Analysis of the upper face and selection of rejuvenation techniques.
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Endoscopy↗
Biomedical subjects
Wayne F Larrabee
Publications and source records attributed to Wayne F Larrabee.
Anatomy of the eyelids.
The variety and complexity of periorbital surgical procedures continue to increase. Successful completion of reconstructive and esthetic ocular procedures requires an exacting knowledge of the relevant anatomy. Interestingly, the definition of ocular and periorbital anatomy continues to evolve, including more recent descriptions of the orbitomalar ligament and a new understanding of eyelid lymphatics. This article presents the most recent descriptions of periorbital anatomy.
Eyelids↗
Update in three-dimensional imaging in facial plastic surgery.
PURPOSE OF REVIEW: Facial plastic surgeons have always relied on photography for preoperative and postoperative analysis, medicolegal documentation, and communication. The current standards for analysis and documentation of facial structures have been determined by obtaining measurements and parameters from two-dimensional photographs or radiographs. However, the face and neck are three-dimensional structures and require manipulation in three planes within the constraints of esthetics, stability, and function. Recent advances in technology have made three-dimensional imaging and analysis possible. RECENT FINDINGS: The ability to capture images in three dimensions has opened up new avenues for observation and has increased the ability to analyze changes after surgery. Whereas only linear distances, angles, and areas can be determined by use of two-dimensional images, soft tissue volumetric data and surface topography can also be measured accurately; this can be helpful in validating changes in patients undergoing aging facial or orthognathic procedures. Recent studies have focused on descriptions of imaging techniques, validation of measurements, and the creation of normative data and its applications in surgery. SUMMARY: The availability of three-dimensional imaging and software systems presents new opportunities for the facial cosmetic surgeon to plan, execute, and assess the outcomes in patients undergoing surgery of the face and neck.
Cephalometry↗
The history of otolaryngology in plastic surgery.
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History, 20th Century↗
Outcomes of facial cosmetic procedures.
Facial cosmetic procedures lend themselves to outcomes studies in ways that traditional reconstructive procedures may not. The most important measures of outcome in facial cosmetic surgery are quality of life and patient satisfaction, in contrast to other, more objective measures such as complications or mortality rates. For this reason, outcomes research in facial cosmetic surgery deserves a special focus of attention. In this article, we review outcomes studies for the more common facial cosmetic procedures, discuss in depth what aspects of patient-related satisfaction have been quantified by these existing studies, and highlight the direction that future outcomes research projects may wish to follow. There exists an abundance of potential interesting areas of study in facial cosmetic surgery, and the application of outcomes research methodology to these realms may allow the facial plastic surgeon to better define the success or failure of each individual facial cosmetic surgery procedure.
Airway Resistance↗
Cosmetic surgery procedures as luxury goods: measuring price and demand in facial plastic surgery.
OBJECTIVES: To evaluate the relationship between cosmetic facial plastic surgery procedure price and demand, and to test the hypothesis that these procedures function as luxury goods in the marketplace, with an upward-sloping demand curve. METHODS: Data were derived from a survey that was sent to every (N = 1727) active fellow, member, or associate of the American Academy of Facial Plastic and Reconstructive Surgery, assessing the costs and frequency of 4 common cosmetic facial plastic surgery procedures (face-lift, brow-lift, blepharoplasty, and rhinoplasty) for 1999 and 1989. An economic analysis was performed to assess the relationship of price and demand for these procedures. RESULTS: A significant association was found between increasing surgeons' fees and total charges for cosmetic facial plastic surgery procedures and increasing demand for these procedures, as measured by their annual frequency (P</=.003). After a multiple regression analysis correcting for confounding variables, this association of increased price with increased demand holds for each of the 4 procedures studied, across all US regions, and for both periods surveyed. CONCLUSIONS: Cosmetic facial plastic surgery procedures do appear to function as luxury goods in the marketplace, with an upward-sloping demand curve. This stands in contrast to other, traditional, goods for which demand typically declines as price increases. It appears that economic methods can be used to evaluate cosmetic procedure trends; however, these methods must be founded on the appropriate economic theory.
Attitude to Health↗
Photographic standards for facial plastic surgery.
The purpose of this article is to provide the facial plastic and reconstructive surgeon with guidelines to achieve standardized photographic views for specific facial plastic and reconstructive procedures. It is our hope that through standardization of photography, the surgeon will achieve consistency, demonstrate relevant anatomic detail, allow preoperative planning as well as reproduce accurate preoperative and postoperative comparisons.
Female↗
Quantitative assessment of nasal changes after maxillomandibular surgery using a 3-dimensional digital imaging system.
OBJECTIVE: To evaluate nasal changes after maxillomandibular surgery by means of images taken with a 3-dimensional digital camera. DESIGN: Thirty-two patients (26 female and 6 male) with preoperative and postoperative 3-dimensional photographs were studied. The patients underwent maxillary movement with impaction (upward rotation), maxillary movement with lengthening (downward rotation), or maxillary movement without rotation. With the 3-dimensional imaging software, preoperative and postoperative calculations were performed for interalar width, internostril width, nasal tip projection, and columellar length from the 3-dimensional digital images. The nasolabial angle was also measured. RESULTS: Postoperative interalar and internostril widening was significant (P<.05) for all 3 categories of maxillary movement. However, there was no statistically significant change in nasal tip projection and columellar length. Interestingly, movement of the maxilla with upward rotation did show a statistically significant decrease in the nasolabial angle. CONCLUSIONS: Changes to the nose clearly occur after orthognathic surgery. There was a statistically significant increase in postoperative interalar width and internostril width with maxillary movement. However, no clear correlation could be determined between amount of change and maxillary movement. Interestingly, maxillary advancement did not show any significant change in nasal tip projection or columellar length, with data showing both increases and decreases in measurements. The nasolabial angle in patients who underwent maxillary advancement with impaction (upward rotation) was the only measurement that showed a statistically significant increase.
Adolescent↗
Cleft lip-palate deformities in Western China: epidemiology, surgical reconstruction, and cost.
A series of 46 procedures (42 patients) was performed on youth with cleft lip-palate deformities in Lanzhou, China. Patients' ages ranged from 6 months to 18 years. There were no short-term complications in this series, which included many advanced cases. The estimated cost per patient was 1590 US dollars. Youth with unrepaired cleft lip-palate in western China can be treated in a cost-effective manner.
Adolescent↗