Midface is one of the most important structures which impresses, combining with eyes and nose. Youthful midface shows the blending of lower eyelid and the anterior cheek, therefore the goals of midface rejuvenation is harmony between the lower eyelid and anterior cheek. The purpose of this article is to provide an overview of current concept of midface rejuvenation including preoperative patient assessment, surgical methods, postoperative management and complications. A critical understanding of patient expectation, anatomy and operative technique is important to achieve satisfactory results and to avoid complications.
Adipose Tissue ; Adolescent ; Blepharoplasty ; Cheek ; Eye ; Eyelids ; Humans ; Nose ; Rejuvenation ; Rhytidoplasty

No abstract available.
Anniversaries and Special Events*

Plastic surgeons have been in pursuit of natural appearance in rhinoplasty, which means harmonious relationship between nasal tip and dorsum. If silicone implant is used alone for the augmentation of the nasal tip, there is a possibility of the thinning of the nasal tip skin and exposure of implant. For these reasons, plastic surgeons have used a cartilage fixation over the silicone implant for nasal tip augmentation. However, fixation by sutures is technically challenging, so authors tried to use Histoacryl glue instead of sutures. Twelve New Zealand white rabbits were used in this study. Four 5mm diameter and 1mm thick cartilages were harvested from ear. Two cartilages were fixed to the silicone blocks by chromic catgut and the others were attached by Histoacryl glue. Four cartilage-silicone complexes were implanted into the subcutaneous pocket of the rabbit's head. In the 1st, 3rd and 5th week, the cartilage- silicone complexes were harvested and the shearing forces between cartilages and silicones were measured by texture analysis. The shearing forces were not changed in the Histoacryl group with the lapse of time but decreased in the suture group. However, the difference between the 2 groups were not statistically significant. The histologic findings of both groups showed progressive fibrosis. This study showed the possibility of using Histoacryl glue as a simple method of fixing cartilage to the silicone.
Adhesives* ; Cartilage* ; Catgut ; Ear ; Enbucrilate* ; Fibrosis ; Head ; Rabbits ; Rhinoplasty ; Silicones* ; Skin ; Sutures

The fracture of zygomatic arch is one of the common fracture of the facial bone and commonly reduced by Gillies or Dingman method However, if the reduced bone segments are unstable after reduction, they tend to be displaced by mastication or unintentional external forces. Though many techniques have been introduced for the treatment of the unstable zygomatic arch fracture, all of those techniques have their own shortcomings. We devised a new fixation method to prevent the displacement of the reduced zygomatic arch segments with 0.047 inch K-wire under the fluoroscope. After reduction of zygomatic arch using Gillies method under the fluoroscope, a thin K-ire was inserted along the undersurface of the zygomatic arch through zygoma body for rigid fixation. The inserted K-wire was removed in 4 weeks. In ten cases, good cosmetic and functional results were observed without complications such as infection, facial nerve injury, displacement of fractured segments, and operative scar during the follow up period of 3 months. However, while the pin was being inserted, patients complained discomfort on their cheeks. This technique may be an available method to prevent the displacement of the reduced zygomatic arch and to obtain the rigid fixation.
Cheek ; Cicatrix ; Facial Bones ; Facial Nerve Injuries ; Follow-Up Studies ; Humans ; Mastication ; Zygoma*

Many kinds of alloplastic implants have been used for surgical reconstruction of orbital wall fractures. Although complication rates caused by them are known to be higher than that by autologous grafts such as calvarian bone graft, there are few reports about collective cases for individual alloplastic implants. A retrospective review was performed on 115 patients who underwent orbital blow-out fractures reconstruction with silicone sheet(Silastic(R)) implants between 1989 and 1998. After the follow-up period from 1 month to 5 years, six patients(4.3%) had to undergo reoperations for implant removal because of complications such as infection, hematoma, displacement and extrusion of implant. Symptoms of Silicone sheet complications were progressive periorbital swelling, tenderness, proptosis, hypesthesia and persistant diplopia. Complications were diagnosed by history of Silicone sheet insertion, physical examination and follow-up facial bone or orbit CT. Mean duration of onset was 23.3 months. In all cases of complication, implants were surgically removed and proper antibiotics were used postoperatively. The symptoms subsided immediately without any other sequelae. The reconstruction of blow-out fractures with silicone rubber implant may cause serious late complications such as infection, displacement, hematoma, migration and extrusion. Therefore, careful follow up is nesessary, and prompt sheet removal should be considered first, if such complications are confirmed.
Anti-Bacterial Agents ; Diplopia ; Exophthalmos ; Facial Bones ; Follow-Up Studies ; Hematoma ; Humans ; Hypesthesia ; Orbit ; Orbital Fractures* ; Physical Examination ; Retrospective Studies ; Silicone Elastomers ; Transplants