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1037
INDEX
A
Abdominal wall, reconstruction o , 806–808
blood supply, 806
challenges, 808
characteristics, 807
components separation technique, 807
desmoid tumor, 808
evaluation, 806
ap, 808
goals, 806
implantable mesh, 807
intraoperative maneuvers, 808
role, 808
skin and so t-tissue de ects, 807
tissue expansion, 807
ventral hernia, options or, 808
Abnormal Schirmer’s test, 23
ABPS examinations
ormat o written examination, 5
multiple choice tests, strategies or, 5–6
strategies or studying or, 2–4
study techniques or, 4–5
Acland (vessel strip) test, 703
Acquired hypercoagulable disorder, 861
Acrochordons, 559, 970
Acticoat, 739
Actinic cheilitis, 560
Activated protein C resistance, 409
Acute abdomen, eponyms or examination o , 867
Adjuvant chemotherapy, or breast cancer, 170
Aeromonas hydrophila, 682
A erent papillary de ect (APD). See Marcus-Gunn pupil
Aging
endogenous changes with, 41
ace, actors or, 41
ALARA principle, 220
Allen’s test, 262
AlloDerm, 740, 958
Allogra t, 727
Alloplastic acial augmentation, 89
Allotransplantation, vascular composite, 727–730
acute rejection, 728
allogra t, 727
antigens or, 728
autogra t, 727
central tolerance, 729
chronic rejection, 728
cyclosporine and FK506 in, 729
cytotoxic drugs in, 729
ethics o , 730
gra t-versus-host disease, 730
heterotopic transplants, 727
history o , 727
hyperacute rejection, 728
immunology o , 728–730
immunosuppressive medications in, 729
isogra t, 727
mycophenolate mo etil in, 729
nomenclature, 727
orthotopic transplants, 727
peripheral tolerance, 730
rejection, type o , 728
steroids in, 729
tolerance, 729
types o , 727
xenogra t, 727
Alopecia, 48
male, 107
5-Alpha-reductase, 108
Alveolar ventilation, 863
Amastia
unilateral, 136
Amateur tattoos, 981
Amazia, 136
Ameloblastoma, 766
American Board o Medical Specialties (ABMS), 1
American Board o Plastic Surgery (ABPS), 1, 11
American Society or Surgery o the Hand, classi cation o congenital
de ormities o hand, 250
Amniotic band syndrome, 933
Anagen e uvium, 108
Anatomic snu box, 251, 251 , 329, 953
Anesthesia, 265–281
action o local anesthetics, 266–269
American Society o Anesthesiologists (ASA) classi cation or,
280
balanced, 279
general, 279–281
nerve blocks, 272–279
nerve cell physiology, 265–266
new developments, 281
stages o , 279
toxicity o local anesthetics, 269–272
or upper extremity, 272
Angiogram, 868
Angiosarcoma, o breast, 171
Anterior compartment, 818
Anterior interosseous nerve (AIN), 321
Anterior interosseous syndrome, 943
Anterior lamellae, 20
Anterolateral thigh (AL ) ap, 820
Antia-Buch ap, 880
Apert syndrome, 577, 578, 580
Apex o brow, 18
Apligra , 958, 964
Aponeurotic ptosis, 884
Arcus marginalis, 20
Arm contouring, 119
Aromatase inhibitors, 168–169
Arte ll, 102
Arteriovenous mal ormation, 671
history, 671
morbidity, 671
Arthrogryposis, 948
Aschner phenomenon, 447
Aspirin, 409, 702
Athelia, 136
Atypical cle t hand, 940
Note: Page numbers ollowed by indicates gure.

1038
Index
Augmentation o acial skeleton, alloplastic, 85–90. See also Biomaterial
biomaterials or, 85
ceramics and bioactive glass, 86
chin implant, 89
circumstances, 85
ideal implant, 85
implant placement, 75
in raorbital rim augmentation, 88
malar implant, 89
pediatric cranio acial applications, 86
pediatric cranio acial applications, 86
porous implants, 87
pre abricated polymers, 86
silicone, 88
sites o , 87
Autogenous tissue breast reconstruction
advantages o , 195
contraindications o , 196
indications or, 195
smoking, e ect o , 206
Autogra t, 727
Autologen, 103
Autologous bone gra ting, 85
Autologous breast reconstruction, 211–215
Autologous aps, or breast reconstruction
and mammographic changes, 207
Axillary artery, 275
Axonotmesis, 460
B
Basal cell carcinoma (BCC), 563–565, 952, 957
Bazex’s syndrome, 975
Becker implant, 184
Bell’s palsy, 458–459, 890
Bell’s phenomenon, 459, 459
Belotero, 102
Benign breast lesions, 160–161
broadenoma, 161
brocystic disease, 160
galactocele, 160
giant broadenoma, 161
intraductal papilloma, 161
Mondor’s disease, 160
palpable cyst, 160
Bilateral de ormational plagiocephaly, 914
Bilateral subcondylar ractures, 920
Binder syndrome, 912, 923
Binomial test, 858
Biobrane, 739, 958, 964, 971, 986
Biodegradable polymers, 86
Biomaterial
or augmentation o acial skeleton, 85
de nition o , 85
or acial skeletal augmentation in adults, 87
osteoconductive, 86
osteoinductive, 86
Black box warning, 33
Blair, Vilray P., 11
Blauth classi cation, o hypoplastic thumb, 929
Blepharochalasis, 17, 753, 885
Blepharophimosis syndrome, 885
Blepharoplasty, 17–26
complications o
diplopia, 25
lower lid malposition, 25
retrobulbar hematoma, 25
goals o , 17
markings or
Asian eyelids, 22
lower blepharoplasty, 22
upper blepharoplasty, 22
postoperative care, 23
postoperative chemosis, 21
preoperative evaluation, 23
ptosis management during, 22
transconjunctival, 22
Blue-green tattoos, 895
Body contouring, 115–122, 891–893
arm, 119
liposuction, 120–122
thigh, 119–120
truncal, 115–119
Body dysmorphic disorder (BDD), 960
Bogorad syndrome, 460
Bolus, 221
Boost, 220
Botox, 894, 895, 963, 970
contraindications, 33
evidence or migraine headaches, 34
o -label uses, 33
Botox party, 32
Botulinum toxins, 458
Botulinum toxin type A (BoN -A)
adverse events due to, 32
application, 32
bacterial organism, 29
black box warning or, 33
bunny lines, 31
cause o ptosis, 31
contraindications to use o
absolute, 33
relative, 34
cosmetic indication, 33
ormulations o , 29
or glabellar lines treatment, 33
higher dose o , 32
mechanism o action, 29
mimetic e ects o , 31
o -label use o , 33
platysmal bands, 32
ptosis a ter, 31
recommendation, 30
signi cance o concentration, 30
spread o toxin e ect o , 33
synergistic e ect o toxin, 32
treatments, 29
undesirable mimetic e ects o , 31
vertical perioral rhytids, 32
Boutonniere de ormity, 254, 308, 340
Bowen’s disease, 566, 967
Boxer’s racture, 257
Brachial plexus, 272–273, 369–378
anatomy, 370–372
demographics, 369–370
electrical studies, 373–374
injuries
compression, 369
location o , 369
mechanism or, 369
in motor vehicle accidents, 369
root avulsions levels, 370
nerve trans er, 375–377
obstetrical brachial plexus injury, 377–378
physical examination, 372–373
radiology, 373
treatment principles, 374–375

Index
1039
Brachioplasty, 119, 891, 893
Branchial cle t anomalies, 477, 478
Branchial cle t cysts, 478
Branchial cle t stula, 899
Branham sign, 985
Breast, 871–877
aesthetic subunits o , 196
estrogen in, 242
Breast anatomy/embryology, 135–141
aberrant breast tissue, site o , 136
areola complex, 138
axillary artery, branches o , 137
axillary lymph nodes, 137
breast parenchyma, 138, 139
congenital inverted nipple, 140
internal mammary artery, 137
lobes in breast, 136
long thoracic nerve, 139
mammary ridge, 135
Montgomery glands, 138
nipple–areola complex, 137, 138
nonptotic breast, youth ul, 140
pectoralis major muscle, 137–140
serratus anterior muscle, 139
suspensory ligaments o Cooper, 138
thoracodorsal artery, 139
tuberous breast de ormity, 141
Breast augmentation, 143–147
and aerobic pathogen, 146
Baker grades, o capsular contracture, 144
breast tissue and chest wall, long term changes in, 146
and capsular contracture rate, 144, 145
complication o , 145
considerations be ore, 145
dual plane, 145
incisions or placing implants, 146
in ection rate a ter, 146
in ection treatment a ter implant placement, 146
in ramammary incision, 146
mastopexy with, advantage o , 147
MRI or evaluating implant integrity, 147
periareolar incision, 146
pinch test, 145
rate o decreased nipple sensation, 146
saline and silicone implants, 145
saline- lled implants, rupture o , 146, 147
silicone gel prosthesis, 147
in subglandular plane, 144
in subpectoral plane, 144
synmastia a ter, 147
textured implants, advantage o , 145
transaxillary approach, 146
tuberous breast de ormity, 147
upper-pole ullness and distortion, risk o , 144, 145
Breast binding, 837
Breast cancer, 157–172
angiosarcoma, 171
benign breast lesions, 160–161
chemotherapy or, 168–170
ductal carcinoma in situ, 164–165
genetics, 159
hormonal therapy or, 168–169
imaging or, 159–160
in ammatory, 172
invasive breast cancer, 165–168
lobular carcinoma in situ, 164
male, 170
Paget’s disease o breast, 171–172
phyllodes tumor, 161–162
risk actors and screening, 157–158
annual mammogram a ter age, 158
cancer genetic counseling, 158
clinical breast examination, 158
modi ed Gail model, 157
screening guidelines, 158
staging, 162–163
Breast implants, 151–156
capsular contracture, 155
closed capsulotomy, 156
extracapsular silicone gel rupture, 154
Institute o Medicine’s report on, 152
mammograms with Eklund displacement views, 152
materials or, 151
NCI Breast Implant Study and, 153
rate o silicon implant rupture, 155
reoperation rates, 155
saline breast implant de ation rates, 154
saline breast implant rupture, detection o , 154
silent implant rupture, 154
silicone implant rupture, 155
silicone implants, 151
textured shell, 151
and visualization by mammogram, 152
Breast ptosis, 871
Breast reconstruction
abdominal tissue or, 201
alternative aps or, 195–207
expander-implant and nipple-areolar reconstruction,
181–191
ree aps or, 197, 201
gluteal artery per orator ap or, 204
I-GAP ap or, 204
lateral transverse thigh ( FL) ap or, 205
method or, selection o , 195
microsurgery and autologous reconstruction, 201, 211–215
pedicled aps or, 196
per orator aps or, 202–203
radiation therapy and, 224–226
random aps or, 197
S-GAP ap or, 203
SIEA ap or, 202
thoracodorsal artery per orator ( AP) ap or, 205
Breast reduction and mastopexy, 239–245
breast- eed a ter reduction mammoplasty, 241
circumareolar (“doughnut”) mastopexy techniques, 244
cup size o bra, 239, 240
dusky postoperative NAC, management o , 240
ree-nipple gra t, 239, 240
Goes mesh mammoplasty technique, 245
Hall–Findlay procedure, 242
in erior “dermal sling” concept, 245
Lejour technique, 242
nipple–areolar complex (NAC), 239–240
nipple position, guidelines or, 243
periareolar mastopexy procedures, 244
planning error with, 243
sensory innervation to breast areas, 239
Strömbeck and McKissock techniques, 241
vertical breast reduction technique, 242
British Medical Research Council grading system, o muscle
strength, 372
Brow
depressor muscles, 30
elevator muscles, 30
Brow depression, muscles or, 35
Brow elevation, muscles or, 35

1040
Index
Brow li t, 35–39
contraindications, 38
nonsurgical, 37
Brow position, normal, 35
Brow strain, 36
Buerger disease, 262
Bunnell opponensplasty, 954
Bunny lines, 31
Burkhalter opponensplasty, 954
Burn care, 733–742
ABA criteria, or trans er to specialized burn center, 733
acticoat, 739
AlloDerm, 740
biobrane, 739
burn injury, depth classi cations o , 735
burn size, estimation o , 733
carbon monoxide poisoning, treatment o , 737
cardiovascular response and, 735
chemical burn, 738
cultured epithelial autogra t, 740
Curling’s ulcer, 736
electrical injury, management considerations or, 737
escharotomy incisions, 735
ex oliating burns, 742
eyelid ectropion reconstruction, 742
acial burn coverage, normal appearance in, 741
rst step in, 733
aps used in burn reconstruction, 742
uid resuscitation in, 733–734
ull-thickness injury, 735
high-voltage electrical exposure, 737
histologic zones o burn injury, 735
hypermetabolic response, 736
inhalation injury, 736
inosculation, 740
Integra, 740
lightning injury, 737
neovascularization, 741
overlay gra ting method, 739
Parkland ormula, 734
partial-thickness wound bed, 735
plasmatic imbibition, 740
primary contraction, 741
reconstruction o burn alopecia, 741
renal insuf ciency in patient, 736
secondary contraction, 741
surgical treatment or burn wounds, 739
ransCyte, 740
xenogra t, 740
Byrd classi cation system, 819
C
Camper’s chiasm, 258
Camptodactyly, 935, 938, 951
Cancer
head and neck, 483–490
Canthopexy/canthoplasty, 22
Capillary mal ormation, 670
Capsulopalpebral ascia, 18
Captique, 102
Caput ulna, 942
Caput ulnae syndrome, 358
Carbon dioxide laser, 95
Carpal bone ractures, 257
Carpal compression test (C S), 318–319
Carpal tunnel, 254
Carpal tunnel syndrome, 946, 954
Carpenter’s syndrome, 577, 917, 950
Carpometacarpal (CMC) joint, 256
Carpue, Joseph, 10
Cat bite in ections, 958
Causalgia, 939
Cellulite, 126
Chalazion, 887
Champy plate, 452
Chemical peeling, 77–84
agents used or, 77
Baker’s ormula, 78
clinical course o , 78
complications o , 82
de nition o , 77
e ect on dermis, 77
ex oliants, categories o , 77
Hetter phenol–croton oil peel, 77
indications or, 77
Jessner’s solution, 78, 80
phenol or, 72, 73, 72–73, 78
Retin-A, 80
salicylic acid or, 79
scars a ter, treatment options o , 83
and taping, 7
CA peel, 72, 79, 80
Chemosis, 25, 887
Chest wall abnormalities, 876
Chest wall, reconstruction o , 801–808
bronchopleural stula, 801
ap choices, in chest wall reconstruction, 803
goals and principles, 802
intrathoracic dead space, 801
latissimus dorsi muscle ap, 803
median sternotomy wounds,
nonrigid, semirigid, and rigid reconstruction, 802
omental ap, 805
pectoralis major muscle, 803
radiation therapy, 803
rectus abdominis muscle, 803
rigid reconstruction, 802
serratus anterior muscle, 803
sternal wound in ection, 804
Chromophores in skin, 92
Chylothorax, 863
Chylous stula, 926
Cigarette smoking, e ect on ap blood ow, 206
Cle t lip and palate, 595–601, 897
Abbe-Estlander ap, 601
alveolar bone gra ting, 601
arterial supply o upper lip, 601
bilateral cle t lip de ormity, 600
blood supply o so t palate, 596
cle t eeding aids, 599
cle t nasal de ormity, 601
etiological actors in cle ting, 596
acial prominences, 597
orked ap, 601
orme ruste cle t lip, 600
Furlow palatoplasty, 597
gingivoperiosteoplasty in in ancy, 599
incidence o cle ts, 598
intravelar veloplasty, 597
isolated cle t palate, 599
Latham appliance, 599
Le Fort I distraction, 598
lesser palatine oramen, 596
levator veli palatini, 595, 596
lip adhesion, 601
and middle ear e usion, 599

Index
1041
Millard technique o cle t lip repair, 600
myringotomy tubes, 598
nerve supply o upper lip, 601
Noordho ap, 598
palatal cle t morphology, 601
palatal mucoperiosteal ap, 595
presurgical orthopedics and presurgical orthodontics, di erence
between, 598
presurgical orthopedics, purpose o , 597
Randall- ennison repair, 600
Simonart band, 597
submucous cle t palate, 595
unilateral cle t lip, 599
Veau-Wardill-Kilner technique o palatoplasty, 598
von Langenbeck palatoplasty, 599
Cleland’s ligaments, 253, 940
Clinodactyly, 950
Clonidine, 280
Clostridium perfringens, gas gangrene by, 303
CLOVES syndrome, 672
C-M sutures, 54
Cobb syndrome, 898
Collar button abscess, 300, 937
Compartment syndrome, 251, 253, 255, 819, 937, 942
Compressive neuropathies and peripheral neuropathies, di erence
between, 313
Computed tomography, or upper extremity tumors, 283
Con dence interval, 855
Congenital breast, 649–654
ectopic polymastia, 652
gynecomastia
causes o , 651
classi cation o , 650
complication a ter correction o , 651
development o , 650
incidence o , 650
and incidence o breast cancer, 651
and multiple disease states, 651
in neonate, 651
role o liposuction in, 650
surgical management o , 650
juvenile breast hypertrophy, 651
Poland syndrome, 652
polythelia, 652
tuberous breast de ormity, 653
unilateral hypoplasia, 653
Congenital ear de ormities, 635–641
antihelical old, 639
arterial blood supply to ear, 636
concha, 636
conchal hypertrophy, 640
conchomastoid sutures, 640
constricted ear, 640
cryptotia, 640
ear growth, normal, 635
ear size, normal, 640
ear taping, 639
external auditory meatus, 635
innervation o ear, 636
microtia, 637
Mustard`e sutures, e ect o , 640
otoplasty surgery complication, 640
prominent ear de ormity, 639
total ear reconstruction, stages in, 637
triangular ossa, 636
venous drainage o ear, 636
Congenital hand surgery, 657–664
Apert syndrome, 664
camptodactyly, 662, 662
clinodactyly, 661, 661
congenital trigger thumb, 662
constriction ring syndrome, 660
macrodactyly, 662
opponensplasty, options or, 663
Poland syndrome, hand mani estations o , 664
polydactyly, 659
radial, 658, 658
types o , 658
ulnar, 658
radial club hand, 663
radial thumb de ciency, 664
short digits, treatment options or, 661
surgical release o rst webspace, method or, 660
symbrachydactyly, 661
symphalangism, 661
syndactyly, 660
thumb hypoplasia, 663
web-creep, 660
Congenital nevi, 643–646
acquired nevus, 644
compound nevus, 644
giant nevus, 643
incidence o , 633
intradermal nevus, 644
junctional nevus, 644
large, 645
and leptomeningeal melanoma, 644
nevi o Ota, 645
and risk o melanoma, 644
small, 644, 645
Constricted ear, 56, 881, 882
Core needle biopsy (CNBx), 862
Corrugator muscles, 37
medial aspect o , 35
origin and insertion o , 35
Cottle’s sign, 61
Coup de sabre de ormity, 897
Cranial nerve III, 469
Cranial nerve VII, 542
Cranio acial microsomia, 909
Cranio acial syndromes, 577–582
Apert syndrome, 577, 578
Binder syndrome, 581
Carpenter syndrome, 577
cephalic (or cranial) index, 581
CHARGE association, 582
conotruncal anomaly ace syndrome, 579
cranial expansion in, 581
cranio rontonasal dysplasia, 578
Crouzon syndrome, 577
DiGeorge syndrome, 579
Goldenhar syndrome, 579
harlequin sign, 580
hypertelorism, 581
Kleeblattschädel, 578
lambdoid synostosis, 581
Moebius sequence, 579
Muenke syndrome, 577
Nager syndrome, 578
OMENS classi cation system, 579
P ei er syndrome, 577, 580
PHACE syndrome, 582
Pierre Robin sequence, 578, 579
Romberg disease, 580
Saethre–Chotzen syndrome, 577
Stickler syndrome, 578, 579

1042
Index
Cranio acial syndromes (Contd.)
reacher–Collins syndrome, 578, 579, 582
unicoronal synostosis, 581
van der Woude syndrome, 578
velocardio acial syndrome, 579
Virchow’s principle, 579
Craniosynostosis, 583–594
Antley-Bixler syndrome, 590
Apert syndrome, 589
Baller-Gerhold syndrome, 584, 589
bilateral coronal suture synostosis, 591
brachycephaly, 586
Carpenter syndrome, 589
compensational plagiocephaly, 585
cranial suture usion, 583
cranioscoliosis, 588
Crouzon syndrome, 588
de ormational plagiocephaly, 581, 585
acial suture usion, 583
orehead plagiocephaly, 584
goals o therapy in, 591
incidence o , 583
Jackson-Weiss syndrome, 584, 589
Kleeblattschädel, 590
lambdoidal synostosis, 592
lambdoid synostosis, 587
Melbourne technique, 592
metopic synostosis, 591
Moss’s unctional matrix theory, 583
operative and postoperative complications o , 593
orthotic cranioplasty, 591
osteoblast-derived growth actors, role o , 584
P ei er syndrome, 589
Saethre-Chotzen syndrome, 577
sagittal synostosis, 591
scaphocephaly, 586
surgical intervention or, 590
synostotic orehead plagiocephaly, 584
trigonocephaly, 586
unilateral coronal suture synostosis, 591
CRES syndrome, 953, 961
Cricothyroidotomy, 864
“Crocodile tears,” 460
Cross- acial nerve gra ting, 463, 472
Crouzon’s syndrome, 905
Cryptotia, 746, 881, 882, 918
Cubital tunnel, 315, 317
Cubital tunnel syndrome, 317, 943
compressive structures in, 317
Froment’s sign, 315
Martin–Gruber anastomosis, 317
Riche–Cannieu anastomosis, 317
Cup ear, 919
Curling’s ulcer, 736
Cushing’s triad, 864
Cutis aplasia, 978
Cutis laxa, 42, 961, 975
Cymetra, 103
D
Dacryocystorhinostomy, 883, 885
De Curtorum Chirurgia per Insitionem, 10
Deep posterior compartment, 817
Deep temporal ascia (D F), 449
Deep vein thrombosis (DV ), 862
De nitive so t-tissue reconstruction, 820
Dental anatomy and occlusion, 523–532
Angle classi cations, relationship in, 529, 529
dental terminology, 527, 527
occlusal relationships, 526, 528, 528
openbite, 528, 528
parts o tooth, 525, 525
sur aces o teeth, 526, 526
teeth, types o , 523, 523
Universal Numbering System, or dentition, 524
de Quervain’s syndrome, 264
Dermabrasion, 75
Dermalogen, 101
Dermatochalasis, 17, 885
Dermato broma, 959
Dermoid cyst, 899
Depressor muscles, o brow, 30
Descriptive statistics
dispersion, measures o , 854
interquartile range, 854
mean, 853
measures o central tendency in, 853
median, 853
mode, 854
range, 854
standard deviation, 854
standard error, 854
Dexmedetomidine (precedex), 864
Dextran, 702
Digital arteries, 262, 263
Digital replantation, 403–408
arterial insuf ciency a ter, 404
arteries and veins or, 406
avulsion amputation, 406
contraindications to, 406
digital reoperation a ter, 407
ailure causes, 404
uorimetry, 407
goal o , 403
indications or, 403
lumbrical plus de ormity, 404
maximal cold ischemia time or, 405
Moberg ap, 406
multiple digit replant order, 404
nerves or nerve gra ting, 404, 405
no-re ow phenomenon, 408
PIP joint arthroplasty, 407
preoperative workup, 403, 404
and prophylactic asciotomies, 405
quadriga e ect, 405
ray amputation o index nger, 404
red stripe sign, 406
skeletal stabilization in, 404
thumb tip amputation, 405
veins on hand dorsum, 406
venous congestion a ter, 405
Diplopia, 25
Direct brow li t, 38
Distal radioulnar joint (DRUJ), 354
Distraction Osteogenesis, 619–623
advantages o , 619
clinical indications or mandibular distraction, 621
clinical phases o , 621
concept o , 619
de nition, 619
disadvantage, 620
ailure o , 621
growth actor, role o , 620
mandibular, 622
o mid ace, 623
palatal distraction, indications or, 623
zones o , 620
DNA microarray, 168

Index
1043
Dongyue, Yang, 415
Dorsal intercalated segmental instability, 929
Dorsoventral development, limb bud, 250
Double chin, 48
Double crush syndrome, 313
Doxorubicin extravasation, 958
“Dual plane” augmentation, 145
Ductal carcinoma in situ (DCIS), 164–165
breast-conserving therapy in, 165
margin-negative excision o , 164
recurrence o , and treatment, 165
treatment options or, 164
Dupuytren disease, 305
and carpal tunnel syndrome treatment, 308
cause o , 305
collagen in, 306
dermato asciectomy, 311
di erential diagnosis or, 308
diseases associated with, 305
extension and recurrence o , 311
and Garrod’s nodes, 307
hallmark o , 307
MCP joint exion contracture in, 307
nonsurgical treatments or, 308–309
percutaneous needle asciotomy, 310–311, 310 –311
PIP joint exion contracture in, 307
postoperative management in, 312
risk actors or, 306
skin gra ting, indications or, 311
surgical treatment o , 309, 312
tabletop test, 309
Dupuytren’s diathesis, 306
Dupuytren’s disease, 941
E
Ear, 880–883
anatomy o , 743–744, 743
block with local anesthesia, 51
burns, 745
constricted, 881
embryologic origin o , 51
hematomas, 48
hematomas, 745
inclination o , 52
innervation o , 745
Stahl’s, 56
temporal scalp, angle, 52
vascular supply o , 51
Ear prominence, 53, 880
Ear reconstruction, 743–750. See also Ear
anesthesia o , 745
Antia-Buch reconstruction technique, 747, 747
autogenous, 750
Banner ap, 748
or conchal bowl and helical root, 747
Converse’s tunnel procedure, 747
cryptotia, 746
or de ects o middle one-third o the ear, 748
de ects o skin and perichondrium, repair o , 746
Die enbach’s ap, 748, 748
ear burns, treatment or, 745
rostbite, treatment or, 745
hematomas, 745
innervation o , 745
lobular reconstruction, 749
lymphatic drainage o , 744
malignancies o , 745
otoplasty goals, 746
partial ear amputation, 749
split earlobe, 749
Stahl’s ear, 746, 746
anzer’s excision, 747
temporoparietal ascial ap, use o , 749
total ear amputation, 749
tubed pedicle technique, 747
vascular supply o , 744
Ear replantation, 411
Ectrodactyly, 938
Ehlers–Danlos syndrome, 961, 975
Eikenella corrodens, in human bite wounds, 294
ElectroMyoGraphy (EMG), 461
ElectroNeuroGraphy (ENoG), 461
Elevator muscles, o brow, 30
Elson test, 261
Embolization, 671
Enchondroma, 931, 949
Endoscopic brow li t, 35, 39
brow support during, 39
plane o dissection in, 39
relative contraindications or, 38
sentinel vein, 38
and unilateral brow paralysis, 39
Endoscopic carpal tunnel release, 320
Enophthalmos, 23–24
Entropion, 17
Ephelides, 969
Ephelis, 983
Epiblepharon, 886
Eponychium, 252, 252 , 344
Erb palsy, posture o , 366, 366
Erb’s point, 371
Error, types o , 858
Er:YAG laser, 96
Erythroplasia o Queyrat, 975
Estrogen, 140
Ethmoid sinus, 481
Evidence-based medicine, 858–859
de nition o , 858
levels in, 858–859
Evolence, 101
Expander-implant and nipple-areolar reconstruction, 181–191
Becker implant, 184
breast pocket, overexpansion o , 184
complete submuscular coverage, 183
contraindications to, 182
delayed breast reconstruction, 181
expansion process a ter surgery, 184
goals o , 190
immediate breast reconstruction, 181
implant types, 184
indications or, 182
indistinct in ramammary old, techniques or, 186
local aps, or nipple reconstruction, 187, 188 , 189
nipple position in emales/males, 191
nipple projection, 190, 191
nipple reconstruction, techniques or, 187
nipple sharing and complications, 189
premature removal, causes o , 185
problems with, 183
procedure or breast reconstruction, selection o , 181
tattooing work, 191
techniques or, 186, 191
tissue expander
placement o , 183
types o , 182
tissue expansion and skin ap viability, radiation e ect on, 185
EXPAREL, 281
Extensor system, hand, 259–261, 260 , 261

1044
Index
Extensor tri urcation, 339
External beam radiation, 220
Extra octave racture, 257
Eye, 883–887
Eyelids
anatomy o , 19–23
anterior lamellae, 18, 20
at pockets, 19
lateral canthus, 19
lateral retinaculum, 19
lower lid ligamentous system, 19
posterior lamellae, 18, 19
tarsoligamentous structure, 19
aqueous layer o , 21
Asian vs. Caucasian, 22
cancers o , 24
carotid artery supply to, 19
constrictor muscles o , 31
elevator muscles o upper eyelid, 31
innervation o , 20
layers o the, 18
lymphatic drainage or, 21
oil-secreting glands o , 21
Eyelid surgery, aesthetic and reconstructive, 751–759
A- rame de ormity, 755
aged eyelid, 751
Asian eyelids and Occidental eyelid, di erences between, 753
Bell’s phenomenon, 752
blepharochalasis, 753
canthopexy, 758
canthoplasty, 758
chemosis, 759
Cutler-Beard ap, 755
dermatochalasis, 753
double vision/blurry vision a ter eyelid surgery, 759
Fasanella-Servat procedure, 754
at redistribution, 758
at resection in lower eyelid, 758
atty compartments
in lower eyelid, 752
in upper eyelid, 752
Hewes ap, 755
Hughes ap, 755
lacrimal sac, 752
laophthalmos, 756
lamellae o eyelid, 751
levator unction, degrees o , 753
lid de ect, reconstruction o , 754
lower lid cosmetic, 756–759
lower lid malposition/ectropion, treatment o , 759
Mustarde’ ap, 745
open sky technique, 755
orbicularis oculi muscle
anatomy o , 751
unction o , 752
innervation o , 753
orbicularis oculi muscle, anatomy o , 751
orbitomalar ligament, 758
ptosis repair, methods o , 753
retrobulbar hematoma, 758–759
skin-muscle ap, 757
transconjunctival lower lid blepharoplasty, 756–757
upper lid blepharoplasty, 753, 755–756
upper lid cosmetic, 755–756
Whitnall’s tubercle, 752
F
Face, 887–891
Faceli t, 41–49
approaches to, 45
complications o , 48
contraindications to, 42
and hollowed outlook o cheek, 43
incisional approaches to, 49
less-than-ideal results in, actors or, 41
male and emale ace, di erences between, 43
neck treatment in, 47
nerves and, 46
and retaining ligaments, 44
Facial nerve, 455–464
blood supply to, 456
embryology and anatomy, 455–458
evaluation and rehabilitation, 461–464
extratemporal branches o , 456
landmarks or, 456
pathology, 458–460
Facial paralysis
in adults, 460
in children, 460
eye protection in, 461–462
in neonates, 460
static and dynamic treatment o , 465–473
Facial paralysis, static and dynamic treatment o , 465–473
babysitter procedure, 471
browli t through orehead excision, 469
cosmetic goals o , 467
cross- acial nerve gra ting, 472
unctional goals o , 467
unctional muscle transplantation, 472
lateral tarsorrhaphy, 470
lid weights, 469, 470, 470
lower eyelid with ectropion, 468
lower lip, 469, 472–473
marginal mandibular palsy, 472–473, 473
masseteric branch o trigeminal nerve, 471
McLaughlin temporalis trans er, 471, 471
nasal airway obstruction, 470
nasal aperture, 468
paralyzed brow, 467, 468
temporalis trans er, method or, 470
upper eyelid treatments, 469
upper eyelid with lagophthalmos, 468
Facial skeleton, buttresses o , 443
Facial trauma, 443–453
racture in children, 443
rontal sinus, 445–446
general, 443–445
imaging or, 444
mandible, 451–453
maxillary racture, 450
nasal, 446
orbit, 446–449
tracheostomy in, 444
zygomaticomaxillary complex, 449
Fasanella-Servat procedure, 884, 886
Fascia, normal, 306
Fascian, 103
Fat embolism syndrome (FES), 122
Felons, 297, 297 , 946
Femoral triangle, 928
boundaries o , 817
Fibroadenoma, 161
Fibrocystic disease, 160
Fillers, 99–104
anterograde injection o , 103
biodegradable, 99
characteristics o , 99
collagen as, 100–101

Index
1045
cosmetic complications o , 104
cross-hatching, 104
discom ort o injection o , reducing o , 103
anning, 104
at as, 100
hyaluronic acid analogues, 101–102
intravascular injection, 104
linear threading, 104
mid ace treatment with, 104
or nasal dorsum and tip, 104
nodule management, 104
permanent, 102
radiesse and sculptra, 102
retrograde injection o , 103
Fine needle aspiration (FNA), 862
Finger buds, 249
Fingertip, 251
First dorsal metatarsal artery (FDMA), 416
First plantar metatarsal artery (FPMA), 415
Fitzpatrick sign, 959
Flag ap, 954
Flaps, 705–710
abductor digiti minimi ap, 709
angiosome, 708
arc o rotation o , 707
de nition o , 697
deltopectoral ap, 707
asciocutaneous, 707
bula ap, 706
orehead ap, 709
gastrocnemius muscle, 705, 708
gluteus maximus muscle, 707
gracilis ap, 706, 707
gracilis muscle, 709
ischemic ap, 707
lateral arm ap, 706
latissimus dorsi muscle, 708
monitoring, 705
muscle, 697, 705
nasolabial ap, 709
omental ap, 709
parascapular ap, 706
pectoralis major muscle, 709
random pattern ap, 709
rectus emoris muscle, 709
sartorius muscle, 705
soleus muscle, 708
tensor ascia lata ap, 709
trapezius muscle, 709
Flexor system, hand, 258–259, 258 , 259
Flexor tendon, 258
Fluorimetry, 407
Forehead, sensory nerves o , 37
Forehead
height o , 38
high, correction o , 38
sensory nerves o , 37
Fractionation, 220
Fractures/dislocations, 327–332
Bennett’s racture, 328
Boxer’s racture, 329
carpal bone ractures, 329
carpal instability nondissociative, 330
Gilula’s lines, 331
greater arc injury, 330
hook o hamate nonunion, 331, 332
Jahss maneuver, 332
lesser arc injury, 330
metacarpal sha t ractures, 327
phalangeal ractures, 328
o PIP joint, 328
Salter–Harris classi cation o physeal injuries, 331
scaphoid racture, 329, 331
scaphoid humpback de ormity, 329
scapholunate angle, 330
scapholunate dissociation, 330
snu box tenderness, 329
space o Poirier, 329
Stener lesion, 328
erry-T omas sign, 330
Watson’s scaphoid shi t test, 330
Free radicals, 218
Frey’s syndrome, 460, 915
Frontalis muscle, 37
Frontal sinus, 481
Frontal sinus ractures, 445–446, 920
Frontalis sling, 23, 24
Frostbite, 745, 960
Furnas technique, 881
G
Gail model, modi ed, 157
Galactocele, 160
Gamma rays, 217
Gantzer’s muscle, 321, 437
Garlic supplements, e ect on surgery, 956
Garrod’s nodes, 307
Gender con rmation surgery, 835–839
breast binding, 837
estrogen hormone therapy, 837
or acial eminization, 839
or acial masculinization, 839
or emale-to-male individuals, 836, 838
eminization hormone therapy, 836
gender dysphoria, 835, 836
gender identity, 835
intestinal transplantation, 837
or male-to- emale individuals, 837
male versus emale chest, 836
masculine versus eminine, 838–839
masculinization hormone therapy, 836
metoidioplasty, 838
nerve coaptations, options or, 838
phalloplasty, ap options or, 838
sexual reassignment surgery (SRS), options or, 837
thyroid chondroplasty reduction, 839
transsexualism, 835, 836
vaginoplasty, 837
vascular anastomoses, options or, 838
voice surgery, 839
Gender dysphoria, 835
Giant cell tumors, 952, 955
Giant congenital nevus, 976
Giant broadenoma, 161
Gibson’s principle, 54
Gillies, Harold Del , 9, 11
Glabellar rown lines, 37
Glasgow coma scale (GCS), 866
Gluteal augmentation, 118
Goldenhar syndrome, 881
Gore- ex, 103
Gorlin syndrome, 896
Graham and Gault otoplasty technique, 881
Grayson’s ligaments, 253, 940
“Growing” skull racture, 444
Guillain–Barrè syndrome, 459
Gummy smile, 900
Gustilo classi cation system, 819

1046
Index
Guyon’s canal, 254, 315, 318
Gynecomastia
chronic diseases associated with, 234
clinical etiologies o , 232
complications with surgical resection, 237
de nition o , 231
drug-induced, 233
amilial, 232
gonadotropins levels and, 234
hallmark location o , 231
with hyperthyroidism, 234
incidence o , 231
liposuction or, 236
in liver tumor patients, 234
male mastectomy, 237, 238
medical treatments or, 236
newborn, 232
pathologic, 232
prolactin level in, 236
pseudogynecomastia, 231
pubertal, 232, 233
radiation or reducing o , 236
radiographic modalities or, 235
saucer de ormity, 238
senescent, 233
Simon classi cation o , 231
surgical options or, 236
symptomatic, 232
and tamoxi en use, 236
H
Hair removal/transplantation, 107–113
androgenic alopecia, 108
complications, 110
donor site area, 108
donor site dominance, 108
hair growth cycle, phases o , 109
laser hair removal, 112–113
male pattern alopecia, 107, 109
micro- ollicular gra ting, 109
microgra t, 109, 110
minigra t, 109, 110
Norwood and Hamilton grading systems, or male alopecia, 108
punch gra t, 109, 110
scalp reduction, 110–111
selective photodermolysis, 112
selective photothermolysis, 112
standard gra ts, 109
tissue expansion, 111
Halothane, 280
Hand anatomy
anastomoses, 264
bones and joints, 255–256, 256
bursae and spaces, 255
and compression syndromes, 264
extensor system, 259–261, 260 , 261
ascia and ligaments, 253–254, 254
exor system, 258–259, 258 , 259
and ractures, 257
muscles, 252–253
nail and nail bed, 252, 252
nerves, 262–263
so t tissue, 251
sur ace anatomy, 251, 251
vascular, 261–262
Hand compartment syndrome, 942
Hand embryology
axes o development, 250
congenital de ormities, 250
limb, organization o , 249
timing o development, 249–250
tissue di erentiation, 250
Hand in ections, 293–304
a ter elective hand surgery, 302
algae in ections, in sherman, 300
area around ngertip and, 296
cellulitis, 294
chronic paronychial in ection, 296
collar button abscesses, 300
cultures requested in, 295
deep spaces o hand and, 299, 299
in diabetic patients, 294, 297
ascial spaces o hand and, 299
elon, 297, 297
herpetic whitlow, 297
in HIV patients, 295
horseshoe abscess, 298
human bite wounds, 294
in immunocompromised patients, 294
interdigital pilonidal cyst, 301
interdigital sub ascial web space, 300
midpalmar space in ection, 301, 302
milker’s node, 301
mimickers o , 300
MRSA in ection, 295
mycobacterial in ections, 303
necrotizing ascitis, 303
osteomyelitis, 303
paronychia, 296, 296
potassium hydroxide preparation, use o , 295
pyogenic exor tenosynovitis, 298
runaround abscess, 296
septic arthritis, 303
site o , 293
sporotrichosis, 302
stains needed in, 295
subcutaneous abscesses, 294
suppurative exor tenosynovitis, 298
axol in ection, 303
thenar space in ections, 300, 301
treatment principle or, 293
Hand tumors, 283–291
benign tumors, 284–289
Aneurysmal bone cyst (ABC), 287–288
desmoid tumors, 286
enchondromas, 286–287
epidermal inclusion cysts, 284
bromatosis, 286
brous dysplasia, 289
giant cell tumors (GC s), 285
juvenile aponeurotic bromas, 286
keratoacanthomas, 285
mucous cysts, 284
neurilemmoma, 285, 286
neuro broma, 285, 286
neuro bromatosis type 1, 286
neuro bromatosis type 2, 286
osteoblastoma, 288
osteochondromas, 288
osteoid osteoma, 288
pyogenic granuloma, 284
unicameral bone cysts (UBCs), 287
biopsy o , 283
imaging modalities, 283
malignant tumors, 289–291
angiosarcoma, 291

Index
1047
bronchogenic carcinoma, 291
chondrosarcoma, 291
dermato brosarcoma protuberans (DFSP), 290
enchondroma, 291
epithelioid sarcoma, 290
Ewing sarcoma, 291
brohistiocytoma, 290
osteogenic sarcoma, 291
peripheral nerve sheath tumor, 290
squamous cell carcinoma, 289
subungual melanoma, 290
synovial cell sarcoma, 290
staging system or musculoskeletal tumors, 289
subungual glomus tumor, 284
Head and neck cancer, 483–490
comprehensive neck dissection, 488
Frey’s syndrome, 486
laryngeal tumors, 486, 487
maxillary de ect reconstruction, 488
modi ed radical neck dissections (MRNDs), 488
orbital oor reconstruction, 488
osteoradionecrosis, 487
parotid tumors, 485, 486
postoperative radiotherapy, indications or, 484
reconstruction plate, use o , 485
selective neck dissection, 488
vascularized bone, as ree ap, 485
Head and neck embryology, 475–481
artery o branchial arch, 476–477
auricle, 480
branchial apparatus, 475, 475
branchial cle t anomalies, 477
branchial cle t cyst, 478
congenital midline nasal mass, di erential diagnosis o , 479
mid ace, 478, 479
nerve o branchial arch, 476–477
nose and upper lip, embyrogenesis o , 479, 479
palate, 480
thyroglossal duct cysts, 480
tongue, 480
Head and neck reconstruction, 509–516
buccal de ects, options or, 512
dental extractions, radiation therapy and, 511
bula ree ap, 510
ap pedicle and anastomotic problems, minimization o , 516
rozen neck, 514
iliac crest ree ap, 510
“in-continuity” neck dissection, 512
mandible reconstruction, 509
mandibular condyle, reconstruction o , 511
microvascular aps, or mandible reconstruction, 510
mid ace reconstruction, ree aps or, 515
mouth, muscles o , 509
oral cavity reconstruction, 512
osteoradionecrosis, 511
partial/total tongue reconstruction, 513
pharyngoesophageal reconstruction, 513, 514
plate reconstruction, disadvantages o , 510
radiation therapy, e ect on normal tissue, 511
recipient vessels or, 516
scalp reconstruction, 516
skull base reconstruction, 515, 515
speech rehabilitation a ter pharyngolaryngectomy, 513
tongue and oor o mouth reconstruction, ap options or, 512
tongue oral cancer, de ects a ter resection o , 513
xerostomia, implications o , 511
Hemangiomas, 557. See also Vascular anomalies
complication o , 557
history, 557
PHACE syndrome, 558
Hematoma, rhytidectomy and, 48
Hemi acial microsomia, 905, 907
Hemophiliac joint, treatment o , 861
HER2, 168
Herceptin (trastuzumab), 170
Hertel exophthalmometer measurement, 22
Hetter phenol–croton oil peel, 78
Hidradenitis, 963, 964
Hillocks o His, 480
Hirudin, 408
Hirudo medicinalis, 408
Homeobox-containing (HOX ) genes, 249
Hordeolum, 887
Hormonal therapy, or breast cancer, 168–169
Horner’s syndrome, 18, 372
Horseshoe abscess, 255
House–Brackmann grading system, 458, 458
Huber opponensplasty, 954
Hunter rod, 338
Hutchinson’s reckle, 980
Hyaluronic acid (HA), 101–102
Hydro uoric acid burn, 979
Hydroquinones, 895
Hyla orm, 101
Hyperhomocysteinemia, 410
Hyperbaric oxygen therapy, 684
Hyperthermia, malignant, 865
Hyponychium, 252, 252 , 344
Hypothalamic–pituitary–adrenal (HPA), unction o , 865
Hypothenar hammer syndrome, 262, 938, 941
Hypothenar muscles, 253
I
Ice-pick acne scars, 895
Implant-related in ections, 90
In raorbital rim augmentation, surgical approaches,
88
In raorbital rim implant, 88
In antile digital bromatosis, 927
In ltration and extravasation injuries, 841–849
calcinosis cutis, 847
and calcium chloride, 847
calcium extravasation, interventions or, 847
complications rom, 842
de nitions, 841–842
di erence between, 841
DNA-binding agents, 848
doxorubicin extravasation, 848–849
epidemiology, 842
Gault technique, 846
grades o , 844
hyaluronidase or, 845–846
interventions or mannitol, 847
interventions or PN, 847
irritant, 841, 842
necrosis interval, 846
non–DNA-binding agents, 848
nonirritant, 841
pathophysiologic mechanisms o , 843
phenytoin extravasation, treatments or, 848
prevention, 842
purple glove syndrome, 848
recall e ect, 848
risk actors or, 842
signs and symptoms o , 844
surgical intervention, 846

1048
Index
In ltration and extravasation injuries (Contd.)
treatment o , 844–849
vesicant, 841, 842
In ammatory breast cancer, 172
Integra, 958, 964
Internal mammary vessels, 214
or microvascular anastomosis, 200
Intersection syndrome, 946
Intracranial pressure (ICP), 863, 866
Intraductal papilloma, 161
Intrinsic plus de ormities, 951
Invasive breast cancer, 165–168
adjuvant chemotherapy, 167
contraindications or breast-conserving therapy in, 166
lumpectomy, 166
modi ed radical mastectomy, 166
preoperative chemotherapy, 168
radical mastectomy, 166
recommended workup a ter diagnosis o , 165
sentinel lymph node biopsy, 167
simple mastectomy, 166
Stage I and Stage II, treatment or, 165–166
Isogra t, 727
Isolagen, 103
J
Jersey nger racture, 257, 335
Joe Hall Morris device, 452
Jones I test, 448, 883, 884
Jones II test, 448, 883, 884
Juncturae tendinae, 261
Juvederm, 102
Juvenile rheumatoid arthritis (JRA), 362, 363
K
Kanavel’s signs, 255, 936
Kaplan’s line, 320
Kaposi orm hemangioendothelioma, 668
Kasabach-Merritt syndrome, 981
Kazanjian, Varaztad H., 11
Keloids, 681–682
earlobe, 682
and hypertrophic scars, di erence between, 681
intralesional steroid therapy or, 682
and normal scar tissue, 681
partial-thickness burn scar, 682
radiation therapy or, contraindications to, 682
scarless wound healing, 682
Keratoacanthomas, 967, 979
Kienbock disease, 397–398, 953
Kite ap, 950
Kkline elter’s syndrome, 235
Klippel-Feil syndrome, 912
Klippel– renaunay syndrome (K S), 672, 929, 964
L
Lagophthalmos, 23
Lambdoidal craniosynostosis, 914
Lambdoid synostosis, 922
Landes angle, 922
Langer’s lines, 534
Laser, 91–96
basic concepts in, 91, 111–113
continuous wave (CW) laser, 92
energy, 91
uence, 92
optimal pulse duration time, 91
power, 92
power density, 92
properties, 91
pulsed laser, 92
pulse energy, 91
Q-switched laser, 92
thermal relaxation time, 91
clinical applications, 92–96
ca é-au-lait spot treatment, 93
CO2 lasers, 96
Erbium:YAG laser, 96
selective photothermolysis, 92
tattoo removal, 94
tretinoin, use o , 95, 894
Latency, 313
Lateral compartment, 817
Lateral digital sheath, 941
Latissimus dorsi (LD) ap, 196
advantages o , 198
blood supply and classi cation o , 197
disadvantages o , 198
skin paddles or, 198
variations o , 198
Latissimus dorsi muscle
origins and insertion o , 197
Ledderhose’s disease, 305
Leech therapy, 408, 985
Lejour reduction mammaplasty, 874
Levator aponeurosis dehiscence, 885
Levator unction, evaluation, 22
Lidocaine, 409
Li eboat veins, in microsurgical breast reconstruction, 215
Limb buds, 249, 250
Liposuction, 120–122
complication o , 121
death ollowing, 121
lidocaine toxicity, 121, 122
subcutaneous in ltration techniques, 120
superwet and tumescent techniques, 120
tumescent solution, 120
ultrasound-assisted, 121
zones o adherence, 121
Lip reconstruction, 785–791
Abbé ap, 789, 790
cheiloscopy, 785
complications o , 790
Estlander ap, 790
etiology o commissure wounds, 791
Gillies an ap, 544
goals o , 787
in raorbital nerve block, 786
Karapandzic ap, 789, 790
lips
anatomic landmarks o , 785
blood supply to, 541, 786
embryologic development o , 793
lymphatic drainage rom, 786
motor innervation to, 786
sensory innervation to, 786
lip-switching, 789
mental oramen, 787
perioral subunit principle, 785
primary closure, 787
principles used in, 787
subunit principle, 785
vermilion lesions, treatment o , 788
Lip replantation, 411
Littler ap, 936
Lobular carcinoma in situ (LCIS), 164

Index
1049
Local and regional aps, or head and neck reconstruction, 533–550
cheek reconstruction, 545–548
aesthetic zones o cheek, 545
cervico acial aps dissection, 546
cervicopectoral ap, 545, 546
deltopectoral ap, 547
in erolaterally based cervico acial aps, 546
internal mammary artery per orator (IMAP) ap, 547
Juri’s cervico acial ap, 546
lower trapezius ap, 548
platysma turnover ap, 548
sternocleidomastoid ap, 548
sternocleidomastoid muscle ap, 548
submental ap, 546
temporalis muscle ap, 548
trapezius muscle, vascular supply to, 548
general reconstruction principles, 533–537
A-to- ap/O-to- ap, 537, 537
bilobed ap, 534, 534 , 535
Burow’s triangle, 534
Du ourmentel ap, 535, 535
extended V-Y advancement ap, 536, 536
local aps, pre erence or, 537
reconstructive elevator, 533
reconstructive ladder, 533
rhomboid ap, 535, 535
tissue movement o local aps, modes o , 533
lip reconstruction, 541–545
Abbe ap, 543, 544
blood supply to lip, 541
complications o , 542
Estlander ap, 543, 544
acial artery, 542–543
FAMM ap, 543
Gillies an ap, 544
goals o , 542
Karapandzic ap, 544
lower lip, primary closure o , 542
replacement o vermilion tissue, 543
strategies used in, 543
upper lip, primary closure o , 542
nasal reconstruction, 537–541
alar wings, support or, 541
auricular composite gra t, 541
bilobed ap, 539
blood supply to external nose, 537
columella, option or, 541
contour classes or nasal subunits, 538
rontonasal ap, 540
glabellar ap, 540
innervation to external nose, 537
nasal de ects, management o , 538
nasal lining replacement, options or, 540
nasal tip, blood supply to, 538
nasolabial ap, 539
paramedian orehead ap, 540
rhinophyma, etiology o , 541
single-lobed aps, 539
scalp and orehead reconstruction, 549–550
blood supply to scalp, 549
Crane principle, 550
orehead de ects, local aps or, 549
rotation-advancement aps, 550
vessels or scalp survival, 549
Local anesthetics
allergic reactions to, 272
amide, 268, 269
and conduction block, 266–267
epinephrine, use o , 271
ester, 268
groups o , 267
lidocaine, use o , 270–271
and methemoglobinemia, 271
onset o , 268
pain rom, minimization o , 267
or peripheral nerve blocks, 271
pharmacological activity o , 268
pH o solution o , 267
pKa o , 268
and sequence o blockade, 267
structure o , 267
toxicity o , 269
cardiovascular system, e ect on, 270
CNS toxicity, 270
dose o lidocaine with epinephrine, 271
dose o lidocaine without epinephrine, 270
epinephrine, addition o , 269
seizures ollowing CNS toxicity, 269
systemic reactions, prevention o , 270
Long ace syndrome, 900
Lop ear, 919
Lower extremity, 819
Lower extremity salvage/reconstruction, 820
Lower extremity reconstruction, orthopedic concepts, 823–829
acute osteomyelitis, 829
bony gap/de ect in tibia, 828
bony sarcomas, 825
Charcot oot, 824
compartments exist in thigh and leg, 823–824
compartment syndrome, 828
Girdlestone procedure, 825
Gustilo’s classi cation o open tibial ractures, 826
limb-threatening lower extremity injury, 826
Lis ranc amputation, 828
mangled extremity severity score (MESS) classi cation, 826
peroneal nerve injury, 825
Symes amputation, 828
Lower extremity replantation, 411–412
Low–molecular-weight heparin (LMWH), 868
Luckett procedure, 881
Luck’s classi cation, o disease, 306
Lumbrical muscles, 258
Lumbrical plus de ormity, 945, 948
Lunula, 252, 252
Lymphatic mal ormation, morbidity, 670
Lymphedema, 811–815, 927
Charles procedure, 815
complication o , 813
diagnosis o , 813
excisional procedures or, 814
lymphaticovenous anastomosis, 815
Meige disease, 813
Milroy disease, 813
operative intervention or, 814
physiological procedures or, 814
primary, 812
secondary, 813
treatment or, 814
types o , 812
Lymph node, levels o axillary dissection, 167
M
Macrostomia, 907
Madelung’s disease, 893, 948
Ma enide acetate (Sul amylon), 739
Ma ucci syndrome, 931

1050
Index
Magnetic resonance imaging (MRI)
or breast cancer, 159–160
or upper extremity tumors, 283
Malar augmentation
complication, 89
surgical approaches, 89
Malar at pad, 43
Malar region, zones o , 890
Male breast cancer, 170
Malignant hyperthermia, 865
Malignant melanoma in situ (MMIS), 568
Mallet nger, 340–341
Mallet nger injuries
classi cation o , 341
types o , 341
Mallet ractures, 327
Mandible ractures, 451–453, 922
Mandibular, excess, 900
Mandibular reconstruction, 765–775
anatomy, 765
Andy Gump de ormity, 766
blood supply, 765
condylar implants, risk o , 771
condylar reconstruction, options o , 771
dental implants, 771
double-barreled bula, 772
bula, blood supply to, 771
ree bula ap or, 772
unction, 765
goals o , 765
iliac crest or, 770 , 773
indications or, 766
miniplates, use o , 767
nonvascularized bone gra ts, use o , 766
options or, 766
osseocutaneous bula ap, 772
osseointegrated implants, 771
osteoradionecrosis (ORN)
resection and reconstruction o , 768
use o hyperbaric oxygen or, 768
peronea arteria magna, 773
primary osseointegration, 771
radial orearm ap, 774–775
reconstruction plate extrusion, risk actors o , 766
reconstruction plate use, 767
scapular ap, 774
so t tissue aps or, 767
Manner elt lesion, 932
Manner elt–Norman syndrome, 358
Mann–Whitney U-test, 857
Marcus–Gunn pupil, 447
Marjolin’s ulcer, 973
Martin–Gruber anastomosis, 264, 317
Mastectomy, borders o , 176
Maxillary excess, 915
Maxillary ractures, 450
Maxillary sinus, 481
McCune Albright’s syndrome, 922
Mechanical creep, 685
Meckel’s cartilage, 923
Median nerve compression in elbow/ orearm,
320
Melanoma, 567–573
ABCDEs o , 567
in Asian populations, 573
biopsy technique choices or, 571, 573
in black Americans, 573
complete axillary lymph node dissection, 571, 572
ollow-up/surveillance or, 572
metastatic to lymph nodes, 572
prognostic actors associated with, 570
recommended surgical resection margins or, 568
risk actors or development o , 567
sentinel lymph node biopsy, 568, 571
sites o distant metastasis, 571
staging system or, 569
subungual, 573
survival rates associated with, 570
Melanonychia, 928
Melkersson–Rosenthal syndrome, 459
Mephisto brow, 36
Metacarpal sha t ractures, 327
Metacarpophalangeal (MCP) joint, 261, 307
Metoidioplasty, 838
Microdermabrasion, 75
Microgenia, 888, 890
Microsurgery, 697–705
adventitial stripping, 698
anastomosis in, 700, 701, 701
aspirin, use o , 702
computed tomography angiography (C A) in, 705
contraindications to replantation, 704
dextran, use o , 702
end-to-side anastomosis, 698, 701
ree ap monitoring, 699
heparin use, 702
microvascular ree aps, 697
microvascular surgery, in children and elderly, 705
microvascular suture, 700
no-re ow phenomenon, 702
streptokinase, use o , 703
supermicrosurgery, 701
thrombolytic agents, working o , 702
Virchow’s triad, 703
Microsurgical breast reconstruction, 211–215
Microvascular anastomosis, 700, 700
Midpalmar space, 301, 302
Milroy’s disease, 983
Minimal access cranial suspension (MACS) li t, 891
Moberg ap, 948, 955
Mobile wad, 253
Mondor’s disease, 160
Montgomery glands, 138
Mucous spot test, 23
Mucoepidermoid carcinoma, 493, 494
Muir- orre syndrome, 979
Murray, Joseph, 727
Mustarde otoplasty approach, 881
Mustardé sutures, 53
Myasthenia gravis, 24
Myelin sheath, 266
N
Nager syndrome, 917
Nasal, 446
Nasal bone spur, 62
Nasal reconstruction, 761–764
aesthetic subunits o nose, 761
bilobed ap, 762, 762
cartilage warping, prevention o , 762
dorsal nasal ap, 762
orehead ap, 763
ull-thickness nasal de ect, reconstruction o , 761
nasal lining, selection o , 763
nasolabial ap, 763
role o ree microvascular tissue trans er in, 764

Index
1051
septal mucoperichondrial aps, 764
subunit principle, 761
Nasal trauma, 446
Natatory cord, 950
Natatory ligaments, 253, 307
National Cancer Institute (NCI) Breast Implant Study, 153
National Comprehensive Cancer Network (NCCN) guidelines, on risk
o breast cancer, 157
Neck, trauma zones o , 865
Negative Pressure Wound T erapy (NPW )
basics o
contraindications to, 687
de nition, 686
draining wounds, 687
e ect wet, 687
indications o , 686
introduction o , 686
maintain wound homeostasis
principle o , 687
clinical uses o
enterocutaneous stulae, 690
extremity compartment syndrome, 690
prevention, 690
wave orms, 688
wound–inter ace material, 688
Negative predictive value (NPV), 859
Negative vector de ormity, 89
Nerve action potentials (NAPs), 374
Nerve blocks
axillary brachial plexus block, 274
Bier block, 275
brachial plexus blocks, 273
central nerve blockade, 279
digital block, 276–277
elbow block, 276
in raclavicular brachial plexus block, 274
interscalene brachial plexus block, 273
metacarpal block, 276
peripheral nerve blocks, 276
postoperative neuritis, causes o , 276
regional anesthesia, use o , 272
stellate ganglion block, 279
supraclavicular brachial plexus block, 274
wrist block, 276
Nerve cell
action potential o , 266
conduction in myelinated neurons, 266
depolarization o membrane, 265
ionic relations in, 265
membrane repolarization, 266
node o Ranvier, 266
re ractory period, 266
resting potential o , 265
Nerve compression syndromes, 313–324
cubital tunnel compression, 315–318
median nerve compression, 318–321
radial nerve compression, 322–324
thoracic outlet syndrome, 314–315
ulnar nerve compression, 314–318, 316
Nerve injury/repair, 48
classi cation and assessment, 430–432
advancing inel’s sign, 431
clinical tests or nerve unction, 432
motor nerve injury, 431
sensory nerve injury, 431
peripheral nerve entrapment syndromes, 434–439
anterior interosseous syndrome, 437
carpal tunnel, anatomic borders o , 436
cavernous nerves, 438
clawing o hand, 436
erectile unction a ter radical prostatectomy, 439
Froment’s sign, 435
interscalene triangle borders, 434
laceration o ulnar nerve in distal orearm, 436
Martin-Gruber anastomosis, 437
median nerve, sites o compression o , 436
peripheral nerve decompression, complication a ter, 439
posterior interosseous nerve syndrome, 438
pronator syndrome, 436, 437
radial nerve, site o compression o , 438
radial tunnel syndrome, 438
Riche-Cannieu anastomosis, 437
suprascapular nerve entrapment, 435
tarsal tunnel, 438
thoracic outlet syndrome, 434, 435
ulnar nerve entrapment, 435
Wartenberg’s sign, 435
peripheral nerves, anatomy o , 429–430
treatment o , 432–434
collagen conduits, 434
donor nerves or nerve gra ting, 433
epineural repair, 432
group ascicular repair, 432
nerve gra ts, 433
nerve trans er, 434
neuromas, 434
secondary nerve repairs, 433
Nerve o Jacobson, 894
Neuropraxia, 460
Neurotmesis, 460
Nevus ammeus neonatorum, 898
Nevus o Jadassohn, 983
Nicoladoni, Carl, 415
Nipple–areolar complex, 873
Nipple-sparing mastectomy (NSM), 179–180
Node o Ranvier, 266
Nonparametric tests, 857
Nose, 877–880
blood supply to tip o , 60
bony base width and alar base width o , 63
external nasal valve, 62
internal nasal valve, 61
keystone area, 61
lateral nasal vessels, 60
lobule-to-nostril ratio, 63
nasal dorsum, 64
nasal vaults, 60
scroll area, 61
septum, 61
skin o , 59
tension, 60
tip supporting mechanisms o , 61
turbinates, role o , 62
Null hypothesis, 858
O
Oberlin trans er, 375, 376
Oblique retinacular ligament, 340
Obstetrical brachial plexus injuries, 365–368, 377–378
cause o , 365, 377
Cesarean section (C-section) against, 366
children with partial lesions, treatment o , 378
classi cation system or, 367
Erb palsy, posture o , 366, 366 , 377
actors during birth associated with, 365
etal actors associated with, 365

1052
Index
Obstetrical brachial plexus injuries (Contd.)
Horner’s syndrome in, 367
incidence o , 365, 366
Klumpke’s palsy, 377
maternal actors associated with, 365
modi ed Mallet classi cation system or, 367
phrenic nerve palsy in, 367
studies to evaluate, 367
surgery in, 368
types o , 366
Oculocardiac re ex. See Aschner phenomenon
Ollier’s disease, 287, 931
Open lock de ormity, 901
Oral glossectomy, 796
Orbit
bones o , 18, 443
depth o oor, 446
entrapment, signs o , 447
Jones I test, 448
Jones II test, 448
Marcus–Gunn pupil, 447
medial canthal ligament, 447
orbital apex syndrome, 448
ORIF o , 448
posttraumatic enophthalmos, mechanism o , 449
risk o ectropion, 447
superior orbital ssure syndrome, 448
surgical approaches to, 448
“trap door” pattern o , 447
Whitnall’s tubercle, 446
Orbital apex syndrome, 910, 919
Orthognathic surgery, 625–633
anteroposterior maxillary de ciency, 629
blood supply o maxilla, 631, 631
dento acial analysis, 626
descending palatine artery, 631
acial categorizations, 625
genioplasty, complications o , 632
lateral cephalometric radiograph, 627
long ace syndrome, 629
mandibular de ciency, 629
mandibular excess, 629
mandibular osteotomies, complications o , 631
open bite de ormity, 630
osteotomies per ormed in, 625
phases o distraction osteogenesis, 630
short ace syndrome, 629
skeletal relationships, classi cations o , 626
treatment planning or, 627
vertical maxillary changes, 630
Osborne’s ligament, 928
Osler-Weber-Rendu syndrome, 965
Osseous genioplasty, 914
Osteoinduction, 86, 925
Osteoradionecrosis, 222–223
Otoplasty, 51–57. See also Ear
age or, 50
anesthesia or, 51
antihelical old, de ciency in, 53
C-M sutures, 54
complications o , 57
conchal excess, 54
conchal reduction, 54
Gibson’s principle, 54
headbands, use o , 56
hidden helix, 56
indications or, 52
in ection a ter, 57
lobular setback, techniques o , 55
markings or, 53
Mustardé sutures, 53
nonsurgical technique, 52
nonsurgical molding, 53
and postoperative care, 56–57
Stenström’s technique, 54
Overbite, 906
Overjet, 906
Oxytocin, 140
P
Pachydermoperiostosis, 895
Paget’s disease o breast, 171–172
Pancoast tumor, 863
Papaverine, 409, 699
Parametric tests
ANOVA, use o , 856, 857
continuous variables, analysis or, 855
correlation, 856
omnibus F-test, 856
partial correlation, 856
planned contrasts, 857
posthoc tests, 857
range or r in, 856
regression analysis, 855
statistic or correlation in, 856
statistic or regression in, 856
t -test, use o , 856
Paranasal augmentation
role or, 89
surgical approaches, 89
Parkes–Weber syndrome, 672, 965
Parona’s space, 937
Paronychia, 252
Particle therapy, 220
Pasteurella multocida, in animal bite wounds, 295
Pearson’s chi-square test, 857
Peau d’orange, 32, 172
Pectoralis major muscle, 137–140, 183
Penis replantation, 412
Phenol elimination, 84
Percutaneous needle asciotomy, 310–311,
310 –311
Per orator aps, 713–724
advantages o , 714
anatomical basis or, 713
angiosome, 713
anterolateral thigh ap, 716–718
arterial source o , 713
or breast reconstruction, 719
chimeric ap, 723–724
cutaneous vessels, 713
DCIP ap, 721
DIEP ap, 719, 720
donor site, acceptable, 714, 715
examples o , 716
ree-style ree ap, 715
IMA per orator ap, 723
location o , 714, 721
medial plantar per orator ap, 722–723
medial sural artery per orator ap, 721
pedicled per orator ap, 716
per orator thrombosis, 715
reliable per orator vessels, 714
as sensate ap, 716, 719
SGAP ap, 720
supermicrosurgery technique, 715–716

Index
1053
aylor and Daniel, contribution o , 713
thigh aps, 718
thinning o , 715
thoracodorsal artery per orator ap, 724
traditional gluteal maximus myocutaneous ap, 720
true per orator ap, 713
Per orators, 202
Perionychium, 252, 252 , 343–352
anatomy, 343–345, 343
arterial supply, 344
eponychium, 344
germinal matrix, 344
lunula, 344
nail bed, 344
nail old, 344
nail plate, 344
nerve supply, 344
paronychium, 344
perionychium, 343
sterile matrix, 344, 345
in ectious diseases o , 349–351
acute paronychia, 349
bacterial in ection o nail, 350
chronic paronychia, 350
herpetic whitlow, 350–351
onychomycosis, 350
paronychial in ections, 350
medical pathology, 346
chromonychia, 346
clubbing, 346
and oncology, 351–352
benign periungual tumors, 351
glomus tumors, 351
Hutchinson’s sign, 352
mucous cyst, 351
pyogenic granuloma, 351
physiology, 345–346
ngernail, unction o , 345
hyponychium, 345
nail, production o , 345
nail growth, 346
nail plate adherence, 345
surgical pathology, 346–349
avulsed nail plate, 348
hook nail de ormity, 348
longitudinal splitting o nail plate, 346
nail bed injuries, 347
nail bed repair, 347
nail cysts/spikes, 349
nail ridges, 349
nail spikes, 347
nonadherence o nail plate, 349
nondisplaced ractures, 348
onycholysis, 346
pincer nail de ormity, 348
split nail bed gra ts, 348
split nail de ormity, 349
subungual hematoma, 347
trephination, 347
unstable displaced ractures, 348
Periorbital region, 23–25
Peripheral nerves, anatomy o , 429–430
bands o Büngner, 430
basic elements, 429
blood supply sources, 429
ascicular plexus, 429
nerve potential, propagation o , 430
node o Ranvier, 430
saltatory conduction, 430
Wallerian degeneration, 430
Perlane, 102
Pes anserinus, 456
Peutz-Jeghers syndrome, 556
Peyronie’s disease, 305
P ei er’s syndrome, 950
PHACE syndrome, 558
Phalangeal ractures, 328
Phalen’s test, 319
Pharyngocutaneous stula, 222
Pharyngoplasty/pharyngeal aps/speech therapy, 611–617
anterior nasal ricative, 613
Cul-de-sac test, 614
diphthong, 613
ricative, 613
glottal stop, 613
Hynes pharyngoplasty, 616
hypernasality, 613
intravelar veloplasty, 614
levator veli palatini, 611
muscles o velopharyngeal mechanism, 611
nasal endoscopy, 614
Orticochea pharyngoplasty, 616
palatal obturator, 614
palatopharyngeal aps, 616
Passavant’s ridge, 612
patterns o velopharyngeal closure, 612
pharyngeal augmentation, 615
pharyngeal ricative, 613
posterior nasal ricative, 613
posterior pharyngeal ap (PPF), 615, 615
pressure- ow instrumentation, 614
retropharyngeal space, 615
rhinolalia aperta, 612
sphincter pharyngoplasty, 616
stop plosive, 613
tensor veli palatini, 611
velocardio acial syndrome, 615
video uoroscopy, 614
Phenol burns, 979
Phosphorus burns, 979
Phyllodes tumor, 161–162, 877
local recurrence, and treatment, 162
subtypes o , 162
total mastectomy, indications or, 162
treatment or, 162
Pierre Robin sequence, 890, 912
Pilomatricoma, 899
Pincer nail de ormity, 941
Pitanguy’s line, 457
Plastic surgery, 9
contribution to
Celsus, 9
Die enbach, 10
Dupuytren, 11
Galen, 9
Gaspare agliacozzi, 10
Paulus Aegineta, 10
Sushruta, 9
essier, 12
von Grae e, 10
von Langenbeck, 10
decline o , 10
Golden Age o , 12
history o , 9–10
clinical skin gra ting, 11
esthetic/cosmetic surgery, 12

1054
Index
Plastic surgery (Contd.)
ap surgery, 12
general ages in, 9
human skin gra ts, rst, 11
microsurgery, 13
surgical procedures, rst, 9
period o Modern imes in, 11
rebirth o , 10
Renaissance in, 10
World War I and developments in, 12
World War II and, 12
Platysmal bands, 32
“Pocket principle,” 411
Poland syndrome, 140
Porous implants, 87
Porous polyethylene (Medpor), 86
advantages o , 88
disadvantages o , 88
Positive predictive value (PPV), 859
Posterior cord, 371, 373
Posterior de ormational plagiocephaly, 914
Posterior interosseous nerve compression, 323
Posterior interosseous nerve (PIN) syndrome, 323
Posterior interosseous syndrome, 943
Posttransplant malignancies, 864
Prednisone therapy
advantages, 667
disadvantages, 667
Pre abricated polymers, 86
Preganglionic brachial plexus lesion, 370
Pressure sores, 831–834
bacteria associated with, 832
development o , risk actors or, 831
diagnosis o osteomyelitis in, 832
etiology o , 831
Girdlestone arthroplasty, 833
in ections associated with, 832
ischial pressure sores, 833
prevention o , 834
recurrence, 833
sacral pressure sores, 833
sites o , 831
and spasticity, 832–833
stages o , 831
treatment and reconstruction, 832
trochanteric pressure sores, 833
wound healing, 833
Procerus, unction o , 21
Procerus muscle, 36, 37
origin o the procerus muscle, 36
Progeria, 975
Progesterone, 140
Prolactin, 140
Prominent ears, 880
Pronator syndrome, 321, 436–437, 943
Propo ol, 864
Propranolol therapy
advantages, 667
disadvantages, 667
Proteus syndrome, 979
Prothrombin 2021A mutation, 410
Proximal interphalangeal (PIP) joint, 307, 327
Proximodistal development, limb bud, 250
Pseudogynecomastia, 119
Pseudoptosis, 243, 873, 875
Pseudoxanthoma elasticum, 42
Ptosis, 884
Ptotic lacrimal gland, 888
Pulleys, 254
Purple glove syndrome, 848
Pur ox, 29
Pyogenic granuloma, 668
Q
Quadrangular space, 945
Quadriga e ect, 948
Quadriga syndrome, 337
Questions/answers
breast and cosmetic, 871–896
body contouring, 891–893
breast, 871–877
ear, 880–883
eye, 883–887
ace, 887–891
nose, 877–880
skin/lasers, 893–896
comprehensive, 956–986
cranio acial, 896–927
hand and extremities, 927–955
R
Radial club hand, 947, 954
Radial nerve compression, 322–324, 322
Wartenberg’s sign, 324
Wartenberg’s syndrome, 435
Radial tunnel syndrome, 943, 944
Radiation enteritis, 862
Radiation therapy, 217–226
absorbed dose, 218
American Society o Clinical Oncology (ASCO) Guidelines or, 224
basic principles o , 217–220
breast reconstruction and, 224–226
and cranio acial growth disturbances, 223–224
de ned, 217
dose equivalent, 218
ractionation, 220
head cancer and, 221–223
or laryngeal and hypopharyngeal carcinoma, 221
by medical imaging, 219
neck cancer and, 221–223
oncology, 220–221
and reconstructive surgery, 221
and wound healing, 221
Radiesse, 102
Radiosensitivity, 218
Radioulnar development, limb bud, 250
Rapid sequence intubation (RSI), 864
RBC trans usion, indications or, 861
Reconstructive elevator, 533
Reconstructive ladder, 533
Rectus abdominis muscles, unctions o , 211
Re ractory period, 266
Regional anesthesia
advantages o , 272
contraindications to use o , 272
disadvantages o , 272
or upper extremity, 272
Reichert’s cartilage, 923
Rejection, types o , 864
Replantation, 403–412
digital, 403–408
ear, 411
hypercoagulable states, 409–410
leeches and anticoagulants, 408–409
lip, 411
lower extremity, 411–412

Index
1055
penis, 412
scalp, 410
Retin-A, 71, 80–81
Respiratory quotient (RQ), 862
Restylane, 101
Retrobulbar hematoma, 448
Reverse cross- nger ap, 929
Rheumatoid hand, 353–363
Bouchard’s nodes, 354
boutonnière de ormity in, 361
classes o drugs or, 354
Clayton’s procedure in, 360
extensor pollicis longus rupture in, 358
extensor tendon trans ers in, 359
exor pollicis longus (FPL) rupture, 358
exor tenosynovitis, 359
joint involvement in, 354
MCPJ ulnar dri t, steps or, 360
Nalebu classi cation o MCPJ in, 360
pathogenesis o , 353
piano keyboard sign, 358
preoperative evaluation, 353
principles in surgery o , 353
pseudotendon in, 358
scallop sign, 358
stages o , treatment or, 362
surgical sequence in, 353
and swan neck de ormity, 361
thumb de ormity in, 361
total wrist arthroplasty, 356, 357
treatment goals, 353
wrist, e ect on, 354
wrist de ormities with, 355, 355
Rhinoplasty, 59–68, 878–880. See also Nose
autologous cartilage gra ts, sources o , 67
cephalic trim o lower lateral cartilages, 67
columellar strut gra t, 67
dorsal aesthetic lines, 62
endonasal approach, 65
incisions in, 65
indications or, 59
inverted V de ormity, 66
marginal incision, 65
naso rontal angle, 63, 63
open rhinoplasty approach, 65
septal resection, 61
three-point dorsal palpation test, 66
tip gra ts, 67
tip projection, 66
tip rotation, 67
tip suture modi cation, 66
Rhinosporidiosis, 964
Rhytidectomy, 467, 888, 889. See Face li t
complications o , 48
Riche–Cannieu anastomosis, 264, 317
Romberg’s syndrome, 905
Ruben’s ap, 204, 213
S
Saddle nose de ormity, 879
Sagittal bands, 339
Sagittal split osteotomy, 909, 911
Salicylic acid peels, 78
Salivary gland tumors, 491–508
acinic carcinomas, 494
adenoid cystic carcinoma, 493, 494
benign salivary neoplasm, 492
cystic parotid mass in HIV patient, 495
ne-needle aspiration (FNA) or, 497–498, 498
gustatory sweating, 507
histological eatures o salivary glands, 491
incidence o malignancy, 492
lobes o parotid, 500
malignant mixed tumors, removal o , 494
malignant tumor, 492, 493, 494
mucoepidermoid carcinoma, 493
neck dissection or parotid tumors, 505
oncocytomas, 493
parapharyngeal space, 507, 508
parotidectomy, steps o , 501, 501 , 502 , 502–503, 503 –505
parotid tumors, 494–500
pediatric parotid tumors, 494
postoperative radiation therapy, 506
radical parotidectomy, 500
regional metastases in parotid, 506
total parotidectomy, 500, 503, 503
Vernet syndrome, 508
Warthin’s tumor, 492–493, 493
Salvage laryngectomy, 222
Sarcoidosis, 964
Scalp and calvarial reconstruction, 777–783
anatomy o
calvarium, 778
scalp, 777
calvarial reconstruction
alloplastic, 783
autologous bone in, 782
indications or, 782
scalp reconstruction
ree ap or, indications or, 780–782, 782
galeal scoring, 779
local ap design or, 780, 780
local aps or, 778
regional aps or, 780
skin gra ting or, 778
tissue expansion in, 779
Scalp replantation, 410
Scaphocapitate syndrome, 330
Scaphocephaly, 912
Schirmer’s test, abnormal, 23
Schwann cell, 266
Scleroderma o hand, 953
Sclerotherapy, 670
Scorpion stings, 981
Sculptra, 102
Secrétan’s disorder, 949
Senile ptosis, 17, 23, 886
Sensitivity, 859
Sensory nerve action potentials (SNAPs), 373
Sensory nerves o orehead, 37
Sentinel vein, identi cation o , 20
Seymour racture, 257
Shaw ap, 936
Short ace syndrome, 900
Shprintzen’s syndrome, 912
Silent implant rupture, 154
Silicone
advantages o , 88
disadvantages o , 88
implants, 87
Silver nitrate solution, 739
Silver sul adiazine (Silvadene), 739
SIMON, 231
Single-stage technique, 463–464
Skin dehiscence, 48
Skin gra t ailure, causes o , 684

1056
Index
Skin gra ting, principles o , 693–696
allogra t, 695
autogra t, 695
composite gra t, 694, 695
donor-site dressing, 694
ailure o skin gra t, 696
ull-thickness skin gra t (F SG), 693
gra t adherence, 696
gra t thickness, e ects o , 695
meshing, 693–694
phases o skin gra t, 695
imbibition, 695
inosculation, 695
revascularization, 695
postoperative bolster, 694
primary contraction, 695
secondary contraction, 695
split-thickness skin gra t (S SG), 693, 694
xenogra t, 695
Skin/lasers, 893–896
Skin lesions, benign, 555–560
Becker’s nevus, 556
blue nevus, 555
congenital melanocytic nevus (CMN), 556
dysplastic nevus, 556
brous and in ammatory lesions, 558–559
acquired digital brokeratoma, 558
acrochordons, 559
chondrodermatitis nodularis helicis, 559
dermato broma, 559, 559
in antile digital bromatosis, 927
halo nevus, 556
labial lentigo, 556
melanocytic lesions, 555–556
melanocytic nevi, 555
Mongolian spot, 556
nevus, 555
nevus o Ito, 556
nevus o Ota, 556
nevus spilus, 556
premalignant lesions, 560
actinic keratoses, 560
Paget’s disease, 560
seborrheic keratoses, 560
Spitz nevus, 555
subcutaneous lesions, 560
dermoid cysts, 560
keratinous cysts, 560
lipomas, 560
pilar cysts, 560
vascular lesions, 556–558
angiokeratomas, 557
cherry angiomas, 557
acial telangiectasias, causes o , 558
glomus tumors, 557
hemangioma, 556, 557
Osler–Weber–Rendu syndrome, 558
PHACE syndrome, 558
port-wine stain, 557
pyogenic granulomas, 558, 558
Sturge-Weber syndrome, 557
Skin lesions, malignant, 563–566
basal cell carcinoma (BCC), 563–565
classic locations or, 564
clinical types o , 564
curettage and electrodessication,
564
Mohs surgery, 565
risk actors or, 563
treatment or, 564
skin cancer, 563
squamous cell carcinoma (SCC), 565–566
keratoacanthoma (KA), 566
metastatic risk or, 566
risk actors or, 565
Skin resur acing, 69–75
Accutane, stopping o , 70
AHA peels, 71
Baker/Gordon phenol peel, 73
chemical peel, 69, 71
cleansing a ter, 70
CO2 laser, 74
conditions or, 69
contraindications to, 70
croton oil, use o , 73
dermabrasion, 75
Er:Yag lasers, 74
Fitzpatrick skin type, 69
grenz zone, 70
hyperpigmentation, a ter laser treatment, 74
Jessner’s peel, 72
laser, 73–74
makeup a ter, 70
microdermabrasion, 75
modalities, 69
Nd:Yag laser, or hair removal, 74
Obagi Blue Peel, 72
phenol peel, 72–73
pre-peel regiment, 71
hydroquinone, 71
Retin-A, 71
Septisol, use o , 73
CA peel, 72
Skin slough, 48
Skin-sparing mastectomy (SSM), 175–177
complication o , 177
contraindications to, 175
de nition o , 175
incision in, 176, 177
indications or, 175
operative procedure in, 176
versus simple mastectomy, 175
site o local recurrence, 177
skin ap, 176
surveillance plan or, 177
Sleep apnea, 280
Speci city, 859
Sphenoid sinus, 481
Sphincter pharyngoplasty, 903, 921
Spiral cord, 306, 934
Split nail de ormity, 939
Squamous cell carcinoma (SCC), 565–566
Stahl’s ear, 746, 746 , 881, 882
Staphylococcus aureus
acute osteomyelitis by, 829
hand in ections by, 293
Staphylococcus epidermidis, in breast tissue, 136
Statistical methods, 853–860
bias in study design, 859–860
descriptive statistics, 853–854
diagnostic studies, assessment o , 859
error, types o , 858
evidence-based medicine, 858–859
in erential statistics, 855
mean, 853
nonparametric tests, 857

Index
1057
parametric tests, 855–857
variables, types o , 854–855
Stener lesion, 257, 328, 951
Stenstrom’s technique, 881
Sternal wound in ections
management, 804
presentations o , 804
risk actors or, 804
Stewart– reves syndrome, 171
Still’s disease, 363
Stress relaxation, 685
Sturge–Weber syndrome, 672, 965
Subconjunctival hemorrhage, 909
Suborbicularis oculi at pad (SOOF), 20
Succinylcholine, 279
Suction-assisted lipectomy (SAL) breast reductions, 241
Suction lipectomy, 125–130
body at or adult, percentage o , 125
cellulite, 126
complication a ter, 130
contour de ormity, 130
dry technique, 127
at layers, 126
emale pattern o at distribution, 125
large volume liposuction, 129
lidocaine, dose o , 127–128
male pattern o at distribution, 125
mortality rate, 130
super cial liposuction, 126
superwet technique, 127
syringe versus vacuum aspiration, 128
tumescent technique, 127
ultrasonic-assisted liposuction (UAL), 129
VASER system, 129
wet technique, 127
zones o adherence, 126
Sunderland classi cation, o nerve injuries, 263
Super cial in erior epigastric artery (SIEA), 202
Super cial musculo aponeurotic system (SMAS), 457
Superior gluteal artery per orator (SGAP) ap, 212
Superior orbital ssure syndrome, 448, 909, 919
Supermicrosurgery, 701
Surgery, general, 861–868
anesthesia/airway management, 864–865
uids/electrolytes/nutrition, 862
head, 863–864
hematology/blood products, 861–862
neck, 863–864
oncology, 862–863
site in ections, management o , 866
thoracic, 863
trauma and critical care, 865–868
vascular, 868
Surgisis, 958
Sutton’s nevus, 966
Swan neck de ormities, 940
Symblepharon, 887
Syndactyly, 250
Synkinesis, 460
Synmastia, 147
Synostotic plagiocephaly, 913
Systemic in ammatory response syndrome, 973
T
amoxi en, 169
ear lm, composition o , 20
ear trough de ormity, 21
elogen e uvium, 108
emporal li t, 38
endon injuries, 333–341
anatomy and physiology o tendon, 333–334
extensor tendons, 338–341
FDP avulsion injuries, 335
bro-osseous tunnel, 334
exor tendons, 334–338
exor zones o ngers, 334
jersey nger, 335
gra t, 336, 337, 338
nourishment to tendons, 333
pulleys in nger, 333–334
vincula, 333
endon trans ers, 381–390
combined nerve palsies, 390
donor muscle, selection o , 381
median nerve, 385–387
excursion o brachioradialis muscle, maximization o , 387
Huber trans er, 386
opponensplasty, 385, 386
sensory de cits, signi cance o , 387
thumb opposition, 386
patient’s joints, assessment o , 381
preoperative therapy, goals o , 381
principles o , 381–382
radial nerve, 382–385
Boyes tendon trans er, 383
delayed tendon trans ers, 383
donor muscles or tendon trans ers, 383
dynamic splint a ter tendon trans er, 385
early tendon trans er, 382
indications or tendon trans er, 382
limb dys unction a ter radial nerve palsy, 382
MPJ extension, restoration o , 383
position o immobilization a ter, 384
tenodesis e ect, 382
tendon excursion, 382
ulnar nerve, 387–390
Bouvier maneuver, 388
Bunnell-Stiles tendon trans er, 389
claw de ormity, 387, 388
Duchenne’s sign, 388
Froment’s sign, 388
Jeanne’s sign, 388
low ulnar nerve palsy, 387, 388
static anti-claw trans er, 389
thumb adduction, 388
Wartenberg sign, 388
Wartenberg’s syndrome, 388
Zancolli lasso procedure, 389
enon’s capsule, 923
ensor veli palatini, 904, 913
essier acial cle t, 917
T enar ap, 955
T enar muscles, 253
T enar space, 932
T igh contouring, 119–120
T oracic outlet syndrome ( OS), 314–315, 863
Adson’s maneuver, 314
rst-line therapy or, 315
nerve a ected in, 314
Roos maneuver, 315
Wright’s maneuver, 314–315
T oracoacromial artery, 214
T orazine, 409
T umb-in-palm de ormity, in cerebral palsy, 947
T umb reconstruction, 419
T yroglossal duct cyst, 899

1058
Index
ibial injury
Byrd classi cation system, 819
Gustilo classi cation system, 819
issue expansion, 645–646, 684–686
advantages o , 645
and blood ow, 645
and cellular proli eration, 645
creep, 645
dermis, e ect on, 646
disadvantages o , 645
epidermis, e ect on, 646
expander placement, 646
ap properties, e ect on, 684
hair growth, e ect on, 686
histologic changes on, 685
irradiated tissue and, 686
maximal tissue recruitment by, 685
mechanical creep, 685
rejuvenation surgery, 686
stress relaxation, 685
textured sur ace on tissue expander, 646
tissue zones rom, 685
oe-to-hand trans er, 415–426
care o donor oot, 426
closure o wounds in, 417
cobra de ormity, 423
combined second/third toe trans er, 424
complications o , 422
considerations or, 416
correct thumb length, 420
early work o , 415
rst dorsal metatarsal artery (FDMA), 415–416
rst plantar metatarsal artery (FPMA), 415
glabrous skin, 422
great toe and thumb, di erence o , 420
incision on plantar and dorsal eet, 417
metacarpal hand, 424
motion o great toe M P joint, 418
mutilated hand, 423
neo-thumb reconstruction by toe trans er, 425
nerves or sensation o trans erred toe, 416
pedicle, choice o , 417
plantar digital artery, 416
preoperative arteriography, 417
primary, 419
secondary procedures or, 418
second toe or thumb reconstruction, 420
structures, to be preserved, 417
thumb absence/dys unction, 419
thumb reconstruction, 419
thumb to nger pinches, 419
trimmed toe trans er, 421
two-point discrimination o great toe in situ, 418
vascularized joint trans er, 425
wraparound great toe ap, 421
ongue reconstruction, 793–798
blood supply o , 795
cadaveric donor, 798
chorda tympani nerve, 794
circumvallate papillae, 793
de ects, 798
determinates o , 798
embryological structures, 793
nger unction, 795
unctions, 795
ungi orm papillae, 793
lingual de ects, 797
lymphatic drainage o , 795
midlateral aspect, 796
motor supply to muscles, 795
musculature o , 794
noninnervated aps, 797
oral glossectomy, 796
oral portions, 793
palatal build-down prosthesis, 798
pharyngeal portions, 793
pharyngeal tongue, 793
radial orearm ree ap or, 798
radiation therapy, 797
residual tongue unction, 796
sensation, 794
squamous cell carcinoma, 795
sur ace anatomy o , 794
survival rates, 796
taste buds, 794
otal parental nutrition ( PN), 862
oxin e ect, distant spread o , 33
RAM reconstruction, 872, 874
ransCyte, 964, 971
ransplant, steroid use in, 864
ranssexualism, 835
ransverse retinacular ligament, 254
ransverse upper gracilis ( UG) ap, 214
raumatic boutonniere de ormity, 950
reacher-Collins syndrome, 905
riangular ligament, 340
riangular space, 945
ransconjunctival blepharoplasty technique, 22
richloroacetic acid ( CA) peel, 72, 77
male pattern, 107
rumpet nail de ormity, 941
runcal contouring, 115–119
abdominoplasty and complications, 115–116
blood supply to abdominoplasty ap, 115
blood supply zones o abdomen, 115
Fleur-de-lis abdominoplasty, 117, 117
ull abdominoplasty, 116
lower body li t, 118
mini-abdominoplasty, 116
optimal procedure or, 116
umbilical oat procedure, 116
uberous breast de ormity, 141, 146, 147, 245
urribrachycephaly, 906
ype I errors, 858
ype II errors, 858
ypical cle t hand, 940
U
Ulnar nerve compression, 314–318, 316
Ulnar nerve entrapment, 264
Ultrasonic-assisted liposuction (UAL), 129
Un ractionated heparin (UFH), 868
Upper lid blepharoplasty and brow li t, 38, 753
UV light damage, 41
V
Vancomycin, 295
van der Woude syndrome, 912
Variables, types o
categorical, 854
continuous, 854
ordinal, 854–855
parametric versus nonparametric tests, 855
Vascular anomalies
classi cation, 665
congenital hemangiomas, 667

Index
1059
corticosteroid injection, 666
in antile hemangioma
NICH management, 668
operative intervention, 667
pyogenic granuloma, 558
pyogenic granuloma, 668
RICH management, 668
Sturge-Weber syndrome (SWS), 557
Vascular arches, in hand, 261
Vascular endothelial growth actor (VEGF), 685
Vascular leash o Henry, 323
Vascular mal ormations, 668, 670
Vascular mal ormation overgrowth syndromes, 671
Vascular tumors, 668
VASER system, 129
Vaughn–Jackson syndrome, 358
Velocardio acial syndrome, 910
Velopharyngeal inadequacy, 603–608
black hole, 608
closure patterns on nasopharyngeal endoscopy, 606
evaluation o , 605
nonsurgical treatments or, 606
perceptual speech assessment, 606
pharyngeal ap, 607
posterior wall augmentation, 606
SMCP, 608
sphincter pharyngoplasty, 607
surgical treatments or, 606
symptoms and signs o , 603
velocardio acial (VCF) syndrome, 607
velopharyngeal space, 604
velopharynx close, 605
Venous air embolus, 867
Venous mal ormations, 670, 671
Venous thrombosis, 868
Vertical maxillary de ciency, 900
Vertical perioral rhytids, 32
Viable ap, 699
Virginal (juvenile) hypertrophy, 242
Vitamin C de ciency, 958, 980
Volkmann’s contracture, 324, 951
von Hippel-Lindau disease, 964
W
War arin, 861
Wartenberg’s syndrome, 323–324, 946
Watson’s scaphoid shi t test, 330
Werner’s syndrome, 975
Wilcoxon rank-sum test, 857
Wound. See also Keloids
healing, principles o , 675–678
cell types involved, 675
chronic wound, 677
collagen types, 676
corticosteroids, e ects o , 677
epidermis and dermis, layers o , 675
epithelialization across wound, 675
actors impairing healing, 678
FGF, role o , 676
nerve injuries, classi cation o , 430
operative wounds, classi cation o , 678
steps in healing, 675
tensile strength o scar, 677
wound contracture, 676
wound remodeling, 676
therapy, 682–684
acticoat, 682
alginate gels, 683
biologic dressings, 683
hyperbaric oxygen therapy, 684
Regranex gel, 683
skin gra t, 683
topical antimicrobial agents, side e ects o , 683
types o , 679–681
bite wounds, organisms or, 679
rostbite, 680
necrotizing asciitis, 681
pressure sores, 679
pressure ulcers, 680
rabies exposure, 680
sacral wound management, principles o , 679
tetanus prone wounds, 680
Wrist, extensor compartments, 261, 261
Wrist kinematics, 393–400
Barton’s racture, 399
carpal height ratio, 393
Colles racture, 399
distal radius ractures, 400
dorsal intercalary segment instability (DISI), 395
DRUJ, stabilizers o , 394
orce transmission through wrist, 394
Geisler scapholunate (SL) instability, 398–399
Gilula’s lines, 396
hook o hamate ractures, 397
hook o hamate nonunion, 397
Kienbock’s disease, 398
lunate and perilunate dislocations, 396
lunate dislocation, 396
lunatotriquetral ligament tear, 398
muscles or wrist motion, 393
perilunate dislocation, 396
progressive perilunate instability, 395
proximal pole ractures o scaphoid, 395
scaphoid ractures, 395, 397
scaphoid shi t test, 396
scapholunate advanced collapse (SLAC) procedure, 398
scapholunate ligament, 394, 395, 396
sigmoid notch, 394
Smith’s racture, 399
spilled tea-cup sign, 395
Stage I perilunate instability, 395
Stage II perilunate instability, 396
Stage III perilunate instability, 396
Stage IV perilunate instability, 396
erry T omas sign, 395
triangular brocartilaginous complex ( FCC), 394
triquetral ractures, 397
ulnar translocation o carpus, 397
volar intercalary segment instability (VISI), 394, 395
wrist range o motion, 393
X
Xanthelasma, 969
Xenogra t, 695, 727, 740
Xeomin, 29, 30
Xeroderma pigmentosum (XP), 961, 975
X-rays, 217
Z
Zancolli lasso procedure, 935
Zyderm I, 100
Zyderm II, 100
Zygomaticomaxillary complex racture, 23, 449
Zyplast, 100