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Technical Strategies – Methods in Gummy Smile Correction

The gummy smile is a well known perioral appearance that occurs when too much of the gums (gingiva) shows when smiling. The interpretation of too much gingival show will vary amongst different people and their aesthetic sense. But the general aesthetic standard is that if more than a few millimeters shows when smiling it would Read More…

OR Snapshots – Sagittal Crest Skull Reduction

A bony ridge that runs down the midline of the head is known as a sagittal crest. This is a palpable raised ridge of bone that when high enough can cause a peak-shape to the head from the front view. The normal more convex shape off the head becomes more triangular shaped. This is most Read More…

OR Snapshots – Custom Occipital Skull Implant for the Flat Back of the Head

There are over fifteen types of aesthetic skull deformities. But the most common amongst them is various forms of flattening of the back of head. Perhaps because the back of head is exposed to various pressures in utero and after birth more than any other area of the head, it is prone to deformational pressures Read More…

Technical Strategies – Fishtail Earlobe Reshaping in Otoplasty

Otoplasty or ear pinning is the most common aesthetic surgery performed on the ear and its cartilages. (technically earlobe repair would be the most common aesthetic ear surgery… but it contains no cartilage) In repositioning the shape of the protruding ear back towards the side of the head a variety of techniques are used to Read More…

Plastic Surgery Case Study – Teenage Male Cleft Rhinoplasty

Background: Of all the difficult cases in rhinoplasty surgery, the cleft nose remains one of the most challenging. While this challenge is magnified in the bilateral cleft nose, it is only slightly less in the unilateral cleft lip and palate patient. The challenge its not in understanding the deformity but working with nasal tissues that Read More…

Plastic Surgery Case Study – The Lifting Effect of Breast Implants

Background: Many women who present for breast augmentation have varying degrees of breast ptosis or sagging. Some have the belief that a breast implant has the capability to lift the sagging breast and avoid the need for some type of breast lift. Unfortunately this is almost never the case much to the chagrin of the Read More…

Long-Term Outcome of ePTFE Ear Reconstruction

Ear reconstruction for partially or completely removed/lost ears in adults must take into consideration the needed soft tissue coverage. While the cartilage of the ear can be replaced by either a synthetic framework or rib cartilage, it requires vascularized tissue and a skin graft to have a reconstruction result that survives and hopefully looks good. Read More…

Plastic Surgery Case Study – Posterior Sagittal Crest Reduction Through a Limited Scalp Incision

Background: The sagittal suture is the fibrous connection between the two parietal skull bones running down the midline of the head. It remains as a soft tissue connection until the second or third decide of life when it closes and disappears. Premature closure of the suture in utero or early after birth results in the Read More…

OR Snapshots – The Fate of the Cut Muscle Edge from Temporal Reduction Surgery

Temporal reduction is an effective method for narrowing the wide head. The wide head is defined as the area above the ears that has too much convexity or fullness. Extreme fullness at the sides of the head occurs when the width of the head gets near a vertical line drawn up superiorly from the inside Read More…

Technical Strategies – Transcoronal Approach for Posterior Zygomatic Arch Osteotomy

Cheekbone reduction by osteotomies is the only surgical method for narrowing a wide face. While most commonly performed on Asian patients all around the world, I have done an equal number on other ethnicities as well. By performing a bone cut through the main body of the cheek (zygoma) and at the back end of Read More…