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The Aesthetic Basis of Female Crown of the Skull Augmentations

Augmentation of the crown of the skull is one of the most common requests among female skull reshaping patients. A prominent crown of the skull has long been recognized as an important head shape element as seen by many hairstyles over the years. This raises the question as to.why do women value a high crown Read More…

Custom Implant for Female Crown of Skull Augmentation Case Example

A custom crown-of-the-skull implant is designed to increase the height and smooth the contour of the upper central skull (vertex) while maintaining a natural feminine head shape. Unlike implants that widen the sides of the head or augment the back of the skull, a crown implant selectively builds the highest point of the skull to Read More…

Common Misconceptions About Facial Implant Materials

While the available materials for custom facial implants, silicone, PEEK, porous polyethylene and titanium, have been around for years I find few patients and even many surgeons don’t think about them properly. Misconceptions about their properties abound and the following are a few of the most common. Common Misconceptions “Rigiduty Means A Superior Aesthetic Result” Read More…

Custom Facial Implant Materials – Silicone, PEEK, Porous Polyethylene, and Titanium: How To Choose the Right Material

Custom facial implants are manufactured from several biocompatible materials, most commonly solid silicone, PEEK, porous polyethylene, and titanium. Each has unique advantages and limitations, and no single material is best for every patient or every procedure. The most important factor in a successful custom facial implant is not the material—it is the implant’s design. A Read More…

Contour Augmentation with Alloderm Grafts in Masseteric Muscle Dehiscence Case Example

Masseteric muscle dehiscence is one of the more frustrating soft tissue complications that can occur after custom jaw angle implant surgery. While meticulous muscle dissection and ligamentous release is the primary method of prevention, muscle retraction over the implant can still occur. The masseter muscle normally inserts onto the lateral surface of the mandibular angle. Read More…

The Technique of Shoulder Widening by Clavicle Lengthening Osteotomies

Shoulder widening by clavicle lengthening osteotomies is the opposite of shoulder narrowing surgery. Rather than shortening the clavicles, the bones are divided (osteotomy) and immediately lengthened to increase biacromial shoulder width. Indications This is a rare procedure that may be considered for: Congenitally narrow shoulders. Patients seeking greater upper body width for aesthetic masculinization. Selected Read More…

Bony Orbital Shapes in Undereye Holllowing and Negative Orbital Vectors

The shape and position of the bony orbit is one of the most important anatomic factors in the development of undereye hollowing and a negative orbital vector. While aging and soft tissue descent contribute to tear troughs, many younger patients have these features because of the underlying skeletal anatomy. The Normal (Positive Orbital Vector) In Read More…

The Role of Rib #10 in Waist Narrowing Surgery

What is the most important tib to remove/modify in waist narrowing surgery? If the goal is to achieve the greatest reduction in structural waist width, the 10th rib is the single most important rib to modify or remove. While aesthetic rib surgery has historically focused on removing the free-floating 11th and 12th ribs because they Read More…

Preoperative Testing in Shoulder Widening Surgery

Some patients before shoulder widening surgery, through either deltoid implants or clavicle lengthening techniques, may want to test how much width they desire and compare that to what the surgeries can actually achieve.. This can be done by broadening the shoulders under clothing using silicone shoulder pads which are commercially available in several designs. The Read More…

The Pleura in Rib Removal Waistline Narrowing Surgery

In rib removal surgery of the lower rib cage for a waistline narrowing effect the most feared complication is that of a pneumothorax. A pneumothorax occurs because the pleural lining of the lung is inadvertently opened or torn during surgery and is not recognized. This allows air to escape from the lungs and, if enough Read More…