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Plastic Surgery Case Study – Submental Excision/Tuck for Hyperdynamic Chin Pad Excess

Background: The large chin (macrogenia) can be caused by excessive bone, soft tissue or both. A unique form of congenital macrogenia, most commonly seen in females, is a pure soft tissue excess known as chin pad hypertyrophy. Often called a fleshy chin the size of the overlying soft tissue is disproportionately larger than that of Read More…

Assessment of Bone Healing Across The Grafts Interpositional Gap in Vertical Lengthening Bony Genioplasties

When significant lengthening of the chin is needed the opening wedge bony genioplasty is the best procedure to do so. In this procedure the chin bone is cut with a horizontal osteotomy and down fractured. The desired vertical lengthening is then set by the application of a fixation plate c reating a bony gap between Read More…

Plastic Surgery Case Study – Vertical Lengthening of the Short Female Chin by Opening Wedge Osteotomy

Background: The vertical length of the female face extends from the frontal hairline (trichion ) down to the bottom of the chin. (pogonion) It is aesthetically divided in thirds which are ideally proportionate. From a surgical manipulation standpoint the facial thirds can be thought of as the forehead, nose-upper lip and chin as all of Read More…

Plastic Surgery Case Study – Long Term Results of a Custom Jawline Implant in the High Angle Male Face

Background: Improving the shape of the jaw is one of the most challenging of all facial augmentations. It is.a complex bone by facial standards and is also the largest surface area in the face to augment. In addition the type of dimensional changes needed in the chin are different from what is needed in the Read More…

Plastic Surgery Case Study – The Two Stage Approach to Large Custom Skull Implants for Female Crown of Head Augmentation

Background: In larger skull implant augmentations it is necessary to undergo a 1st stage scalp expansion. What defines a skull implant size that requires an initial scalp expansion depends on several factors, the most important of which is the scalp’s ability to stretch to accommodate the size of the implant underneath it. There is not Read More…

Plastic Surgery Case Study – Frontal Hairline Approach to Upper Forehead Lipoma Removal

Background: The forehead is prone to the development of benign masses or growths more so than any other surface of the skull or scalp. Whether it is because it is more visible or whether it sustains more low level trauma the forehead is prone to developing benign slow growing masses. The most common forehead masses Read More…

Plastic Surgery Case Study – Bilateral Parietal Eminence Skull Reduction in a Female

Background: The skull develops through numerous methods, one of which is ossification of certain bony eminences. (aka primary bone growth centers) One of these is the well known parietal eminence area which ultimately forms the large parietal bones of the skull. These quadrilateral-shaped skull bones located at the sides and posterior roof of the skull Read More…

Plastic Surgery Case Study – Shoulder Narrowing in the Thin Clavicle Patient with Prominent Show

Background: Shoulder narrowing surgery works by its obvious shortening of the horizontal length of the clavicle bone. In so doing the most critical step is putting back together the bone with its new shortened length using plate and screw fixation. That step is what most significantly differentiates it from clavicle fracture repair where the goal Read More…

Plastic Surgery Case Study – Extended Custom Chin Implant after Vertical Lengthening Bony Genioplasty

Background: The chin is a three-dimensional structure whose length, width and projection must be considered in any augmentation procedure. While an implant works fine for modest dimensional changes of the chin it does not work well for larger changes. This is particularly true when significant vertical lengthening is needed as this where the role of Read More…

Plastic Surgery Case Study – Custom Skull Implant for the Flat Back of the Head Augmentation in the Older Male

Background: The shape of the skull is a collection of largely convex surfaces that interface with each other. Fundamentally there are five such convex skull surfaces (front, top, back and two sides) that collectively create the aesthetic shape of the skull. While the degree of convexity varies on each surface anything less than some convexity Read More…