Category: rib removal | technical strategies

Technical Strategies – Incision Placement in Posterior Rib Removal Surgery

Rib removal surgery eliminates the last anatomic ‘obstruction’ to maximal horizontal waistline reduction. The ends of the free floating ribs (#s11 and 12) and the lowest false rib (#10) provide the only skeletal support to the sides of the torso at and above the waistline area. By pushing in on the sides of the waistline Read More…

Technical Strategies – Submental Chin Reduction and the Geniohyoid Muscle

Chin reduction is the least commonly performed chin reshaping procedure. This is because how to reduce a large chin is not well known or practiced by most plastic surgeons. While a reverse sliding genioplasty is commonly believed to be an effective chin reduction procedure, it is not. Pushing the bone back with its attached tissues Read More…

Technical Strategies – Vertical Chin Cleft Creation with Chin Implant Augmentation

The chin has few topographic features on an otherwise round convex shape as it covers the projecting chin bone. Chins can have either a dimple or cleft. A chin dimple is a circular central indentation of the soft tissue chin pad. A chin cleft is a vertical indentation through the lower half of the chin Read More…

Technical Strategies – Subcostal Rib Reduction by Shaving

Most of the ribs are near circumferential bone and cartilage ‘fingers’ that provide shape to the chest and abdomen. Some of these ribs can be modified to improve the shape of the torso. In the upper abdominal region is the subcostal portion of the ribcage which is composed of the union of ribs #7 through Read More…

Technical Strategies – Mapping Multilevel Temporal Artery Ligations

The superficial temporal artery (STA) is a branch of the facial artery that crosses in front of the ear and heads northward into the scalp. At a fairly predictable point above the ear it turns into a Y configuration with an anterior branches coursing across the forehead at it turns up into the scalp. It Read More…

Technical Strategies – Submental Chin Reduction for Chin Pad Prominence Reduction

Unlike chin augmentation, chin reduction surgery is performed far less commonly. As a result, it is not a well understood procedure in terms of proper diagnosis and technique. While chin reduction is often perceived as an intraoral bony burring procedure, this is a very limited procedure that is rarely effective and often leads to postoperative Read More…

Technical Strategies – Custom Skull Implants with Frontal Hairline Design

Skull implants are a versatile treatment strategy for a variety of head augmentation concerns. Made from the patient’s 3D CT scan they can be designed to provide increases in skull projection that are only limited by the stretch of one’s scalp. One of the not uncommon indications for custom skull implants is to increase the Read More…

Technical Strategies – Webbed Neck Correction with Trapezius Myotomies

The webbed neck occurs is a wide variety of medical conditions and has variable presentations. While most commonly associated with Turner’s, Noonan and Klippel-Feil syndromes where the webbed necks are severe, they also occur in lesser presentations that may have no specific syndrome associated with them. While non-syndromic neck webbing is less severe, it may Read More…

Technical Strategies – Buccal Fat Grafting of the Labiomental Fold

The labiomental fold is a small and often overlooked facial feature. Lying between the lower lip and chin, it is a crease or fold of varying depths amongst different people. Why a labiomental fold even exists at all is a function of many factors including chin projection, the attachment of the mentalis muscle to the Read More…

Technical Strategies – Multi-Point Temporal Artery Ligation

The development of visible temporal arteries in the forehead is not rare. Occurring almost exclusively in men, the frontal or anterior branch of the superficial temporal artery becomes dilated and its course up into the forehead becomes prominent. Often occurring after exercise, heat exposure or alcohol intake, the muscular walls if the artery dilate makes Read More…