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Glossary of plastic surgery 2

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complication rate abdomenoplasty

smoker

non-smoker
smoker = 50%

non smoker = 25%
% rhytidectomy requiring

drain hematoma
3-5%
most common acquired ptosis
degeneration levator apponeurosis
buccal fat pad hernia (pseudo-hernia)

what fascia
buccopharyngeal fascia
NAC sensability
3rd, 4th, 5th intercostals

90% lateral branch crosses throug the pect. major

lateral branch T4
infiltrate/aspirate/blood loss

superwet

tumescent

wet
superwet 1:1 1-4% ebl

tumescent 2-3:1 1% ebl

wet 25% ebl
malar fat pad

arterial supply
angular artery
botox complication

blepharoptosis Rx?
alpha adrenergic gtts.
traumatic tatoo Rx?
Q switched laser
Retenoids
decrease activation of metalloproteases

by inhibit AP1 transcription
laser wave length with the greatest affinity for water
2940 nm

Erb:Yag
upper lid ptosis Rx

reposition lev appon >3mm
advance mueller muscle <3mm
Fasenella Servat
Levator resection
Frontal resection
good levtr func. = reposition

advan muell musc=<3 mm ptosis
eyebrow suspen.= poor lev func
Fas.Serv = lev >10mm,ptos <2mm
shortens lower components of the lid (tarsus,conjunctiva,mueller's)
lev resect = ptos >3mm,
lev func 4 - 10 mm
frontal suspn = poor lev func.
exception to complication secondary to smoking
no fat necrosis
Propecia inhibits ?
5 alpha reductase
cartilage graft

survival most related to ?
protoglyco matrix
endermologie
Rx cellulite

increases transverse collagen in the deep sq tissue
fat grafting

most common complication
retension

greatest resorption
mst com complx = under correction

retensoion = 40 - 78%

greates resorption = NLF
Jessener's solution
ETOH
Lactic acid
Resorcinal
Hyaluronic acid
Abdomenoplasty

nerves at risk

nerves not at risk
risk = iliohypograstic
ilioinguinal
intercostal

not at risk = genitofemoral
fat retension
50% 6 month

30% 9 month
cause of arm skin ptosis
clavopectoral fascia
most common complication of

tip graft for poor tip projection
visability of graft
dermal peel after rhytidectomy

delay?
3 months
width of nasal alar defect for composite graft
1.5 cm
cosmetic subsets of the nose

#
9
zyderm test
1 month
restylene
hyaluronic acid
decrease depth of phenol peel
liquid soap
primary blood supply to the facial skin after

rhytidectomy
transverse facial artery
delay secondary rhynoplasty
12 months
SMAS plication

not safe.........
distal to lateral border of

zygomatic major muscle
innervation of the upper ear
lesser occipital nerve
absence of auriculocephalic sulcus = ?

timing of surgery
cryptocia

delay surgery
otoplasty

revision rate
8 - 24%
prominent ear

apex protrusion
24mm
thigh lift

suture to .........
cole's fascia
purple/violet tatoo
Q switched Ruby laser
medpor
polyethelene

do not resterilize
cosmetic surgery

cutus laxa
erlers danlos
elastoderma
progeria
werner's syndrome
cutus laxa

(premature loss of elastic fibers)
burn scar hypertrophy if not healed by
3 weeks
kelod and hypertroghic scars are higher in .
ATP (adenosine triphosphatase)

fibroblasts
results of a chemical peel
dec. non lamellar collagen
inc. dermal thicness
inc fibroblast density
inc elatic tissue
alpha hydroxy acids

&

trentinoin
inc papillary collagen
inc blood vessels
inc glucosamine and glycans
exfoliates
thickens epidermis
lasers
co2
Erb:yag
alexendrite
pulse dye - copper vapor
Nd:Yag
co2- 10,600

erbyag - lymphatic - 3910

Nd-Yag - tatoo - 1064

alexendrite hair/blue green
tatoo 810

copper vap - small vessel 585
recurrence rate

excision hypertrophic scar
50 - 100%
Dapsone

most com. adverse effect
hemolysis
prominent NLF

results from loosening of ?
zygomatic ligaments
cosmetic dye pigments contain
iron (black pigment)
laser resurfacing and acutane
delay 2 years
fat retension at

9 months
30%
comlication of retrogenioplasty
anesthesia chin
most common nerve injury in

facelift
greater auricular
hair transplant
false growth 1 month

telogen phase 3 months
% breast = fat
50%
acutane =
isotrentoin
pathe of inspiratory air flow
through middle meatus
most ocmmon sequelae of

TCA peel
pigment change

usually hyper pignment which is transient
most important consideration in chin augmentation
occlusion
nerve injury risk in facelift

subsmas : non subsmas
4:1
TCA neutralized by
dermis
breast augmentation

%revision
%breast not seen on mammogram
%capsule contracture
%deflation
25% rev in 10 years

5% brst tiss. not seen on mam.

20-25% capsule contracture

1%?year deflation
BRAC-1

BRAC-2

risk of Ca
50-85%
implant rupture incidence
inc incidence 8-15 years

weak shell = most com cause
with severe atypia on biopsy

what is the incidence of DCIS in subcutaneous mastectomy
17%
implant rupture frequency
50% 7-10 years
presence of galactorrhea
measure prolactin

r/o pituitary tumor
capsule contracture is related to
fibrinogen
(surface bound protein)
ear amputation

artery
found on posterior surface

branches carotid, temporal, occipital
morpheaform BCC
Moh's
dusky 15 mm cartilage/skin composite graft to ear

RX
hyperbaric O2
transaxillary breast augmentation

risk
malposition
common canaliculus enters lacrimal sac
posterior to medial canthal tendon
face lift

most common facial nerve injures
buccal
saddle nose deformity
speader grafts support the septum
blepharoplasty

most common muscle injury
suprtion oblique
effect of corticocsteroids on post op edema and ecchymosis
none
jones test
I = dye flourescein reaches the beneath the inf turbisnate

II = dye in lacrimal sac
negative jones I, positive jnoes II
dacrocystorhynostomy
factor decreasing longevity of saline filled implants
underfilling
adverse effect of infracture of nasal bones
narrowing internal nasal valve
advantage of "extended" latissimus dorsi flap for breast reconstruction
added volume
mammograms >6 months post reduction mammoplast
calcifications
internal nasal valve
septum
nasal floor
caudal edge of upper lateral
cartilage
scleral show and lower lid blepharoplasty
lateral cnthopexy
breast reconstruction and post op radiotherapy
dealayed reconstruction with autologous tissue
planned botox injection of which muscle results in inadvertant ptosis
corregator (the target)

they want you to realize the risk of corregtor injection
ectropion post blepharoplasty

scar between
tarsal plate

and

capsulopapebral fascia
secondary rhytidectomy

risk vs. primary
destort hair line
evaluation of gynecomastia patient
examine genetalia
protect sensation to NAC
blunt dissection lateral to pectorlis muscle border
osseous genioplaste
corrects anterior-posterior

&

vertical deficiency
nasal tip projection
suture medial crura

tip grafting
NAC

nerves
3,4,5 interscostal nerves
(antereolateral branches)
lidocaine dose in tumescent liposection
as high as 55mg/kg
suction lipectomy ok in all except

axillary hyperhidrosis
hiv-assoc lipodystropohy
lymphedema
madelung's disease
liposarcoma
liposarcoma
inner ear abnormalities in

microtia
none

have middle ear abnormalities proportiate to the severity of the microtia
breast ca with post op radiation
delayed autologous tissue reconstruction
liposuction fluid management
infiltrate and iv fluids should = 2 x aspirate
most sensative area of breast
superior quadrants

(NOT nac)
15 y.o. with large breast mass
fibroadenoma
layer of scalp analagous to smas
galea
stahl's ear
3rd crus
ear reconstruction
remember prosthesis in absence of skin and temp fascia
implant breast reconstruction with necrotic skin
implant not exposed = resect skin and close

implant exposed = removal
numbness nasal tip
ext. branch anterion ethmoid
explanation for lack of tumnescent lidocaine toxicity
rate of absorption
complication abdomenoplasty and suction lipec.
avoid central area
rx facial nerve palsy 1 mo. post op facelift
observation
rx ectropion 6 months post blepharoplaty
lateral tarsal strip + skin graft
ear lobe

nerve
great auricular
levator palpebrae tendon
lies immediately superficial to Mueller's muscle
poland syndrome
requires absence of pectoralis muscles
asian vs occidental upper eyelid
preaponeurotic fat more caudal

levator muscle inserts closer to caudal border of tarsal plate
saline implant rupture

more likely with
under filling
(fold flaws)
transconjunctival blepharoplasty

structures incised
conjunctiva

capsulopapebral fascia
3 cm of skin slough post sub-smas rhytidectomy

Rx
observe
local wound care
sal

max dose of lidocaine
35 mg/kg
belt lipectomy

most com. smplx
seroma
stenstrom otobrasion

which surface
anterior anthelical fold
dorsal hump rasping with swelling and erythema 10 days post op
oral antbiotic
epiblepharon
a fold of skin that crosses the free margin of either the upper or lower eyelid so that the eyelashes are pressed against the globe
epiblepharon

Rx
resect redundant skin and orbicularis muscle

more common in asians
nasal septal fracture

physical finding
tear of mucosa
poland syndrome

assoc. anomalies
ipsilateral syndactyly or extremity hypoplasia

rib abnormalities
breast augmentaiton

reoperation rate in 10 yrs
25%
deep transverse glabellar lines

muscle
procerus
medial thigh lift

superficial dessection to avoid
lymphatic plexus
facial muscles innervated on superficial surface
buccal
mentalis
levator anguli oris
otoplasty
furnas
conchomastoid suture
otoplasty
mustarde
antihelical fold suture
otoplasty
stenstrom
carticlage scoring
(on surface opposite to direction of desired bending)
otoplasty
webster
suture tail helix to conchal bowl
otoplasty
lucket
skin resection

(also cartilage incision)
rhynoplasty

resection cephalad lower lat cartilage and resection caudal septum =
rotation tip (shortening nose)
neonatal molding of prominent ears

hormone responsible
estrogen

approx 6 weeks (longer in breast feeding babies)
raising eyebrow with botox

which muscle to target
orbicuolaris oculi
most important factor determining need for mastopexy after implant removal
preoperative ptosis
amputated ear cartilage banking

disadvantage
warping
percent of inferior pedicle breast reduction that are able to breast feed
approximately 60%

(brazillian study)
free margin ear resection 12 mm

best flap
antia buch
dusky composite graft to ear at two days

Rx
hyperbaric O2
advantage of endoscopic transaxillary augmentation vs. standard transaxillary
better implant position
(visualize medial pect, major and divide it)
lancinating pain in eye post blepharoplasty
retrobulbar hematoma

rexploration + steriod + acetazolamide
most commonly injured facial nerve in rhytidectomy
buccal
conjunctivorhynostomy
in patient with obliterated lacrimal sac
smoker risk with abdomenoplasty
50%
nasal infracture narrows what structure
internal nasal valve
advantage of "extended" lat. dorsi flap over standard lat dorsi flap
decrease need for implant
scleral show before bleparoplasy add what
lateral tarsorraphy
best landmark for positioning of nac in red. mamm markings
inframammary crease
methods for nasal tip projection
tip graft

suture medial crura
microtia

inner ear abnormalities?
none
location of hair follicles
subcutaneous
pierre robin mand deformity is ?
retrognathia
(not micrognatia bec in pierre robin the manible grows normally)
most likely effect of intralesional steriod for rx of keloid
relief of itching and burning
blepharophimosis syndrome
a form of congenital ptosis
epicanthal folds, horizontal shortening, severe ptosis
Blepharophimosis

Rx
correct epicanthal folds
correct ptosis
skin laxity arms post wgt loss= laxity of
clavopectoral fascia
blue-green tatoo

Rx
multiple treatments with

Q switched Nd:YAG
or alexendrite
red, brown, orange tatoo

Rx
Nd:YAG
violet-purplw tatoo
Rx
Q swithed ruby laser
upper cranial surface of the ear
nerve
lesser occipital
anterio surface upper ear
nerve
auriculotemoporal
dorasl nasal flap

size ?
position
2 cm
nasal tip
ptosis upper lid with > 10mm levator function

rx
levator advancement
"juvenile melanoma"

Rx
excision with clear margins only
excessive lower lateral cartilage resection with resultant airway obstruction

Rx
they want cartilage graft to increase tip projection
(prob won't work)
immediate post op ptosis
cause
Rx
swelling and hemorrhage into mueller muscle
Rx = observation
midline ant to occiput alopecia

Rx
saggital scalp reduction
nevoid basal syndrome (Gorlin's)
bcc + odontgenic cysts
(also palmar pits rib and spine abnormalities, intracranial calcifications)
Rs of suspected silicone implant rupture
surgery
symptomatic patient
incidence of breast implant rupture
31%
(goes up t0 80% with + ultrasound and 97% with + mri)
burn ear reconstruction
with skin scarring
cart framework with temp parietal flap and skin graft
retinoic acid (trentinoin) increases ?
typr III (embryonic) collagen
recurrent prom. ears
cause =
failure of Mustarde sutures(sutures to create the antehelical fold)
upper lid fat pads

location
superficial to levator palpabrae
posterior to orb. septum
actinic keratosis
5 f.u. cream (5% fluorocil)
effudex
highest position of brow in brow lift
they want from lateral limbus to lateral brow
(not on my patients)
nasal alar defect
nasolabial flap up to 1.75cm
nasal tip defect <1.2cm
banner flap
nasal dorsum defect >1.2 cm
bilobe flap
management of patient with massive wgt loss who will undergo additional20 lbs of wgt loss
they want surgery because "additional wgt loss will only make it worse"

duh - my answer is wait till the wgt loss is stable
another e.g. "can't argue with a piece of paper"
lateral traction on cheek relieving airway obstruction =
int nasal valve problem
vetrical nasal forehead lines

muscle
corregator
foreign body pigment

Rx
Q-switched ruby laser

2 - 3 treatments
epiphora

def.
excess tearing
medial thigh lift

suture to which layer
colle's fascia

(inelastic layer of the superficial perineal fascia)
microtia
usually requires excision of vestigial ear cartilage

True or False
True
breast implant most assoc. with visable wrinkling
textured saline
most common complication post otoplasty
recurrrence
numbness in medial arm post mastectomy

nerve?
intercostobrachial
prominent ear measurements
protrusion
scaphoconchal angle
cephaloauricular
protrusion = 24mm
scaphoconchal angle >90deg
cephaloauricular angle >25 deg
absent nac =
athelia
rapid growing umbilicated lesion =
keratoacanthoma

(key = rapid growth)
ear anesthetic include peripheral nerve block and
nerve of Arnold

(vagus in posterior wall of ext aud canal)
great auricular nerve

branch of
cervical plexus
most common complication of alloplastic malar implant
malposition
nerve at risk during resection of corregator muscle
supratrochlear
most important variable in the peak level of lidocaine in tumescent infiltration
absorption rate

related to epinephrine, tissure infused (vascularity), and rate of infiltration
long term effect of chemical peel in dermis
decrease of nonlamellar collagen
camera focal length for accuarate body images
55mm

face = 90 105mm
nonreplantible traumatic ear amputation

flap cover
post auricular
ectopic polymastia

most common site
chest

also, axilla, groin, vulva, medial thigh
otoplasty recreation of antelelical fold
permanent mattress sutures on posterior surface
(Mustarde)
male pattern baldness is triggered by
sex linked dominant gene

results in increase on 5alpha-reductase
TCA peel neutralized where
dermis
malar implants are placed on which muscle
masseter
male patient requesting aesthetic rhynoplasty
simon
single immature male overexpectant narcissistic

careful, do not operate
when exposing the zygomatic arch through a coronal incision, what layer should be incised
where
superficial layer of deep temporal fascia

level of lateral orbital rim
ratio of facial n. injury in subsmas facelift compared to subcutaneous facelift
4:1
nasal tip
nerve
external branch of
anterior ethmoid
trentinoin Rx

maximize effect with addition of
alpha hydroxy acids
"miniabdomenoplasty

indications
fullness and strtech marks limited to the infraumbilical area

test answer
subsmas dissection not safe
medial to the lateral border of zygomaticus major
facelift
men have more post op hematomas than woemen

true or false
true
bilateral florid adenosis with epithelial hyperplasia

indication for mastectomy
none

no additional risk for breast cancer
1% xylocaine = ? mg/ml
10mg/ml
10 g/l
most effective monitor of adequate fluid resuscitation
urine output
isograft

def.
a graft taken from the same individual or from a genetically identical genotype (identical twin)
bilobe flap is characterized as
transposition (interpolated) flap
most common cause of late silicone implant failure
weakening of silicone shell
kassabach-merritt syndrome
platelet consumptive coagulopathy with hemangiomas
what holds skin grafts in place within the first few days
fibrin bonding
rattle snake bite

venom suction value?
yes if done within 15 minutes

incisions no deeper than the skin
brachioplasty

fascia to anchor
axillary
breast shrinkage occurs with implants

T/F
true
larger implant more shrinkage
inferior oblique muscle function
extorsion,elevation, abuction
angle of divergence
between medial (middle) crura of lower lateral cartilage
wreatler's ear

Rx
evacuation of hematoma

tie through bolster dressing
vertical reduction mammoplasty advantage over inverted T
shorter scar
witch's chin deformity post genioplasty (increased lower tooth show)

cause
inadequate repair of mentalis muscle
wedge resection of lower lid for ectropion

contraindication
prominent globe

would "clothesline" the lid below the limbus
artery at risk in lateral osteotomy nose
angular
suspensory system for the globe
Lockwood's ligament
Poland syndrome

muscle most often missing
sternal head of pectoralis major
burn contracture inhibiting breast expansion

Rx
Integra (dermal regeneration template) said to allow secondary expansion
"washboard" irregularity post liposuction

most likely cause
superficial liposuction through a single port
incidence of occult breast cancer in reduction mammoplasty
0.2%
"side wall" nasal wrinkles caused by which muscle
nasalis
chondrodermatitis helicus

Rx
excision and primary closure
most common cause of death post liposuction
pulmonary embolus (fat or thrombus)
ratio of lobular portion of caucasion nose to columalla
1:2

(don't know what this means)
Rx of stahl's ear
resection of third crus and helical advancement
post mastectomy radiation

reconstruction technique
autologous tissue
orbital ligament

def;
clinical relavence
band of connective tissue fixing the superfial fascia to the bone of lateral orbital rim
must release during browlift
osteointegrated implants in burn ear reconstruction
high rate of complication

choose local flap reconstruction
vertical reduction mammoplasty

limitations
pedicle length (? 9 cm)

better with small (800gm) reductions
massive weight loss incision thigh
medial longitudinal
peak position of brow for brow lift
"between limbus and lateral canthus"

MOT ON MY PATIENTS
early infected ear cartilage reconstruction with fluctuance

Rx
i&d, irrigate, and place irrigation catheters

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