Biomedical subjects

T J Marten

Publications and source records attributed to T J Marten.

6 recordsLinked to original sources

PubMed1999

Hairline lowering during foreheadplasty.

Many patients seeking rejuvenation of their foreheads have high hairlines and are troubled by the prospect that surgery will worsen the deformity. Hairline elevation occurs in both coronal and endoscopic foreheadplasty techniques and is at least part of the reason that many surgeons do not always recommend these procedures when otherwise indicated. Although a pretrichial "hairline" incision prevents hairline retro-displacement, it results in forehead shortening only and not true hairline lowering. When a pretrichial incision is used in combination with a posterior scalp advancement flap, however, true hairline lowering is possible. Experience with this technique encompasses 27 procedures performed over a 5-year period. Patients ranged in age from 35 to 71 years. A significant improvement was demonstrable in all cases and corresponded with a high degree of patient satisfaction. No serious complications were seen. A high hairline must be recognized as the source of both a disproportionate and aged appearance. The ability to lower the hairline and place it in a more proportionate, youthful relationship with the rest of the face adds a new dimension to foreheadplasty equal to or greater in importance to an overall improved appearance as other maneuvers typically performed during the procedure. For many patients, the benefits of hairline lowering far outweigh the trade-off of a more anteriorly situated, and possibly more visible, scar.

Adult↗

PubMed1997

Facelift. Planning and technique.

Experience has shown that a superior facelift result is not possible without modification of the SMAS, platysma, and other deep facial structures. Although techniques vary and a consensus of opinion is unlikely to emerge, any surgeon able to identify the anatomic basis of his or her patients' problems can, through the application of logic and careful planning, select appropriate methods that are safe, effective, and rational. Presented here is the author's technique, which has delivered satisfaction to many patients.

Anesthesia, Local↗

PubMed1993

Surgical correction of the crow's feet deformity.

Improved methods and important adjuncts for rejuvenation of the aging face have evolved as surgeons have recognized the limitations of the techniques they employ. Presented here is a simple, safe, and straightforward technique for correction of the "crow's feet" deformity that has proven to produce a predictable and long-lasting improvement.

Female↗

PubMed1991

The male foreheadplasty. Recognizing and treating aging in the upper face.

Many surgeons remain mistakenly preoccupied with aging in the jowl and neck and often overlook more objectionable changes in the upper face. These changes produce not only an old or aged appearance but also inappropriate expressions. This article outlines the elements of aging in the upper face and details the planning and execution of the foreheadplasty. Topics discussed include upper facial aesthetics, pseudoblepharochalasis, incisions for bald or balding men, and techniques for minimizing scars.

Aging↗

PubMed1991

Physician-administered office anesthesia.

Surgeons who administer office anesthesia accept a serious responsibility for the well-being of their patients. Each must be thoroughly familiar with the agents they employ and prepared to deal with any complications or untoward events that might arise out of their use. Patients who are healthy or have well-controlled mild systemic disease are generally suitable for office procedures. Overly apprehensive patients, those with a history of anesthetic difficulties, or any patient with significant medical problems should be provided an anesthesiologist or competent Certified Registered Nurse Anesthetist (CRNA). It is irresponsible and dangerous to administer anesthesia in a substandard facility or with an inadequate or inexperienced staff. All staff members should be BCLS (Basic Cardiac Life Support) qualified, and key individuals should be encouraged to obtain ACLS (Advanced Cardiac Life Support) certification. Proper pharmacologic preparation of the patient will allay anxiety, increase comfort, and reduce the overall quantity of anesthetic needed. Particularly useful agents include benzodiazepines (Valium and Versed) and diphenhydramine (Benadryl). Medication is not, however, a substitute for human contact, genuine concern, or timely reassurance. All patients receiving anything more than a small quantity of local anesthetic should be monitored by transcutaneous pulse oximetry, noninvasive sphygmomanometry, and real-time electrocardiography. Each provides important information on the patient's physiologic condition. Of these three monitors, the most important information is provided by the pulse oximeter. It is capable of detecting a problem before serious physiologic compromise has occurred and should be considered an indispensible part of each patient's care. A brief period of deep sedation for the administration of local anesthetic can safely be achieved using carefully titrated quantities of the short-acting barbiturate methohexital (Brevital). Gauging the proper end point of methohexital administration is accomplished through skilled observation of the patient. As the proper threshold is reached, a characteristic slackening of the jaw occurs usually in conjunction with a distinctive relaxation of the face. In the majority of cases, no change in the SaO2 will occur.(ABSTRACT TRUNCATED AT 400 WORDS)

Ambulatory Surgical Procedures↗

PubMedDate not supplied

The trifurcated SMAS flap: three-part segmentation of the conventional flap for improved results in the midface, cheek, and neck.

While SMAS surgery revolutionized facelift procedures, the single flap created by conventional dissections suffers the drawback that it can only be advanced in one direction and sutured in place under uniform tension. Division of the flap into three segments overcomes this problem and allows independent pull to be applied in different directions to the upper midface, cheek, and neck.

Adult↗