double-dome tip surgery provides the surgeon the ability to achieve consistent results with high patient satisfaction and a low rate of revision.

Esthetics↗
PubMedDate not supplied

The forehead lift: endoscopic versus coronal approaches.

Rejuvenation surgery of the upper one-third of the face can be accomplished by a number of well-known techniques and approaches. The objectives of this study were to: (1) determine if endoscopic-assisted forehead lifts achieve the same degree of correction as the coronal/pretrichial forehead lifts, (2) to assess the effect of concurrent blepharoplasty on brow elevation, and (3) to evaluate long-term results of coronal/ pretrichial forehead lifts. The study was a retrospective blinded comparison of pre- and postoperative photographs of patients who underwent forehead lifts. In order to control for the differences in photographs, ratios of distances were measured utilizing standard anthropometric sites of the brow, medial canthus, and subnasale. All reviewed cases were operated on by the same surgeon (S.W. Perkins, M.D.). A total of 140 patients having undergone forehead lift procedures and with 12-month postoperative photographic documentation were included in the study. Of these 121 patients had coronal forehead lifts and 19 had endoscopic-assisted forehead lifts. Results revealed that at 1 year follow-up both methods achieved brow elevation without a significant difference in the approach. Concomitant blepharoplasty had no statistical effect on brow position. Additionally, long-term follow-up on the coronal/pretrichial lifts revealed a gradual drop in brow position over 5 years. We conclude that both endoscopic and coronal/pretrichial forehead lifts provide for comparable elevation at 1-year follow-up. Concomitant blepharoplasty has minimal to no significant effect on brow position. Brow elevation in coronal/pretrichial forehead lifts may be temporary.

Blepharoplasty↗