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Commentary on: The Role of Microfat Grafting in Facial Contouring
The authors present their use of microfat grafting as an alternative to the advancement of skeletal osteotomies performed for purely aesthetic concerns.1 They appropriately emphasize the not-insignificant complications and morbidity associated with orthognathic procedures to justify their less morbid treatment preference. Although not mentioned by these authors, fat grafting would also avoid the dysaesthetic contour […]
MoreMaking Concave Faces Convex
Concave faces are often considered less attractive than convex ones. The lesser midface skeletal projection intrinsic to concave faces poorly supports the soft tissues resulting in premature lower lid and cheek descent, as well as visible bags.  These faces are “morphologically prone†to further lower lid descent after blepharoplasty.  The concave midface also makes the […]
MorePeriorbital Skeletal Augmentation Can Improve Blepharoplasty and Midface Surgery Results
Aging results in soft tissue descent with rounding of the palpebral fissure, lengthening of the lower lid, and a loss of cheek prominence. In patients with skeletal deficiency (midface concavity), these signs of aging are early and exaggerated. These skeletally deficient faces are also “morphologically prone†to further lower lid descent after blepharoplasty . Recent […]
MoreConcepts of Midface Soft Tissue and Skeletal Aging
Traditional concepts of periorbital and midface aging and rejuvenation focus on the soft tissues. Recently, senescent changes in the supporting facial skeleton been investigated. Findings in these studies revealed retrusion of the midface skeleton and support the concept of alloplastic augmentation of the midface skeleton as part of the algorithm for periorbital and midface rejuvenation […]
MorePrimary and Secondary Malar Implant Surgery
During plastic surgery training, my chief warned that, too often, patients are displeased with their appearance after alloplastic malar augmentation. Dr. Hoopes facetiously said: “Malar implant surgery is a three- part procedure. You put them in. You adjust them. You take them out†Although this statement exaggerates the frequency of patient dissatisfaction after malar augmentation, […]
More16th Biennial Congress of the International Society of Craniofacial Surgery (ISCFS)
The International Society of Craniofacial Surgery (ISCFS) Tokyo, Japan, September 18, 2015 Lecture on: “The role of Alloplastic implants as an adjunct and occasional alternative to orthognathic surgery” Chairing a panel discussion on “Aesthetic Orthognathic  Surgery ”
MoreChanges in Eyebrow Position and Shape with Aging
Purpose Lack of an objective goal for brow lift surgery may explain why several articles in the plastic surgery literature concluded that brow lifts produce eyebrows with shape and position which are not aesthetically pleasing. By comparing eyebrow shape and position in both young and mature women this study provides objective data to plan forehead […]
MoreEnlarging the Deficient Mandible by: Michael J. Yaremchuk, M.D.
Introduction Patients with small lower jaws may derive aesthetic benefit from alloplastic augmentation of both their anterior and posterior mandible. Augmentation of the contours of their mandible balances†their facial dimensions while adding definition and angularity to the lower third of their face. Most patients with small mandibles have a normal occlusion. Significant mandibular deficiency […]
MoreBridge of Bone Canthopexy by: Michael J. Yaremchuk, M.D.
Introduction The youthful palpebral fissure is long and narrow with a slight lateral upward inclination. Distortions of, or deviations from, this shape may be secondary to heredity, aging, paralysis, trauma or previous surgery. This distortion of shape inevitably manifests as rounding of the fissure with inferomedial descent of the lateral canthus and […]
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