Facial Liposuction and Submentoplasty

Symposia to non-animal material that no longer requires allergy testing. These fillers are injected into lips and facial rhytids to augment lips and efface rhytids. A firm knowledge of topical and local anesthesia as well as facial anatomy is paramount for the proper use of these products. Fillers can be broken down into multiple classes and have different injection targets and carry various advantages and disadvantages. Most fillers are resorbable, but newer fillers contain hydroxylapatite or methylmethacrylate microspheres. These fillers persist longer or are sometimes permanent. Due to this, proper injection technique is paramount. Botox is the first mass marketed botulinum toxin A (BT A) used for cosmetic purposes. BTA prevents the release of ACH from the motor neuron which disrupts nerve transmission and hence muscle movement. Treating patients with BT A involves simple techniques but requires a significant knowledge of facial musculature and injection techniques. Again, OMS are uniquely qualified to perform BT A injections for the aesthetic and functional treatment of muscles of the head and neck. Many BTA treatments are technique sensitive and provide excellent temporary cosmetic improvement.

exclusively red or oxyhemoglobin and are used for elimination of facial vessels. The details of the technology, techniques and results will be demonstrated utilizing a 532 nm laser. Including minimizing thermal injury to surrounding tissues by proper use of proper pulse duration/thermal relaxation time. Secondarily, I will discuss a laser system that affects, in the author’s opinion, significant facial skin rejuvenation with regard to the following: 1. Reduction and/or elimination of keratoses 2. Reduction and/or elimination of dyschromias 3. Improvement in skin tone, texture and color 4. Minor reduction facial rhytids Lasers are named after the constituents of the medium; gases such as Argon and CO2; liquids (pulsed dye laser), solids (alexandrite, diode, erbirum, yttrium, ruby) or solid state (diode). Noninvasive lasers, excluding vascular, are in the 1320 - 1540 nm wave length. Cool touch 1320, Smoothbeam 1450, and Ardmis 1540 are some of the more popular. I will discuss a noninvasive erbium-yag laser. Some wrinkle reduction is possible with this laser although it is not a major component of the treatment. As with the vascular lasers, the mechanisms of action, the down-time and the results will be demonstrated.

References Niamtu, J: The use of Restylane in cosmetic facial surgery. J Oral Maxillofac Surg 64:317, 2006 Niamtu J: New lip and wrinkle fillers. In: Minimally Invasive Cosmetic Surgery Oral and Maxillofacial Surgery Clinics of North America. Saunders, Philadelphia 17:1, 2005, pp 17-27 Niamtu J: The cosmetic use of botox in maxillofacial surgery selected readings in oral and maxillofacial surgery 12, No. 2, Apr 2004, pp l-22

Noninvasive Lasers: Skin and Vascular Rejuvenation Bruce N. Epker, DDS, MSD, Weatherford, TX The currently available selection of lasers is such that it is extremely confusing and complex with regard to what they do, how they do it and predictability of outcome. The spectrum of laser treatment has changed considerably in the past decade from the conventional, yet invasive CO2 lasers that affect major skin rejuvenation, but with significant down-time, to a large number of minimally invasive and noninvasive lasers. This discussion will focus on the noninvasive lasers. In the noninvasive laser group, there are a large number of lasers that do indeed have different functions. The primary function I will address will be skin rejuvenation and elimination of facial vessels. In this regard, I will primarily discuss two systems, one to treat facial vessels and one for skin rejuvenation. Multiple systems in the 525 to 575 nm wave lengths exist to treat facial vessels. These wave lengths target 22

Reference Goldberg D: Lasers and Lights: Vol I; Elsevier Saunders, Philadelphia, PA, 2006 Goldberg D: Lasers and Lights: Vol II; Elsevier Saunders, Philadelphia, PA, 2006

Facial Liposuction and Submentoplasty Angelo Cuzalina, MD, DDS, Tulsa, OK Achieving a beautiful and youthful jaw line and neck contour is a common desire for many cosmetic surgery patients. Certain patients are candidates for isolated facial or neck liposuction if their skin tone and muscle tone are adequate. In addition, the role of chin augmentation to improve a weak chin projection is critical to obtain good facial proportion as well as maximum neck aesthetics particularly when a patient has an anterior or low hyoid position. Often, isolated facelift surgery performed by an assortment of lateral pulling or lifting techniques is performed as an isolated procedure to improve the jowls and neck. A submentoplasty may be mentioned briefly as part of the procedure, but it is not well described and not given the credit it deserves for its role in long term aesthetic neck improvement. Submentoplasty, liposuction and chin augmentation can be invaluable tools to enhance lower face and neck rejuvenation with or without a facelift. In fact, there are many instances where proper treatment planning can yield exceptional neck results with any of these basic techniques. Specific techniques for isolated basic liposuction, chin AAOMS • 2006

Symposia implant placement, and advanced submentoplasty maneuvers will be addressed to improve the chin-neck angle. Treatment of extremely ptotic necks and achieving long-term stability with minimal relapse will also be reviewed. Appropriate patient selection and fundamental techniques are described along with how to avoid common mistakes and management of complications.

AAOMS • 2006

References Housman TS, Lawrence N, Mellen BG, et al: The safety of liposuction: results of a national survey. Dermatol Surg 28:971, 2002 Knize DM: Limited incision submental lipectomy and platysmaplasty. Plast Reconstr Surg 113:1275, 2004 Ramirez OM, Robertson KM: Comprehensive approach to rejuvenation of the neck. Facial Plast Surg 17:129, 2001

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