A

Acne, from lasers, 586, 588

Adverse events, from dermal fillers, 667

from neurotoxins, 664–665

prevention of, 666

Aesthetic expectations, difficult patient and, 579–580

preoperative discussion of, in facelift surgery, 552, 558

Aesthetic violations, from injectable fillers, 590–591

Aging, facial, preoperative assessment of, in facelift surgery, 552

Airway complications, from rhinoplasty, nasal obstruction as, 642, 649–650

Airway management, for facial cosmetic surgery, with conscious sedation, 566

with general anesthesia, for emergence, 569

for induction, 566–568

immediate recovery period, 569–570

Alar asymmetry, from rhinoplasty, of bony vault, 641, 647–648

of middle vault, 641, 647–648

Alar base scarring, from rhinoplasty, 642, 649

Alar cartilage, bossae of, from rhinoplasty, 641, 646–647

Alar retraction, from facial flap surgery, 600–601

from rhinoplasty, 641, 648–649

Alar rim grafts, in rhinoplasty, 641, 648–649

Alar-columellar disproportion, from rhinoplasty, 641–642, 648–649

Alcohol use, complications related to, in facial flap surgery, 600

Alfentanil, in facial cosmetic surgery, 565, 568

Allergic reactions, to dermal fillers, 667–670

prevention and treatment of, 669–670

to neurotoxins, 594–595

Alopecia, from facelift surgery, 557

from forehead lift, 623

Anesthesia, for facial cosmetic surgery, 560–571

blepharoplasty and, 571

burn injuries prevention and, 566–567

conscious sedation in, 564–567

intravenous opioids for, 564–566

successful, 566

dermal fillers and, 667

forehead lift and, 622

general anesthesia in, 566–570

airway management for, 566–568

emergence from, 569

hypotension control and, 568–569

immediate recovery period and, 569–570

induction and maintenance of, 568

pain control postoperative and, 568, 570

PONV and, 568–569

incidence of problems, 563–564

objectives of, 560–561

overview of, 560

patient positioning for, 563

patient safety for, essential requirements of, 560

patient selection and preparation in, 561–563

premedication and monitoring of, 563

procedure-related considerations of, 570–571

rhytidectomy and, 571

septorhinoplasty and, 570–571

strategies and methods of, 563–570

thromboembolism prophylaxis for, 563

for hair restoration, 679

Angle fractures, of mandible, 614–615

Antibody formation, to neurotoxins, 666

Anticoagulants, complications related to, in facial flap surgery, 600, 602–603

in facial trauma, 616

Antihelical malposition/puckering, from otoplasty, 660–661

Antihelical ridges, secondary to cartilage-scoring technique, in otoplasty, 659, 661

Asymmetry, of ala, from rhinoplasty, bony vault, 641, 647–648

middle vault, 641, 647–648

of brow, from forehead lift, 623

of face, in facelift surgery, 552, 557

of nasal tip, from rhinoplasty, 639–640, 643

of nostrils, from rhinoplasty, 641, 647–648

Atrophy, with mandibular fractures, 614–615

Auditory canal meatus, narrowing of external, from otoplasty, 660–662

Auricular composite grafts, in rhinoplasty, 641, 648–649

Auricular nerve injury, in facelift surgery, 554

Auricular proportions, normal, 653–654

Auricular ridges, secondary to cartilage-scoring technique, in otoplasty, 659, 661

Autospreader technique, in rhinoplasty, 645–646

B

Bleeding. See Hemorrhage.

Blepharoplasty, complications in, 625–637

anesthesia safety and, 571

assessment errors and, 625, 627–631

asymmetric eyelid crease as, 626, 629

brow ptosis as, 626, 630–631

canthal webbing as, 626, 630

eyelid ptosis as, 626–628

eyelid retraction/ectropion as, 626, 629–630

lagophthalmos as, 626, 630–632

residual skin excess as, 625–627

superior sulcus contour deformity/hollowing as, 626–629

introduction to, 625–627

summary overview of, 636

surgical, 631–636

corneal abrasion as, 627, 635

diplopia as, 626, 634

dissatisfied patient as, 627, 636

fire/burned skin/lashes as, 627, 635

hemorrhage as, 626, 631–632

horizontal eyelid phimosis as, 627, 635

inadvertent globe perforation as, 626, 631

lacrimal gland injury as, 626, 634–635

preseptal hematoma as, 626, 632

preseptal/orbital cellulitis as, 626, 633–634

retrobulbar hematoma as, 626, 632–633

suture granuloma as, 627, 636

wound dehiscence as, 627, 636

Blindness. See Vision disturbances/loss.

Blistering, from lasers, 586–587

Blood pressure, in facial cosmetic surgery, control of, 568–570

facial flaps and, 602–603

preoperative screening of, 561–562

Blood supply, of forehead, 620

complications with lift procedures, 622

Body dysmorphic disorder, rejecting patient with, 582

Body fractures, of mandible, 614–615

Bone injuries, in facial trauma, 606

fractures as, 607–608. See also Fractures.

with mandibular fractures, 614–615

BoNTA (botulinum toxin type A), 663. See also Neurotoxins.

Bony pyramid complications, from rhinoplasty, 640, 643–644

open roof deformity as, 640, 643–644

overresection of nasal bones as, 640, 643

rocker deformity as, 640, 643–644

stair step deformity as, 640, 644

Bony vault, of ala, asymmetry of, from rhinoplasty, 641, 647–648

Bossae, of tip and ala, from rhinoplasty, 641, 646–647

Botulinum-derived toxins. See also Neurotoxins.

in facial cosmetic surgery, 594–595, 663

pharmacology of, 663

Brain injuries, with facial trauma, intracranial complications of, 605–606, 609–610

types of, 609

Brow anatomy, in forehead lift, innervation, 620

muscles, 619–620

soft tissue, 619

vasculature, 620

Brow asymmetry, from forehead lift, 623

Brow lift, in forehead lift, complications in, 622–623

prevention of, 620–621

coronal, 621–622

direct, 621

endoscopic, 622

midforehead, 621

Brow position, ideal, 620–621

Brow ptosis, from blepharoplasty, 626, 630–631

from neurotoxins, 594–596

in forehead lift, 621

Bruising, from dermal fillers, 589–590, 667

from lasers, 586–587

from neurotoxins, 594–595, 664–665

prevention of, 666

Burns, in facial cosmetic surgery, from lasers, 586–587

prevention of, 566–567

of skin and lashes, from blepharoplasty, 627, 635

B

Bleeding. See Hemorrhage.

Blepharoplasty, complications in, 625–637

anesthesia safety and, 571

assessment errors and, 625, 627–631

asymmetric eyelid crease as, 626, 629

brow ptosis as, 626, 630–631

canthal webbing as, 626, 630

eyelid ptosis as, 626–628

eyelid retraction/ectropion as, 626, 629–630

lagophthalmos as, 626, 630–632

residual skin excess as, 625–627

superior sulcus contour deformity/hollowing as, 626–629

introduction to, 625–627

summary overview of, 636

surgical, 631–636

corneal abrasion as, 627, 635

diplopia as, 626, 634

dissatisfied patient as, 627, 636

fire/burned skin/lashes as, 627, 635

hemorrhage as, 626, 631–632

horizontal eyelid phimosis as, 627, 635

inadvertent globe perforation as, 626, 631

lacrimal gland injury as, 626, 634–635

preseptal hematoma as, 626, 632

preseptal/orbital cellulitis as, 626, 633–634

retrobulbar hematoma as, 626, 632–633

suture granuloma as, 627, 636

wound dehiscence as, 627, 636

Blindness. See Vision disturbances/loss.

Blistering, from lasers, 586–587

Blood pressure, in facial cosmetic surgery, control of, 568–570

facial flaps and, 602–603

preoperative screening of, 561–562

Blood supply, of forehead, 620

complications with lift procedures, 622

Body dysmorphic disorder, rejecting patient with, 582

Body fractures, of mandible, 614–615

Bone injuries, in facial trauma, 606

fractures as, 607–608. See also Fractures.

with mandibular fractures, 614–615

BoNTA (botulinum toxin type A), 663. See also Neurotoxins.

Bony pyramid complications, from rhinoplasty, 640, 643–644

open roof deformity as, 640, 643–644

overresection of nasal bones as, 640, 643

rocker deformity as, 640, 643–644

stair step deformity as, 640, 644

Bony vault, of ala, asymmetry of, from rhinoplasty, 641, 647–648

Bossae, of tip and ala, from rhinoplasty, 641, 646–647

Botulinum-derived toxins. See also Neurotoxins.

in facial cosmetic surgery, 594–595, 663

pharmacology of, 663

Brain injuries, with facial trauma, intracranial complications of, 605–606, 609–610

types of, 609

Brow anatomy, in forehead lift, innervation, 620

muscles, 619–620

soft tissue, 619

vasculature, 620

Brow asymmetry, from forehead lift, 623

Brow lift, in forehead lift, complications in, 622–623

prevention of, 620–621

coronal, 621–622

direct, 621

endoscopic, 622

midforehead, 621

Brow position, ideal, 620–621

Brow ptosis, from blepharoplasty, 626, 630–631

from neurotoxins, 594–596

in forehead lift, 621

Bruising, from dermal fillers, 589–590, 667

from lasers, 586–587

from neurotoxins, 594–595, 664–665

prevention of, 666

Burns, in facial cosmetic surgery, from lasers, 586–587

prevention of, 566–567

of skin and lashes, from blepharoplasty, 627, 635

C

Calcium hydroxylapatite fillers. See also Dermal fillers.

sequelae and complications of, 589–594

special characteristics of, 590, 667

Canthal webbing, from blepharoplasty, 626, 630

Cardiovascular disease, preoperative screening for, in facial cosmetic surgery, 561–562

Cardiovascular incidents, in facial cosmetic surgery, 563

Cartilage, alar, bossae of, from rhinoplasty, 641, 646–647

in auricular surgery, cutting vs. sparring techniques for, 653–654

necrosis of, 656

Cartilage grafts, in rhinoplasty, costal cartilage, 642, 650

for tip and ala, 614, 646–647

visible, 647

Cartilage-scoring technique, in otoplasty, antihelical ridges secondary to, 659, 661

Cellulitis, preseptal/orbital, from blepharoplasty, 626, 633–634

Cerebrospinal fluid (CSF) leaks, with facial trauma, 605–606, 609

Cervical spine injuries, with facial trauma, 605–606, 609–611

Chemotherapeutic agents, complications related to, in facelift surgery, 552

Chronic pain, difficulty in evaluating patient, 583

Close friends, difficulty in evaluating patient, 583

Cobblestoning, of recipient site, in hair restoration, 676

Columella complications, from rhinoplasty, retraction as, 642, 648–649

scar formation as, 642, 649

Comorbidities, multiple medical, rejecting patient with, 582

Complication prevention/management, from lasers, fillers, and neurotoxins, 585–598 . See also Lasers.

from toxins and fillers, 663–673 . See also Dermal fillers; Neurotoxins.

in blepharoplasty, 625–637 . See also Blepharoplasty.

in facelift surgery, 551–558 . See also Facelift surgery.

in facial cosmetic surgery. See also Facial cosmetic surgery.

patient selection and, 579–584 . See also Patient selection.

peri-operative and anesthesia-related, 559–577

in facial flap surgery, 599–604 . See also Facial flap surgery.

in facial trauma, 605–617 . See also Facial trauma.

in hair restoration, 675–680 . See also Hair restoration.

of forehead lift, 619–624 . See also Forehead lift.

of otoplasty, 653–662 . See also Otoplasty.

of rhinoplasty, 639–651 . See also Rhinoplasty.

Compression of grafts, at recipient site, in hair restoration, 676–677

Compressive dressings, in facelift surgery, 555

in facial flap surgery, 603

in otoplasty, 655

Computed tomography (CT) scan, for facial trauma, 616

lower face, 614–615

upper face, 608

Computer imaging, in patient selection, 580

Concha-mastoid suture, in otoplasty, 660–662

Condyle fractures, of mandible, 614–615

Conscious sedation, in facial cosmetic surgery, 564–567

intravenous opioids for, 564–566. See also specific medication.

successful, 566

Contour deformities, from facelift surgery, 557

of nasal tip, from rhinoplasty, 641, 647

of superior sulcus, from blepharoplasty, 626–629

Corneal abrasion, from blepharoplasty, 627, 635

Coronal lift, in forehead lift, 621–622

Correction loss (recurrence), in otoplasty, 657–658

Corrugator supercilii muscles, in forehead lift, 619–620

coronal approach and, 621

endoscopic approach and, 622

neurotoxins and, 666

Costal cartilage grafts, complications of, in rhinoplasty, 642, 647, 650

Cupid’s bow flattening, from neurotoxins, 595–596

D

Deformity patient, minor, difficulty in evaluating, 582

Delayed union, of mandibular fractures, 614–615

Dentition injuries, in facial trauma, 606

with mandibular fractures, 614–615

Depressed patient, difficulty in evaluating, 582

Dermal fillers, in facial cosmetic surgery, 585–598

background on, 666–667

common adverse events from, 667

common available products as, 589–590

complications from, 589–594, 663–673

aesthetic violations as, 590–591

blindness as, 590, 592, 594

bruising as, 589–590

common adverse events vs., 667

cosmetic, 670

edema as, 589–591

erythema as, 589–590

granuloma as, 590–592

hypersensitivity reactions to, 667–670

prevention and treatment of, 669–670

infection as, 590–591

laser technologies sequelae vs., 585–589

lumpiness as, 590–593

necrosis as, 590, 592–594, 667–669

recognition and treatment of, 668

neurotoxin sequelae vs., 594–596, 663–666

Tyndall effect as, 590–593, 670

contraindications to, 667

for small depressions/divots, 584

introduction to, 585

summary overview of, 589–590, 596, 670

Dexmedetomidine, in facial cosmetic surgery, 565–566

Diabetes mellitus, preoperative assessment of, in facial cosmetic surgery, 562

Difficult patients, challenges in evaluating, 582–583

recognizing, for complication avoidance, 579–584

Diplopia, from blepharoplasty, 626, 634

Direct brow lift, in forehead lift, 621

Disliked patients, rejecting, 581

Dissatisfied patient, how to manage, 580, 583–584

with blepharoplasty, 627, 636

with otoplasty, 658, 660

Doctor shoppers, difficulty in evaluating, 582–583

Doctor-patient relationship, patient selection and, 579–580

“Done look,” of rhytidectomy, 558

Donor site, in hair restoration, procedural approach to, 679

surgical assistant duties for, 680

surgical complications of, necrosis as, 675–676

pain as, 675–676

scarring as, 675–676

Dorsal reduction, cartilaginous, in rhinoplasty, dorsal narrowing from, 645–646

Dressings, Glasscock, in otoplasty, 655

postoperative. See Compressive dressings.

Dry eyes, from neurotoxins, 665

Dyschromia, from lasers, 586, 588–589

Dysphagia, from neurotoxins, 595–596

Dysphonia, from neurotoxins, 595–596

E

Ears, normal aesthetics of, 653–654

otoplasty complications of, 653–662 . See also Otoplasty.

Ecchymosis. See Bruising.

Ectropion, from blepharoplasty, 626, 629–630

from facial flap surgery, 601

from facial trauma, 611, 613

from neurotoxins, 666

Edema, from dermal fillers, 589–591, 667

treatment of, 668

from facial flap surgery, 602

from lasers, 586–587

from neurotoxins, 594–595, 664

Elderly patients, anesthesia considerations for, in facial cosmetic surgery, 562

Endoscopic brow lift, in forehead lift, 622

Endotracheal tube (ETT), 566, 569

Enophthalmos, from facial trauma, 612–613

Entrapment, periorbital, from facial trauma, 611–613

Entropion, from facial trauma, 611, 613

Epidermolysis, from facial flap surgery, 602

Erb’s point, in facelift incisions, 554–555

Erythema, from dermal fillers, 589–590, 667

from facial flap surgery, 603

from lasers, 586–587

from neurotoxins, 594–595, 664

from otoplasty, 655–656

Esmolol, in facial cosmetic surgery, 568

External auditory canal meatus, narrowing of, from otoplasty, 660–662

Eye evaluation, in forehead lift, 621

Eye injuries. See also Vision disturbances/loss.

in facial trauma, 606, 608, 610–611

Eyelash burns, from blepharoplasty, 627, 635

Eyelid crease, asymmetric, from blepharoplasty, 626, 629

Eyelid ptosis, from blepharoplasty, 626–628

from neurotoxins, 595–596, 665

Eyelids, eversion of. See Ectropion.

in forehead lift, 621

injuries of, from facial trauma, 608, 611, 613

phimosis of, horizontal, from blepharoplasty, 627, 635

retraction of, from blepharoplasty, 626, 629–630

Eyes, dry, from neurotoxins, 665

F

Facelift surgery, complication avoidance and management in, 551–558

“done look” and, 558

intraoperative, 553–555

auricular nerve injury as, 554

facial nerve branch injury as, 554

immediate postoperative procedures for, 555

incision and flap dissection for, 553–555

jowl liposuction for, 555

parotid duct injury as, 553

positioning and preparation for, 553

skin excision and wound closure for, 555

SMAS plication for, 555

spinal accessory nerve injury as, 554–555

introduction to, 551–553

postoperative, 555–557

alopecia as, 557

contour deformities as, 557

hematoma as, 555

infection as, 556

nerve injury as, 556

scarring as, 556

skin slough as, 556

systemic complications as, 556

preoperative avoidance of, 551–552

summary overview of, 557–558

Facial aging, preoperative assessment of, in facelift surgery, 552

Facial asymmetry, in facelift surgery, as postoperative complication, 557

preoperative assessment of, 552

Facial cosmetic surgery, complication prevention in, 559–577

anesthetic management for, 560–571

blepharoplasty and, 571

burn injuries prevention in, 566–567

conscious sedation in, 564–567

intravenous opioids for, 564–566. See also specific medication.

successful, 566

general anesthesia in, 566–570

airway management for, 566–568

emergence from, 569

hypotension control and, 568–569

immediate recovery period and, 569–570

induction and maintenance of, 568

pain control postoperative and, 568, 570

PONV and, 568–569

incidence of problems, 563–564

objectives of, 560–561

overview of, 560

patient positioning in, 563

patient selection and preparation in, 561–563

premedication and monitoring in, 563

procedure-related considerations in, 570–571

rhytidectomy and, 571

septorhinoplasty and, 570–571

strategies and methods of, 563–570

thromboembolism prophylaxis in, 563

general considerations of, 559–560

perioperative risk reduction guidelines as, 560, 570

solutions to identified problems as, 560

structural recommendations as, 560

surgical safety checklists as, 560–561

patient selection and, 579–584

anesthesia considerations in, 561–562

computer imaging and, 580

difficult evaluations, 582–583

easy rejections, 581–582

fee policy discussions, 580–581

introduction to, 579–580

revision surgery policy discussions, 580–581

summary overview of, 584

techniques for learning more about patients, 580–581

unhappiness handling, 580, 583–584

perioperative management for, 560–563

patient preparation in, 562–563

patient selection in, 561–562

risk reduction essentials, 560, 570

procedure-related. See specific procedure or technique.

summary overview of, 571

Facial fillers. See Dermal fillers.

Facial flap surgery, complications in, 599–604

hematologic, 602–603

infectious, 603

introduction to, 599

ischemic, 601–602

patient evaluation for, 599–600

summary overview of, 603

tension-related, 600–601

Facial nerve, in forehead lift, 620, 622–623

preoperative assessment of, in facelift surgery, 552

Facial nerve injuries, in facelift surgery, 554

in facial trauma, 608, 612

Facial trauma, complications in, 605–617 . See also specific anatomy or injury.

introduction to, 605

lower third of face, 608, 614–615

management of, 614–616

intraoperative, 614

perioperative, 614

postoperative, 614–616

preoperative, 614

middle third of face, 607–608, 611–614

most common, 605–608

of soft tissue, 605–606, 608

of viscera, 605–606, 608–610, 612

pharmacologic, 616

summary overview of, 616

upper third of face, 607–608

Family members, difficulty in evaluating patient, 583

Fee policy, discussions of, in patient selection, 580–581

Fillers. See Dermal fillers.

Fires, on-patient, prevention in operating room, 566–567

skin and lash burns from, in blepharoplasty, 627, 635

Flap dissection, in facelift surgery, 553–555

Flap surgery. See Facial flap surgery.

Flexible laryngeal mask airway (FLMA), 567, 569

Forehead anatomy, 619–620

Forehead lift, complications of, 619–624

alopecia as, 623

anatomy in, 619–620

brow innervation, 620

brow muscles, 619–620

brow soft tissue, 619

brow vasculature, 620

bleeding as, 622

brow asymmetry as, 623

brow lift complications in, 622–623

introduction to, 619

nerve injury as, 622–623

over elevation as, 623

patient history in, 620

physical examination in, 620–621

prevention of, 620–621

scarring as, 622–623

summary overview of, 623

types of, 621–622

coronal lift, 621–622

direct brow lift, 621

endoscopic brow lift, 622

midforehead lift, 621

under elevation as, 623

Fractures, from facial trauma. See also specific anatomy.

lower face, 608, 614–616

middle face, 607–608, 612, 614

upper face, 607–608

Frontal sinus fracture, from facial trauma, 607–608

Frontalis muscle, in forehead lift, 619–620

coronal approach and, 621