Phẫu Thuật Da Liễu: Khía Cạnh Ngoại Khoa (Surgery of the Skin)

833
Index
cytokines and other factors, 738t
growth factors, 102
leg ulcers, 45e1
sutures, 190, 190t
vascular response, 98–99
inflammatory leg ulcers, 45e1
informed consent, 82
in adolescents, 348
elliptical excision, 240
endovenous ablation for varicose veins,
594f
follicular unit hair transplantation, 493,
493b
prior to chemical peels, 395
skin biopsies, 170
infragluteal ligaments, 462
infranatant fractions, autologous fat transfer,
471–472, 472f
infraorbital area, autologous fat transfer
longevity, 478
infraorbital crease, 8f
infraorbital foramen, 11–12, 11f
infraorbital nerve block, 51t, 52, 52f–53f
infraorbital rim, 12
ingrown toenails, 763–768
etiology and treatment, 764t
in infancy, 763–765, 765f
congenital hypertrophic lip of the
hallux, 764
congenital malalignment of the great
toenail, 764–765, 765f
distal toenail embedding with normally
directed nail, 763–764
juvenile, 765–768
clinical stages, 765
treatment, 766–768, 766f–769f
injectable fillers see fillers; specific fillers
injection-site necrosis, hyaluronic acid
injections, 380
inner canthal distance, 12
inosculation, skin grafting, 309
insight, psychiatric exam, 340
Instant Cold Spray, 49t
instruments, 65–72
caring for, 70–71
cleaning, 71
cryosurgery, 154–155, 154f–155f
curettes, 68, 68f
follicular unit hair transplantation, 500
forceps, 67, 67f
full-thickness skin grafts, 310
hemostats, 67
liposuction, 341–342, 344f–345f
liquid sclerotherapy, 583
minimum incision face lift, 612t
Mohs micrographic surgery, 721–722,
721f–722f
nail surgery, 757
neck liposuction, 653–654, 654f–655f,
654t
needle holders, 67–68, 68f
optimizing outcomes, 70–71
pitfalls and their management, 71
practical applications, 71–72, 71f
scalpel handles and blades, 65, 66f
scissors, 65–67, 66f–67f
skin hooks, 67
split-thickness skin grafts, 314, 314f–315f
sterilization, 29–30, 36–38, 38f, 71 (see
also specific methods)
technical aspects, 65–70
see also specific instruments
insulin-like growth factor, 738t
Integra, 123, 749t
integrin receptors in wound healing, 105,
105f
intelligence, psychiatric exam, 340
intense pulsed light (IPL)
and botulinum toxin injections, 443–444
complications, 546
facial erythema, 573
hair removal, 521, 522t
hemangiomas, 572
pigmented lesions, 538–539
epidermal, 540
poikiloderma, 573–574
port-wine stain, 569
postoperative care, 576
safety procedures, 575
skin remodeling, 555
techniques, 576
telangiectasias, 572–573
vascular lesions, 566
interferon-α (IFN-α)
basal cell carcinoma, 724
keloids, 678
melanoma metastases, 43e15
melanomas, 704, 43e14, 728
side-effects, 678
interferon-γ (IFN-γ), 678
interferons, keloid management, 671, 678
interleukin-1 (IL-1), 115–116
wound healing, 738t
wounding, 97–98
interleukin-2 (IL-2), melanoma metastases,
43e15
internal jugular lymph nodes, 21–22
international normalized ratio (INR), 253
interphalangeal joint, distal, 755
interpolation flaps, 292
interpupillary distance, 12
intralesional cryosurgery technique, 155
intralesional steroids, scar revision, 328
intraoperative tissue expansion, 5–6
intravascular clots after sclerotherapy, 586
intravenous regional anesthesia (IVRA),
228–229
involuting hemangiomas, 572
iodine, 29–30
Iodoform, 186
iodophor preparations, film-forming, 35
iontophoresis, 49
ipilimumab, 43e15
iris, 8f
iris scissors, 66, 66f
ischaemia, pressure, 235–236
island graft, 313–314
island pedicle flap, 257–260, 259f–260f
design and execution, 258–260
historical perspective, 257–258
suitable locations, 258
undermining, 260
variants, 260
Isolagen, 369t–374t, 388
isotretinoin therapy
and ablative laser skin resurfacing, 554
atypical moles prevention, 43e10
microdermabrasion/dermabrasion after,
531
skin resurfacing contraindications, 550
itching, postoperative
follicular unit hair transplantation, 508b,
509t
hyaluronic acid injections, 380–381
J
Jacobsen hemostat, 67
Jaeger plate, 643–644, 643f
jawline, fillers for, 367
Jessner’s solution
medium-depth chemical peels, 403–404
superficial chemical peels, 396b, 398, 398b
total body peels, 408–409
jeweler’s forceps, 67
Joint Commission on Accreditation of
Healthcare Organizations, 807–808
accreditation decisions, 807
accreditation process overview, 807
office-based surgery accreditation, 807–808
survey process, 807
jowls, liposuction, 346–347
judgement, psychiatric exam, 340
jugulodigastric lymph node, 22f
jugulo-omohyoid node, 22f
Juvéderm, 369t–374t, 377–378
K
kallikrein, 101
Kaposi’s sarcoma, cryosurgery, 157t, 162–163
Karman cannula, 447
kava kava root, 80t
keloid management
avoidance behaviors, 679
bleomycin, 679
combination therapy, 679
compression therapy, 677
corticosteroids, 673–674
polytherapy for keloid prevention, 674
side effects, 674
solo therapy for existing keloids,
673–674
solo therapy for keloid prevention, 674
cryosurgery, 157t, 158–160, 159f, 159t,
678–679
earlobe, 678
5-fluorouracil, 679
imiquimod application, 678
interferon, 678
intralesional verapamil, 679
laser surgery, 676
mederma, 679
optimizing outcomes, 680
pitfalls and their management, 680
radiation therapy, 676–677
silicone products, 677–678
surgery, 674–676
earlobe keloids, 675–676, 675f–676f
laser surgery, 676
technical aspects, 672–679
vitamin E, 679
keloids, 669–682
after ablative laser skin resurfacing, 554
clinical manifestations, 671–672, 671t,
672f
distinguishing from hypertrophic scars, 671
earlobe, 672
ear piercing, 788
elliptical excision, 249–250
epidemiology, 669
etiology, 669–671
endocrine factors, 670–671
genetic predisposition, 671
infection, 670
skin tension, 670
trauma, 670

834
Index
management see keloid management
pathogenesis, 671
keratin, 167–168, 763
keratinocyte growth factor (KGF)
leg ulcers, 742
wound healing, 738t
keratinocytes
attachment to the basal lamina, 4–5
atypical, 400–401
basal, 3–4
hyperproliferative, 401
migration, 103
proliferation and differentiation, 103
re-epithelialization, 102
wounding, 97–98
keratoconjunctivitis after blepharoplasty, 648
kick buckets, 800–801
kinins, 101
Klein’s basic tumescent anaesthetic solution,
50–51, 50t
knees, liposuction, 345
knots see sutures/suturing, knots
KTP lasers see potassium titanyl phosphate
(KTP) lasers
L
labial incompetence, bone resorption, 426,
427f
labialmental line, 9f
labia majora, 24–26, 26f
labia minora, 24–26, 26f
labrale inferius, 12f
labrale superius, 12f
lacrimal puncta, 8f
lactate dehydrogenase (LDH), melanomas,
702, 726–727
lactomer, 191, 192t
lagophthalmos after blepharoplasty, 648
LaGranges scissors, 66
laminins, 103–104, 104f
Langerhans cells, 102
lanugo hairs, 514
larva migrans, 157–158, 157t
laser-assisted neck liposuction, 655–656,
656f
laser hair removal, 513–526
classification of excess hair, 515
hair anatomy, 513, 514f
hair colour, 514–515
hair growth, 513–514, 514t, 515f
hair type, 514
optimizing outcomes, 523–524, 523f–524f
pitfalls and their management, 524–525
postoperative care, 524
preoperative preparation, 516–517, 516t
techniques, 517–523
alexandrite laser, 520–521, 522t
chromophores, 517–518
cooling, 519–520, 520f
diode combined w/RF electrical energy,
522t
diode laser, 521, 522t
fluence, 519, 519t
fluorescent pulsed light, 522t
histology, 520
intense pulsed light, 521, 522t
microwave technology, 521
Nd:YAG laser, 521, 522t
optical energy combined w/RF electrical
energy, 522t
optimal target, 518
photothermal, 522t
pulse duration, 518–519
ruby laser, 520, 521f, 522t
spot size, 519
treatment delivery, 521–523
wavelength, 518, 518t
test spot, 524
traditional treatment modalities, 515–516
laser resurfacing
antibiotic prophylaxis, 89
with hyaluronic acid injections, 380
in lower eyelid blepharoplasty, 645, 645f
neck rejuvenation, 662–663
postoperative care, 127, 127t
scar revision, 328–329
laser(s)
and botulinum toxin injections, 443–444
for skin rejuvenation, 550t
tissue interaction principles see laser-tissue
interaction principles
see also specific indications; specific lasers
laser surgery, 537–548
combined with chemical peels, 402
hemostasis, 229–230
keloid management, 676
safety procedures, 575
vitiligo, 687–688
see also specific indications; specific lasers
laser-tissue interaction principles, 563–566
electromagnetic radiation, 563
fluence and epidermal protection, 565
pulse duration and thermal relaxation time,
565
selective photothermolysis, 563–566
spot size, 565
wavelength, 564–565, 564f
lateral canthopexy/canthoplasty, 217, 217f
lateral canthus, 8f
lateral longitudinal nail biopsy, 758–759,
763f
lateral palpebral commissure, 8f
lateral plantar nerve, 58f
latex allergy, 81, 454
layered facial closures, complex see complex
layered facial closures
lazy-S repair, 244, 246f
legs
contour, botulinum toxin injections, 443
skin tension lines, 10f
ulcers see leg ulcers
leg ulcers, 735–753
adjunct modalities, 743
antimicrobials, 742–743
arterial ulcers, 735, 737f
bacterial balance of, 742–743
causes of, 735, 736t
compression therapy, 741–742, 742t,
45e3
diabetic ulcers, 736, 737f
dressings, 743, 745t
etiology, 735–737
arterial ulcers, 735, 737f
diabetic ulcers, 736, 737f
pressure ulcers, 737
venous ulcers, 735, 737f
FRAIL (for recognition of adult
immobilized for life), 45e2
inflammatory, 45e1
laboratory evaluation, 741t
pharmacologic therapy, 742
physical findings in, 740t
pitfalls and their management, 750
preoperative preparation, 737–741
diagnostic assessment, 739–741
medical history, 737–739
physical examination, 739
pressure ulcers, 737
prevention, 45e3
effects of stimulation of growth factors,
45e4
removal of bacteria, 45e4
removal of non-migratory tissue, 45e4
removal of senescent cells, 45e4
radiographic tests, 741t
subfacial endoscopic perforator surgery,
45e5–45e6
surgical techniques, 743–750
debridement, 743–746
autolytic, 746
biosurgical, 746
enzymatic and chemical, 746
mechanical, 746
surgical/sharp, 745–746
shave therapy, 750
skin grafting, 746–749
optimizing outcomes, 748–749
pitfalls and their management, 749
preoperative preparation, 747–748
skin substitutes, 749f, 749t, 45e5
techniques, 748
wound bed preparation, 743–744
types, 736t
venous ulcers
etiology, 735, 737f
shave therapy, 750
wound repair physiology, 45e1–45e2
leishmaniasis, 157t
lentigo maligna, 157t, 163
lentigo simplex, 158
lesser occipital nerve, 20
damage in vertical vector face lift, 624
leukocytes, 97–101
leukoderma, genital, 690
leukotrichia
after laser hair removal, 525
surgical treatment of, 42e8
leukotrienes, 99–100
levator anguli oris, 16–18, 17t, 18f–19f
fat autograft muscle injection, 476f–477f
levator aponeurosis, functional assessment,
629–630
levator labii superioris, 16–18, 17t, 18f–19f
fat autograft muscle injection, 476f–477f
levator labii superioris alaeque nasi, 16–18,
17t, 18f–19f
fat autograft muscle injection, 476f–477f
levator palpebrae superioris, 15–16, 17t, 628
levobupivacaine, 45t
lichen planus, 157t
lichen sclerosus, 157t
licorice, 80t
lidocaine, 44t–45t
allergic reactions, 56b, 59, 59t, 451–454
autologous fat transfer harvesting, 471
Bier’s block, 228–229
in children, 60
effect on fat cell growth, 471–472
history, 43
liposuction, 451
maximum doses, 59t
medications interacting with, 455t
nerve blocks, 51
in pregnancy, 74
random pattern cutaneous flaps, 278

835
Index
skin biopsies, 170–171
topical anesthesia, 47, 47t
tumescent anaesthesia, 50–51, 50t
life as art, 353–354, 355f
life crises, 348
life-satisfaction index (LSI), 456
lifting flaps, 327
lighting, 73, 799
light treatment
and botulinum toxin injections, 443–444
vascular lesions, 564t
vitiligo, 687–688, 688f
see also specific light treatments
linear puncture technique, hyaluronic acid,
379
linear threading technique
hyaluronic acid, 379
polymethylmethacrylate injections, 388
Linton procedure, 45e5
lip flaps
axial pattern flaps, 303–304
optimizing outcomes, 307b
see also specific flaps
lipodermatosclerosis, 737f, 750
lipoma
forehead, 179, 179f, 180b
incision and enucleation, 175, 177–180,
178f–179f, 185–187, 186b
infiltrating, of the upper extremities,
179–180, 180b
site of, 177–178
Lipostructure™, 469–470, 474
liposuction, 447–468
aspiration pumps, 341
dry technique, 447
Fischer’s technique, 447
instruments, 341–342, 344f–345f
long-term outcome, 467
in minimum incision face lift, 605,
610–611, 613f
neck see neck rejuvenation, liposuction
optimizing outcomes, 459–465
abdomen, 459–460, 461f
arms, 462–463
axillary hyperhidrosis and bromhydrosis/
osmidrosis, 465
female breast, 464–465
hips, outer thighs, and buttocks,
460–462, 462f
male chest, 463–464
medial thigh and knee, 462
neck and jowls, 463, 464f
physical examination, 456–457
pitfalls and their management, 466–467,
466b
postoperative care, 465–466
immediate, 465–466
preoperative preparation, 447–456
consultation, 447, 448f–450f, 452f
diet and exercise, 454–456
expectations, 456
medical history, 447–451, 451t
medication allergies, 451–454
medications, 451, 455t
surgical history, 451
procedure, 457
questionnaire, 447, 448f–450f, 452f
surgical suite and set-up, 344f–345f,
457
technical aspects, 456–459
touch-up procedures, 466–467
tumescent see tumescent liposuction
tumescent anesthesia, 50–51, 457–459,
459t
in vertical vector face lift, 618, 619f
wet technique, 447
liposuction-curettage (LC), hyperhidrosis, 465
lip(s)
autologous fat transfer longevity, 478
biopsies, 175
fillers for, 367, 378
calcium hydroxylapatite, 382
hyaluronic acid, 379
flap elevation plane, 281
flaps see lip flaps
ideal, 12–13
mucosal advancement flaps, 260–261
muscles, 16–18
topographic landmarks, 9f
tumours, 714
undermining plane, 280t
vitiligo surgery, 690
liquid adhesive bandages, 126
Liquid Bandage, 197
liquid nitrogen, 154–155
liquid sclerotherapy, 583–584
concentration and volume, 583t
duplex ultrasound in, 584
equipment, 583
LMX
laser hair removal, 521–523
topical anesthesia, 47t, 48
load, 5
load cycling, 5–6
lobular keloids, 672, 675–676, 676f
lobule, ear, 23f
local anesthesia/anesthetics
additions to, 45–46, 45t
addition to other local anesthetics, 46
allergic reactions, 56b, 57–58, 81, 176b
amide-type, 43–44, 44f, 44t–45t, 51, 59
in children, 60
ester-type, 43–44, 44f, 44t, 58
follicular unit hair transplantation, 495–496
history, 43
liposuction, 447
mechanism of action, 44–45
Mohs micrographic surgery, 715
pKa, 44
in pregnancy, 44, 74
random pattern cutaneous flaps, 278
safety, 279
soft tissue augmentation, 368
vitiligo surgery, 685
long hair transplants, 506–507
long saphenous vein
foam sclerotherapy, 584
ligation, 589
reflux, 590, 593
lorazepam, anxiolytic effect, 60
Lovenox, 79
lower eyelid, 8f
blepharoplasty see blepharoplasty, lower
eyelid
cross-sectional anatomy, 630f
fat pads, 631f
flap elevation plane, 281f
laxity tests, 629
suspension sutures, 217, 217f
low-molecular-weight heparins (LMWHs), 79
L-plasty, split earlobe repair, 783, 785f
lunula, 756–757, 756f
Luschka’s ligament, 462
Lux 1540 Fractional, 556
Lux 2940-nm fractional handpiece, 552
lymphangiomas, cryosurgery, 160
lymphatics
of the head, 21–22, 22f, 26b
skin grafting, 310
lymph drainage after autologous fat transfer,
481
lymphedema, 304
lymphocele, 599
lymphocytoma cutis, 157t
lymphoscintigraphy, 727, 43e12
M
maceration, 130b, 131f
McGregor’s patch see zygomatic ligament
macrophages, 97–102, 100t
maggot therapy, 125, 746
malar eminence, 217–218
malar fat pad
anatomy, 604f
ptosis, 602–603
suspension sutures, 218–220, 601
male chest, liposuction, 346
male urogenital triangle, 24, 25f–26f
malignant fibrous histiocytoma, 729
malignant melanoma see melanomas
malleability, needle, 195
malnutrition, surgical site infection risk, 86
mal perforans ulceration, 736
mandible, 11, 11f
age-related changes, 417, 418f
mandibular ligament, 602, 602f
mandibular nerve, 20
mania, psychiatric exam, 340
marginal mandibular nerve, 417
injury, 417
chin implants, 424, 425f
during neck rejuvenation, 664
marginal reflex distance (MRD), 629, 632f
margination, 99
marionette lines, 9
autologous fat transfer, 473
botulinum toxin injections, 438t, 441
fillers for, 366–367, 379
MART-1 staining, 718, 728
masks, face, 33–34, 37
masseteric hypertrophy, 442
masseter muscle, 13–14, 13f, 16f, 18f–19f, 20
mast cells, 97–101, 100t
mastication muscles, 20
see also specific muscles
Mastisol, 243
mastoid process, 11, 11f
matricectomy, 761–762, 761f
matrilysins, 109t
matrix, nail, 756–757, 756f
biopsies, 759, 763f
superficial, 759–760, 763f
defects, reconstructive surgery, 774–777
selective lateral excision, ingrown toenails,
767
matrix metalloproteinases (MMPs), 103,
109–110, 109t
matting, after sclerotherapy, 586
mattress stitches
buried vertical, 205, 205f, 282
half-buried horizontal, 201–202, 202f
horizontal, 200–201, 201f, 233f
vertical, 200, 201f, 243
maxilla, 11, 11f
age changes, 352

836
Index
maxillary nerve, 20
Maxon, 69, 191–193, 192t
Mayo scissors, 66, 66f
Mayo surgical stand, 71, 801, 801f
meadowsweet, 80t
meatus, 23f
mechanical creep, 5
mechanical debridement, 125, 746, 746f
mederma, keloid management, 679
medial canthus, 8f
medial malleolus, 25f
medial plantar artery, 25f
medial plantar nerve, 25f, 58f
median nerve, 23, 24f
block, 54, 56f–57f
medical diathermy, 137–138, 138f
Medicare certification and reimbursement,
810
medication history
chemical peels, 396
liposuction, 451
Mohs micrographic surgery, 714–715
medications
and ablative laser skin resurfacing, 554
allergies, liposuction, 451–454
autologous fat transfer, 470–471
causing pigmentation, 542
for excess hair, 516
in follicular unit hair transplantation, 503t,
507, 508b
hair-loss, 508b
impairing hemostasis, 227–228, 227t
interacting with lidocaine, 455t
for leg ulcers, 742
leg ulcers history, 739
random pattern cutaneous flaps, 253
Mediskin 1, 321
Meissner’s corpuscles, 755–756
Meladine, 517–518
Melan-A, 728
melanin, 514–515, 537, 564–565, 564f
hair removal, 517
melanocytes, 102
follicular, 514–515
melanocyte-stimulating hormone (MSH),
670–671
melanocytic lesions, laser treatment,
540–542
melanocytic nevi, laser treatment, 541
melanogenesis, 514–515
melanomas
advanced, 728
clinical features and presentation, 693,
694t
dermoscopic structures and their
histopathologic correlates, 700t
dermoscopy, 698–700, 701f, 43e5, 43e8f,
43e7f
early detection and prevention, 698–701,
700b
chemoprevention, 43e10
examination and biopsy of lesions,
43e10
ophthalmologic examination, 43e9
routine dermatologic examinations,
43e9f
screening, 43e9
self-examination, 43e9
sun protection, 43e10
elliptical excision, 241
follow-up, 704–705, 706t
histological interpretation, 728
immunostains, 728
management, 701–704
adjuvant therapy, 704, 43e14
diagnosis, 701
guidelines, 706t
prognostic factors, 702b
sentinel lymph node biopsy, 703–704,
704f, 727, 727f–728f,
4312e–4313e
staging, 701–703, 702t
surgical management, 703–704, 727
surgical margins, 703, 703t, 706t,
727
survival data, 703t
treatment of metastatic disease, 704,
704f, 43e15
ultraviolet precautions, 702t
margins, 241
metastatic disease, 704–705
Mohs micrographic surgery, 726–728
observation techniques, 700t
pitfalls and their management, 705
postoperative care, 704–705
prevention, 43e4
risk, 43e2–43e3, 432e–433e, 698
short-term mole monitoring (STMM),
435e–436e
specimen staining, 718
staging, 701–703, 702t, 726–727
ungual, 773–774, 775f
melanosomes, 537–538
melasma
laser treatment, 542
recent novel approaches in chemical peels
for, 401
melolabial fold, autologous fat transfer
longevity, 478
melolabial interpolation flap, 292
memory, sutures, 190
mental foramen
anatomy, 11–12, 11f
changing location with age, 53f
in chin implants, 417, 418f, 422
mentalis
anatomy, 17t, 18, 18f–19f
in chin implants, 417, 418f
fat autograft muscle injection, 476f–477f
mental nerve, 417, 418f
in chin implants, 422
injury, 425
mental nerve block, 51t, 52, 52f–53f
mental protuberance, 417, 418f
mentolabial crease, 7, 7f
mentolabial sulcus, 12f
menton, 12, 12f, 416t
meperidine hydrochloride, microdermabrasion/
dermabrasion, 531
Mepitel, 116–117
mepivacaine, 44t–45t
Merkel cell carcinoma
Mohs micrographic surgery, 728–729
radiation therapy, 729
Merkel cells, 102, 755–756
Mersilene, 70, 194t
meshing devices, 315–316, 315f
metacarpophalangeal crease, 24f
metastases
melanoma, 705, 43e15
squamous cell carcinoma, 726
metatarsals, first, 25f
methemoglobinemia, local anesthesia-
associated, 56b, 60
methicillin-resistant Staphylococcus aureus
(MRSA)
antibiotic resistance, 85
antimicrobial dressings, 125
surgical site infections, 85–86
methyl aminolevulinate (MAL), 557–559
metoclopramide, 58–59
Metzenbaum scissors, 66, 66f
microbial colonization, surgical site infection
risk, 87
microcystic adnexal carcinoma, 729–730
microdermabrasion, 527–530
devices, 532
efficacy, 527
histology, 527–528, 529f
historical vignette, 530
optimizing outcomes, 535
pitfalls and their management, 535
postoperative care, 533–535
preoperative preparation, 530–531
safety, 532
studies, 527–530, 529f
technical aspects, 531–532
microepidermal necrotic debris (MEND), 556
microfibrillar collagen haemostat, 232t
microgenia, 420
micrognathia, 420
micropigmentation, vitiligo, 42e6–42e7
microwave technology, hair removal, 521
middle cerebral artery, occlusion after
autologous fat transfer, 481
mid-face
anatomy, 604f
fillers for, 366
suspension sutures, 217–220, 218f–220f
mid-face suspension lift, 218–220, 220f
mid-forehead brow lifting, 637–638, 639f
mid-forehead lifting, 638
mid-infrared lasers, skin remodeling, 555
migraine, after sclerotherapy, 586
milia
ablative laser skin resurfacing, 552
chemical peel complications, 410
cryosurgery, 164
incisional surgery, 182, 185–186
microdermabrasion/dermabrasion, 535
mimetic muscle aging, 351, 352f
miniaturization, androgenic alopecia, 487
Mini-Mental Status Exam, 340
minimum incision face lift, 601–614
anatomy, 601–602, 602f–604f
blood pressure, 605
incision, 606, 606f
instruments, 612t
liposuction in, 605, 610–611, 613f
optimizing outcomes, 610–611
photography, 604
pitfalls and their management, 611–613
postoperative care, 611
preoperative preparation, 604
skin markings, 604–605, 605f
SMAS plication, 608–610, 608f–611f
technical aspects, 604–610
tumescent anaesthesia, 601, 604–606,
605t
undermining of the lateral cheek, 606–608
variations on rhytidectomy, 603–604
SMAS lift, 603
supra-SMAS dissection, 603
minipunch grafting (MPG), 685–686,
685f–686f, 42e10f, 689t
Minor’s test, 444, 465

837
Index
minoxidil and follicular unit hair
transplantation, 492–493
modified Unna’s resorcinol paste, 396b
modiolus, 18f
modulus of elasticity, 5
Mohs layer, 71, 71f
Mohs micrographic surgery, 711–714
advantages, 713–714
cutaneous oncology, 724–730 (see also
specific tumors)
history, 711b–712b
indications, 713, 713t
angiosarcoma, 730
atypical fibroxanthoma, 729
basal cell carcinoma, 714, 724–725
dermatofibrosarcoma protuberans, 729
digits, 714
ear lesions, 714
extramammary Paget’s disease, 730
eyelid lesions, 714
facial malignancies, 714
genitalia, 714
lentigo maligna, 163
lips, 714
malignant fibrous histiocytoma, 729
melanoma, 726–728
Merkel cell carcinoma, 728–729
microcystic adnexal carcinoma,
729–730
mucosal cancers, 714
nose, 714
sebaceous carcinoma, 730
squamous cell carcinoma, 725–726
sweat gland neoplasms, 729–730
instruments, 721–722, 721f–722f
optimizing outcomes, 721–722
pitfalls and their management, 722–724
postoperative care, 722
preoperative preparation, 252, 714–715
skin cancer growth, 712
specimen interpretation, 719–721, 720f
surgical site infection risk, 86
technical aspects, 715–721
technique, 712, 712f
breadloaf method, 712, 713f
mapping and division of specimen,
716–717, 717f–718f
preparation, 715–716, 716f
specimen marking and sequence
numbering, 719f
specimen staining, 718, 718f
stage I excision, 716f
stage II excision, 720f
stage III excision, 720f
training programs, 711
moisture retentive dressings see occlusive/
moisture retentive dressings
moles, atypical see atypical moles
moles breed true, 693–696
molluscum contagiosum, cryosurgery, 157,
157t
Monfreux foam sclerotherapy, 584
monitoring equipment, 801–802, 801f
Monocryl, 192t, 193, 282
monocytes, 97–100, 100t
Monosof, 194t
Monsel’s solution, 229
mons pubis, 24–26, 26f
mood, psychiatric exam, 340
mosquito clamps, 233
motor innervation of the head and neck,
20–21, 21f
motor nerve injury in vertical vector face lift,
624
mouth, facial expression muscles, 17t
M-plasty, 243–244, 245f
mucinous carcinoma, 730
mucocele, cryosurgery, 157t
mucosal advancement flap, 260–261
multibladed knives, follicular unit hair
transplantation, 510
multilayer bandages, leg ulcers, 742, 742t
mummification after cryosurgery, 164
mupirocin, topical, 89
muscle(s)
chin see chin, muscles
dysmorphia, 342–343
facial expression see facial expression
muscles
mastication, 20
repercussions in the ageing process, 434
see also specific muscles
muscle/skin interaction, 351–352, 352f
Mustarde rotation flaps, 264–268
Mycobacterium infection, 480–481
Myobloc, 435t
myofibroblasts, 106
myxoid cyst, cryosurgery, 157t
myxoid pseudocysts, 773, 773f
N
nail avulsion, 760–761
distal, 760, 760f
partial, 761
proximal, 760–761, 760f
nail bed
biopsies, 759, 763f
periosteal flap, 767–768
nail fold, 757
biopsy
lateral, 760
proximal, 760
defects
lateral, 774
proximal, 774, 776f, 778f
reconstructive, 774, 778f
hypertrophy, 768
nail plate, 756–757, 756f
nail(s)
ablation, 761–762, 761f
avulsion see nail avulsion
biopsies see nail surgery, biopsies
clippings, 758
hand scrub, 33, 37, 37f
nerve blocks, 53–54
surgery see nail surgery
surgical anatomy, 755–757, 756f
traumatic shortening, 777, 779f
tumors see nail tumors
nail surgery, 755–780
anesthesia/anesthetics, 757
biopsies, 758–760, 759f
lateral longitudinal nail biopsy,
758–759, 763f
lateral nail fold biopsy, 760
matrix biopsies, 759, 763f
nail bed biopsies, 759, 763f
nail clippings, 758
proximal nail fold biopsy, 760
superficial matrix biopsy, 759–760,
763f
distal nail embedding, 768, 769f
foreign bodies, 762, 763f
infection, 770–771
acute paronychia, 770
chronic paronychia, 770–771
subungual, 771
ingrown toenails see ingrown toenails
instruments, 757
matricectomy, 761–762, 761f
nail ablation, 761–762, 761f
nail avulsion, 760–761
distal, 760, 760f
partial, 761
proximal, 760–761, 760f
onychauxis, 770
onychogryphosis, 762–763
optimizing outcomes, 777
pachyonychia congenita, 763
pincer nails, 769–770, 770f
pitfalls and their management, 777–779,
779b
preoperative preparation, 757–758, 758f
prophylactic antibiotics, 757
racket nails, 763, 764f
reconstructive, 774–777
matrix defects, 774–777
nail fold defects, 774, 776f, 778f
traumatic shortening of the distal
phalanx and nail, 777, 779f
retronychia, 769
surgical anatomy of the nail region,
755–757, 756f
technical aspects, 758–777
trauma, 762, 762f
tumors, 771–774
benign, 771–773
common warts, 771
myxoid pseudocysts, 773, 773f
onychomatricoma, 771–772
onychopapilloma, 771
subungual exostosis, 772, 772f
subungual filamentous tumor, 771
subungual glomus tumor, 772–773,
772f
ungual fibrokeratomas, 771, 771f
malignant, 773–774
carcinoma cuniculatum, 773
epidermoid carcinoma, 773, 774f
ungual melanoma, 773–774, 775f
nail tumors, 771–774
benign, 771–773
common warts, 771
myxoid pseudocysts, 773, 773f
onychomatricoma, 771–772
onychopapilloma, 771
subungual exostosis, 772, 772f
subungual filamentous tumor, 771
subungual glomus tumor, 772–773, 772f
ungual fibrokeratomas, 771, 771f
malignant, 773–774
carcinoma cuniculatum, 773
epidermoid carcinoma, 773, 774f
ungual melanoma, 773–774, 775f
nasal ala see ala nasi; entries beginning alar
nasal bones, 11, 11f
nasal contours, 7
nasal dorsum skin thickness, 4
nasal flare, repeated, botulinum toxin
injections, 438t, 440
nasalis, 18f–19f
nasal muscles, 16
nasal reconstruction
axial pattern flaps for, 291–292, 292f–294f
forehead skin for, 292

838
Index
nasal tip, 8f, 12f
droop, botulinum toxin injections, 438t,
440
skin thickness, 4
nasion, 11, 12f, 416t
nasofacial sulcus, 7, 7f, 9
nasojugal fold, 8f
augmentation, 382
nasolabial fold, 7, 8f–9f
autologous fat transfer, 473
autologous fat transfer longevity, 478
fillers for, 366–367, 378–379, 378f
calcium hydroxylapatite, 381–382
cross-linked porcine collagen, 383
hyaluronic acid, 379
poly-L-lactic acid, 385
polymethylmethacrylate, 387
nasolabial junction, suspension sutures, 220
nasolabial transposition flap, 272–276,
279f–280f
design, 273–276
disadvantages, 276
modifications, 273–276
pedicled, 276
procedure, 273
suturing, 282
uses, 272–273
National Nosocomial Infections Surveillance
(NNIS), 85
N-butyl-2-cyanoacrylate, 197
n-2cyanoacrylate, 197
N-duopropenide (NDP), 32–33
Nd:YAG laser see neodynium:yttrium
aluminium garnet (Nd:YAG) lasers
neck
anterior triangle, 23
botulinum toxin injections, 438t, 442, 443f
incisional surgery, 186
incisions, 23
liposuction, 463, 464f
lymph nodes, 21–22, 22f, 26b
nerve supply, 20–21
posterior triangle, 23
rejuvenation see neck rejuvenation
sensory nerves see sensory innervation of
the head and neck
skin, 23
soft tissue anatomy, 6–7
superficial landmarks, 23
surgical anatomy of, 23, 23f
neck rejuvenation, 651–665
fractionated CO2 laser resurfacing,
662–663
history of, 652b
liposuction, 651, 653–656
anesthesia, 653–654
instruments, 653–654, 654f–655f,
654t
laser-assisted, 655–656, 656f
path of, 654, 654f
pitfalls and their management, 665
procedure, 653–654
skin marking, 653, 653f
optimizing outcomes, 663–664
patient evaluation, 652–653, 652f–653f
pitfalls and their management, 664–665
platysma repair, 651, 656–659
corset, 656t, 657–658, 657f–658f
simple midline, with transection,
656–657, 657f
postoperative care, 663
preplatysmal fat, 652–653
radiofrequency tissue tightening, 652,
659–662, 659f
studies, 659–660
treatment method, 660–662, 660f–662f
retroplatysmal fat, 652–653, 657f
SMAS plication, 658–659, 659f
technical aspects, 653–663
necrosis
chin implants, 427
cryosurgery, 153
injection-site see injection-site necrosis
minimum incision face lift, 612
Mohs micrographic surgery, 723
nail surgery, 779
pressure, 235–236
sclerotherapy, 586
necrotic tissue, 130b, 131f
needle holders, 65, 67–68, 68f
needles, 68, 70
autologous fat transfer, 473
follicular unit hair transplantation, 500
nomenclature, 195
points, 70, 70f
suture, 195, 195f–196f, 197t
neodynium:yttrium aluminium garnet
(Nd:YAG) lasers
endovenous laser ablation, 597–598
facial erythema, 573
hair removal, 517–518, 521, 522t
hemangiomas, 571–572
hemostasis, 230
keloid management, 676
melanocytic lesions, 540–541
nevus of Ota-like macules, 540–541
1320-nm, 555
pigmented lesions, 537–538
epidermal, 540
port-wine stain, 569–570
postoperative care, 576
skin remodeling, 555
tattoo removal, 545
techniques, 576
telangiectasias, 572–573
vascular lesions, 566
venulectasia, 572–573, 573f
neovascularization, 106, 310
nerve blocks, 26b, 51
adverse effects, 57
extremities, 53–55, 55f, 57f
facial, 51–53, 51t, 52f–54f
microdermabrasion/dermabrasion, 531
practical applications, 61
synthetic implants, 368
nerve damage/injury, 57
after sclerotherapy, 586
after vertical vector face lift, 624
nerve fibers, 45, 45t
nerve supply of the head and neck, 20–21
Neurobloc/Myobloc, 435t
neuro-smooth needle holders, 67–68
neurotoxins, 433
neutrophils, 97–100, 100t
nevi
dysplastic see atypical moles
laser treatment, 541
melanocytic, 541
see also specific nevi
nevus of Ota, laser treatment, 540–541, 541f
nevus of Ota-like macules, laser treatment,
540–541
New-Fill, 369t–374t
Nikolsky’s sign, 523
nitrogen gas insufflation after cryosurgery, 164
nitroglycerin, 56–57
nodule formation
after calcium hydroxylapatite injections,
381–382
after hyaluronic acid injections, 380
non-ablative fractional resurfacing, 555–557,
556f
adverse effects, 557
biology of fractional photothermolysis, 556
treatment parameters, 556–557
non-ablative laser skin remodeling, 554–557
mid-infrared lasers, 555
non-ablative fractional resurfacing,
555–557, 556f
adverse effects, 557
biology of fractional photothermolysis,
556
treatment parameters, 556–557
optimizing outcomes, 557
pitfalls and their management, 557
postoperative care, 557
preoperative preparation, 554
technical aspects, 554–557
visible light lasers, 555
non-adherent fabric dressings, 116–117
non-melanoma skin cancer (NMSC),
prevention, 400
non-steroidal anti-inflammatory drugs
(NSAIDs), 79
action, 101–102
autologous fat transfer, 470–471
effect on hemostasis, 227t
liposuction risk, 451
normal flora, 30
Normiflo, 79
Northbent scissors, 67
Norwood classification, hair loss, 488, 488f,
488t
nose
flap elevation plane, 281, 281f
surface geometry, 291–292
topographic landmarks, 8f
tumours, 714
undermining plane, 280t
see also entries beginning nasal
nostril sill, 8f
Novafil, 70, 193, 194t
N-Terface, 116–117
numbness, postoperative
follicular unit hair transplantation, 508b,
509t
vertical vector face lift, 622–624
Nurolon, 69–70, 194t
nutritional supplements
anticoagulant effect, 79, 80t
impairing hemostasis, 227–228, 227t
nutrition and pressure ulcers, 130
nylon sutures, 69–70, 69t, 193
monofilamentous, 193
multifilamentous, 193
properties, 194t
random pattern cutaneous flaps, 282
O
Oasis, 123, 321
oblimersen, 43e15
obsessive-compulsive disorder, 341
occipitalis, 19f
occipital lymph nodes, 21–22, 22f
occipitofrontalis muscle, 7

839
Index
occlusive/moisture retentive dressings,
117–125, 117t
biologic, 121–122 (see also skin grafting)
biosynthetic, 122
leg ulcers, 743
non-biologic, 117–118
wound healing, 110, 111f
see also specific types
octyl cyanoacrylate, 197, 243
ocular fat embolism after autologous fat
transfer, 481
oculocardiac reflex, 648
odor, leg ulcers, 739
Office-based Surgery (OBS) accreditation
program, 807–808
office-based surgery practice, 795–796, 796f
accreditation see dermatology office
accreditation
office-based surgery statutes/rules, 812t–816t
Office of Inspector General (OIG), 810
Ohmic heating, 139
Ohm’s law, 659
oncology, 724–730
see also specific tumours
onychauxis, 770
onychogryphosis, 762–763
onychomatricoma, 771–772
onychopapilloma, 771
open cryosurgery technique, 155, 163
operating tables, 798–799, 799f
operating theatre
cleaning, 36, 38, 802
follicular unit hair transplantation,
494–495, 494f
see also surgical suite
ophthalmic artery, 14
ophthalmic nerve, 20
ophthalmic topical anesthesia, 49
oral commissures, fillers for, 379
oral contraceptives, liposuction risk, 451
orbicularis oculi
anatomy, 15–16, 17t, 18f–19f, 628
in complex layered facial closures, 217
fat autograft muscle injection, 476f–477f
orbicularis oris, 418f
anatomy, 18, 18f–19f
fat autograft muscle injection, 476f–477f
lip repairs, 303
orbitale, 416t
orbital septum, 18f, 628
OrCel, 125
organ transplantation, effect on surgery, 78
Orgaran, 79
orientation, psychiatric exam, 340
ornithine decarboxylase (ODC), 516
ortho-hydroxybenzoic acid, 396b, 399–400
ortho-phthalaldehyde (OPA) sterilization,
36–37
orthotic devices, compression therapy, 129, 129f
osmidrosis, liposuction, 346–347
osteomyelitis, leg ulcers, 740–741
O-T rotation flap, 257
outpatient surgical facilities, 795–797
overcorrection
autologous fat transfer, 480
chin implants, 425
hyaluronic acid, 380
oxidized cellulose, 232t
oxycodone, 60
oxyhemoglobin, 537, 564–565, 564f
O-Z flap, 215
O-Z rotation flap, 268, 269f
P
pacemakers
antibiotic prophylaxis, 91–92
effect on surgery, 78
and elliptical excisions, 239
malfunction due to electrosurgery,
150–151, 150t
pachyonychia congenita, 763
packing, inflamed and infected cysts and
abscesses, 184, 184f, 186
Paget’s disease, extramammary, 730
pain
after Mohs micrographic surgery, 722
control, 130b
leg ulcers, 741t
nail surgery, 777, 779b
venous ulcers, 737–739
palliative treatment, cryosurgery, 157t, 163
palmar incisions, 23
palmar innervation, 56f
palmar skin, 23
palm biopsies, 175
palpebral fissure measurement, 632f
palpitations, follicular unit hair transplantation,
509t
panax ginseng, 80t
papain-urea, 746, 747f
papaya, 80t
papillary eccrine adenoma, 730
papules after polymethylmethacrylate
injections, 387
parachlorometaxylenol (PCMX), 31t
hand scrub, 32
surgical site preparation, 35
paraffin as an injectable filler, 363–364
paralysis, botulinum toxin injections
complications, 445
paramedian forehead flap, 292
additional interim stage, 299, 301f
anatomic basis, 294–295
failure, 304–305
first stage, 295–299, 296f–299f
history, 294
optimizing outcomes, 307b
pitfalls and their management, 307b
postoperative care, 304–305, 305f–306f
preoperative preparation, 295, 295f
second stage, 299, 299f–300f
paraurethral duct, 26f
paresthesia, adverse effects of nerve blocks, 57
paronychia
acute, 770
chronic, 770–771
parotid duct, 13–14, 13f
parotid gland, 13–14, 13f
anatomy, 7
parotid lymph nodes, 21–22, 22f, 26b
passive-aggressive patients, 341
patent foramen ovale, sclerotherapy risk, 586
patient counseling
random pattern cutaneous flaps, 254
vitiligo surgery, 684
patient evaluation, 73–83
allergies, 81
brow lifting, 631–632
chemical peels, 396b
chin implants, 418–420, 419f
consultation area, 73
consultation components, 73–74
elliptical excision, 239–240
follicular unit hair transplantation, 487–490
health questionnaire, 76f–77f
hemostasis, 226, 226t
informed consent, 82
laser treatment of pigmented lesions, 539
medical conditions affecting surgery,
74–79
bleeding disorders, 78–79
cardiovascular disease, 74–78
hepatitis, 78
herpes simplex virus infection, 78
HIV infection, 78
hypertension, 74
implanted deep-brain stimulators, 79
organ transplantation, 78
pregnancy, 74
prosthetic devices, 78
medical history, 74
medications, 79–81
anticoagulants, 79–81, 80t
non-selective β-blockers, 81
neck rejuvenation, 652–653, 652f–653f
optimizing outcomes, 82
physical examination, 75f
pitfalls and their management, 82
random pattern cutaneous flaps, 253
social history, 82
surgical history, 81–82
vitiligo surgery, 684–685, 684f
patient expectations
ablative laser skin resurfacing, 554
follicular unit hair transplantation, 490
liposuction, 456
microdermabrasion, 527
patient preparation, 34–35
botulinum toxins, 436–437
draping, 35
elliptical excision, 241
hair removal, 35, 35f
removal of street clothes, 34–35
surgical site infection risk, 87
surgical site preparation, 35
patient risk factors
axial pattern flaps, 291
surgical site infections, 86–87
patient safety, importance of enhanced,
818
patient selection
ablative laser skin resurfacing, 553–554
blepharoplasty, 628–632
brow lifting, 628–632
non-ablative laser skin remodeling, 554
photodynamic therapy, 558–559
random pattern cutaneous flaps, 253
vertical vector face lift, 617
pearly penile papules, cryosurgery, 157t
peau d’orange, botulinum toxin injections,
441
pedicled transposition flap, 276
Pendrose drain tourniquet, 231f
penicillin in pregnancy, 74
penis, 24, 26f, 157t
pentoxifylline, leg ulcers, 742
perforator vein ligation, 45e5–45e6, 45e5
perioral area muscles, 15–20
perioral wrinkles, botulinum toxin injections,
438t, 440–441, 441f
periorbicular wrinkles see crow’s feet
periorbital area
Mohs micrographic surgery, 723
muscles, 15–16, 628, 629f
skin, 7
topographic landmarks, 8f

840
Index
periosteal elevators, 68
Perlane, 369t–374t, 377–378
Perma-Hand, 193, 194t
Persantin, effect on hemostasis, 227t
personal appearance, 339–340
personality identification, 340–341
hostile and angry, 341
obsessive-compulsive disorder, 341
passive-aggressive, 341
sociopaths, 341
phalanx, distal see distal phalanx
pharmacotherapy, body dysmorphic disorder,
346
phenol
cardiotoxicity, 407
cautery, ingrown toenails, 766–767,
768f
peels see phenol peels
Phenol Peel Exoderm, 407
phenol peels, 394f, 394t, 405–408
history, 393
postoperative care, 408
preoperative preparation, 407
systemic complications, 411
technical aspects, 408
phentolamine, 56–57
pheomelanin, 514–515
philtral columns, 7, 7f, 9f
philtral groove, 9f
philtrum, 9f
photoaging/photodamage, 601
classification, 397t
photodynamic therapy, 558–559
skin elasticity and, 5
photodynamic therapy (PDT), 557–559
anesthesia, 559
hair removal, 518
patient selection, 558–559
pitfalls and their management, 559
postoperative care, 559
protocols, 559t
technical aspects, 558–559
technique, 559
photography
atypical moles, 435e–436e
liposuction, 341
minimum incision face lift, 604
prior to chemical peels, 395
photo rejuvenation, 557
phototherapy
targeted, 687–688, 689f
vitiligo, 687–688, 688f–689f
in vitiligo surgery, 685–686
photothermal laser hair removal, 522t
photothermolysis
fractional, 556
selective, 537
laser-tissue interaction principles,
563–564
vascular lesion removal, 565–566
pigmentation
after chemical peels, 410, 410f
after endovenous ablation for varicose
veins, 599
after laser hair removal, 524–525,
525f
after laser treatment, 543–544, 543f
after microdermabrasion/dermabrasion,
534–535
and keloids, 669
medication-induced, 542
periorbital, 542
pigmented lesions
intense pulsed light (IPL), 538–539
laser treatment, 537–548
anesthesia, 540
dermal pigmented lesions, 540–542,
544–545
epidermal lesions, 540, 543–544
history, 539
optimizing outcomes, 543–545
patient evaluation, 539
pitfalls and their management, 546
postoperative care and complications,
545–546
preoperative preparation, 539–540
safety, 539
technical aspects, 540–542
types of lasers, 537–539, 538t
pilar cysts, 182, 182b, 183f
pincer nails, 769–770, 770f
pinch grafting, leg ulcers, 748, 748f
pinch test, 629, 632f
pin-cushion deformity see trapdoor deformity
pinwheel closure, 215
pixie ear deformity, 612–613
plane of elevation, random pattern cutaneous
flaps, 280–281, 281f
plasticity, sutures, 190
platelet-derived growth factor (PDGF),
98–100, 102, 106–107, 115–116
wound healing, 738t
platelet gels, 232t
platelets, 98–99, 99t
activation, 225
aggregation, 225
disorders affecting, 226t
wounding, 97–98
platysma, 17t, 18–20, 18f–19f, 601–602
fat autograft muscle injection, 476f–477f
general description, 615–616
influence on facial appearance, 615
plication, 611
prominent banding, 652–653, 653f
repair see platysma repair, neck rejuvenation
platysmaplasty, 611
platysma repair, neck rejuvenation, 651,
656–659
corset, 656t, 657–658, 657f–658f
simple midline, with transection, 656–657,
657f
Plavix, 79, 227t
Pliagis, 48
PLLA see poly-L-lactic acid
pneumatic compression, 129
pneumatic skin flattening (PSF), 49
pogonion, 12f, 416t
poikiloderma
of Civatte, 567b, 573–574
laser and light treatment, 573–574, 574f
poikilodermatous changes, management,
357–358
polidocanol, 583
poliglecaprone 25, 193
follicular unit hair transplantation, 497b
properties, 192t
polyacrylamide gel, 366t
polybutester sutures, 69t, 70, 193
properties, 194t
polybutylate suture coating, 193
polydioxanone, 68–69, 191
properties, 192t
polyester sutures, 69t, 70, 193
properties, 194t
polyglactin 910, 68–69, 69t, 191
coating, 189–190
properties, 192t
polyglycolic acid, 68–69, 69t, 191
properties, 192t
polyglyconate, 68–69, 69t
polyhexafluoropropylene-VDF, 193–195, 194t
poly-L-lactic acid, 366, 369t–374t, 383–386
composition, 384
contraindications and adverse effects, 386
general description, 383–384
indications, 384
injection technique, 385–386
key publications, 385
pre and post, 383f–384f
see also Sculptra
polymerase chain reaction (PCR), 169
polymethylmethacrylate (PMMA), 386–388
adverse events with, 387
commercially available fillers, 366t
composition, 386
historical aspects, 364–365
injection technique, 387–388
key studies in the literature for, 386–387
polypropylene sutures, 69t, 70, 193
properties, 194t
random pattern cutaneous flaps, 282
Polysorb, 191, 192t
polytetrafluoroethylene, expanded (e-PTFE),
365, 366t, 375f
polytrimethylene carbonate, 191–193
properties, 192t
poplar, 80t
porcine collagen cross-linked with Glymatrix
technology, 382–383
porcine xenografts, 321
porion, 416t
port-wine stain, 566–570, 567b
alexandrite laser treatment, 569–570
cryosurgery, 160
intense pulsed light treatment, 569
KTP laser treatment, 569–570
Nd:YAG laser treatment, 569–570
pulsed-dye laser treatment, 568–569, 568f
recurrence, 569
positron emission tomography (PET),
melanoma metastases, 705
postauricular area
lymph nodes, 21–22, 22f, 26b
skin, 7
posterior button keloids, 672, 675, 675f
posterior labial commissure, 26f
posterior tibial artery, 25f
postoperative care, 125–130
Abbe cross-lip flap, 305
ablative laser skin resurfacing, 553
complex layered facial closures, 220
cryosurgery, 163–164
deep (phenol) peels, 408
earlobe reduction, 790
elliptical excision, 247–248
endovenous ablation for varicose veins, 595
follicular unit hair transplantation, 502,
507, 508b
hemostasis, 235–236, 236b
incision, drainage and exteriorization, 186
intense pulsed light (IPL), 576
laser hair removal, 524
laser treatment of pigmented lesions,
545–546
liposuction, 465–466
medium-depth chemical peels, 404–405

841
Index
melanomas, 704–705
microdermabrasion/dermabrasion, 533–535
minimum incision face lift, 611
Mohs micrographic surgery, 722
neck rejuvenation, 663
neodynium:yttrium aluminium garnet
(Nd:YAG) lasers, 576
non-ablative laser skin remodeling, 557
paramedian forehead flap, 304–305,
305f–306f
photodynamic therapy, 559
potassium titanyl phosphate (KTP) lasers,
575–576
pulsed-dye lasers, 575
random pattern cutaneous flaps, 282–284
scar revision, 334
skin grafting, 321–323
superficial chemical peels, 401
sutures, 206–207
vertical vector face lift, 622–623
vitiligo surgery, 688
VNUS Closure procedure, 597f
see also wound care
potassium titanyl phosphate (KTP) lasers
facial erythema, 573
hemangiomas, 572
pigmented lesions, 537–538
port-wine stain, 569–570
postoperative care, 575–576
tattoo removal, 545
techniques, 575–576
telangiectasias, 572
vascular lesions, 566
povidone-iodine, 31t
hand scrub, 32
removal, 39b
surgical site preparation, 35
power, 139
prasugrel, effect on hemostasis, 227t
preauricular lymph nodes, 22f
preauricular sulcus, 7
preauricular zone, suspension sutures,
217–220, 218f–220f
prednisone, 101–102
pregnancy
effect on surgery, 74
keloids in, 670
local anesthesia/anesthetics in, 44, 74
pre-jowl augmentation, 420–421
Prejowl Chin Implant, 420, 421f
preoperative assessment
laser treatment of pigmented lesions,
539–540
skin biopsies, 169–171, 169t
sutures, 189
vertical vector face lift, 617–618
see also patient evaluation
preoperative preparation
ablative laser skin resurfacing, 549
autologous fat transfer, 470–471
axial pattern flaps, 295, 295f
chemical peeling, 393–396
deep (phenol peels), 407
chin implants, 418–421, 419f
cryosurgery, 155–156
ear piercing, 786
endovenous ablation for varicose veins, 590
follicular unit hair transplantation,
487–494, 493b
hemostasis, 228
incision, drainage and exteriorization, 177
laser hair removal, 516–517
leg ulcer management, 737–741
liposuction, 447–456
microdermabrasion/dermabrasion, 530–531
minimum incision face lift, 604
Mohs micrographic surgery, 714–715
nail surgery, 757–758, 758f
non-ablative laser skin remodeling, 554
random pattern cutaneous flaps, 252–254
scar revision, 327–328
skin grafting, 310, 310t
skin grafting of leg ulcers, 747–748
soft tissue augmentation, 367–368
superficial chemical peels, 396–397
see also aseptic technique, preoperative
preparation
preplatysmal fat, 652–653
prepuce, 24, 26f
pressure ischaemia, 235–236
pressure ulcers, 96, 97f, 130
etiology, 737
pretrichal forehead lifting, 638–639
Prevail-Fx, 35
prilocaine, 44t–45t
adverse effects, 60
in pregnancy, 74
privileging, 809, 817
probes, cryosurgery, 155, 155f
procaine, 43, 44t
procerus muscle, 16, 17t, 18f–19f
fat autograft muscle injection, 476f–477f
profile analysis, 415–417, 416f, 416t
Prolene, 193, 194t
proliferating hemangiomas, 571, 571f
ProLipo, 655
Pronova, 193–195, 194t
proparacaine, 47t, 49
Propionibacterium acnes, 30, 85
Prosigne, 435t
prostacyclin, 98–99
prostaglandin E2 (PGE2), 101
prostaglandins, 101
prosthetic joints, antibiotic prophylaxis,
91–92, 91t
prosthetic valve endocarditis (PVE), 90
proteases, 99–100
proteinases, 109–110, 109t
proteoglycans, 108
protoporphyrin IX (PpIX), 557
proximal interphalangeal crease, 24f
proximal palmar crease, 24f
prurigo nodularis, cryosurgery, 157t
pseudocysts, myxoid, 773, 773f
pseudoepitheliomatous hyperplasia, 164
pseudohypopigmentation, microdermabrasion/
dermabrasion, 535
pseudomelanoma, laser treatment, 541
Pseudomonas infection, 30, 32
after ablative laser skin resurfacing,
552–553
after autologous fat transfer, 480–481
antibiotic resistance, 85
chemical peel complications, 410–411
psychiatric exam, 339–340
intelligence and comprehension, 340
Mini-Mental Status Exam, 340
mood and affect, 340
orientation, 340
personal appearance, 339–340
schizophrenia, 340
thought processing, 340
psychogenic attacks, local anesthesia-
associated, 57–58
psychosocial issues, 339–349
adolescents and cosmetic surgery, 348
body dysmorphic disorder see body
dysmorphic disorder
optimizing outcomes, 340–341
personality identification, 340–341
pitfalls and their management, 347–348
practical applications, 341–347
psychiatric exam, 339–340
intelligence and comprehension, 340
Mini-Mental Status Exam, 340
mood and affect, 340
orientation, 340
personal appearance, 339–340
schizophrenia, 340
thought processing, 340
technical aspects, 339–340
pulley stitch, 5–6, 206, 206f
pulp, digits, 755–756, 756f
pulsed ablative lasers
scar revision, 334
see also carbon dioxide lasers; erbium:yttrium
aluminium garnet (Er:YAG) lasers
pulsed-dye laser (PDL)
facial erythema, 573
hemangiomas, 571–572
hypertrophic and erythematous scars, 574
keloid management, 676
pigmented lesions, 537–538
epidermal, 540
poikiloderma, 573–574, 574f
port-wine stain, 567–569, 568f
postoperative care, 575
radiation dermatitis, 572, 572f
scar revision, 328
skin remodeling, 555
striae distensae, 574
technique, 575
telangiectasias, 572, 573f
vascular lesions, 566
warts, 574
pulse duration
laser hair removal, 518–519
laser-tissue interaction principles, 565
pulse oximeter, 801, 801f
punch biopsy, 172–175, 173f–174f
puppet face lift, 218–220, 220f
purpura, after pulsed-dye laser treatment, 569
purse string sutures, 205, 234f
putrefied bovine collagen, 229
pyoderma gangrenosum, 45e1
pyogenic granuloma, cryosurgery, 157t, 160,
160f
Q
Q-switched lasers, 537
combined with chemical peels, 402
hair removal, 518–519
nevus of Ota-like macules, 540–541
pigmented lesions, 537–538
dermal, 540–541
epidermal, 540
safety, 539
tattoo removal, 545
see also specific types
R
racket nails, 763, 764f
radial nerve, 23, 24f
block, 54, 56f

842
Index
radiation dermatitis, 572, 572f
radiation therapy
basal cell carcinoma, 724
keloid management, 676–677
Merkel cell carcinoma, 729
and Mohs micrographic surgery, 724
Radiesse, 366, 369t–374t, 381
radiofrequency closure see endovenous ablation
for varicose veins, radiofrequency
closure
radiofrequency tissue tightening
neck rejuvenation, 659–662, 659f
studies, 659–660
treatment method, 660–662, 660f–662f
random pattern cutaneous flaps, 251–287
anesthesia, 278–279
versus axial pattern flaps, 291
blood supply, 254
definitions, 252t
hemostasis, 281–282
history, 251–252
incision, 279–280
optimizing outcomes, 276–282
physiology of flap perfusion, 254
pitfalls and their management, 284–285
plane of flap elevation and surgical
undermining, 280–281, 280t
postoperative care, 282–284
preoperative preparation, 252–254
randomized trials, 253
surgical planning, 277–278
suturing, 282
techniques, 254–276 (see also specific
techniques)
Rassman densitometer, 487
red clover, 80t
re-epithelialization, 102
referrals, body dysmorphic disorder, 346–347
reflex sympathetic dystrophy, 779
refrigerants, microdermabrasion/dermabrasion,
531
reimbursement fees, 802–803
relaxed skin tension lines (RSTLs), 327
repair tray, 72, 72f
request form, skin biopsies, 168
resident flora, 30
resistance, 139
Restylane, 369t–374t, 376f
efficacy, 378
key publications, 377–378
Restylane Fine Line, 369t–374t
retinal injury, laser treatment of pigmented
lesions, 539
retinoids, cryosurgery of actinic keratosis, 156
retrobulbar hematoma, 648
retronychia, 769
retro-orbicularis oculi fat pad (ROOF), 628
retroplatysmal fat, 652–653, 657f
reverse cutting needles, 195, 197t
Reviderm Intra, 369t–374t
rhinion, 12f
rhinophyma
cryosurgery, 158
dermabrasion, 530
rhombic flaps see transposition flaps, rhombic/
rhomboid
rhytidectomy see face lift
rhytids see wrinkles
Riedel’s line, 416t
Rieger flap see dorsal nasal flap
ring block, 50, 50f, 61
follicular unit hair transplantation, 495–496
risorius, 17t, 18, 18f–19f
fat autograft muscle injection, 476f–477f
ropivacaine, 45t
rosacea, cryosurgery, 157t, 158
rotation flaps, 261–268, 262f–263f
backcut, 262, 265f
cervicofacial, 214f
design, 261
dorsal nasal, 262–264, 265f
incisions, 262
mobility, 261–262, 264f
Mustarde, 264–268
O-T, 257
O-Z, 268, 269f
pivotal restraint, 261–262, 264f
placement and creation of tip, 261–262,
264f
purpose, 262
special, 262–268
Tenzel, 264–268, 266f–267f
uses, 261
ruby lasers
hair removal, 520, 521f, 522t
melanocytic lesions, 540–541
nevus of Ota-like macules, 540–541
pigmented lesions, 537–538
epidermal, 540
tattoo removal, 545
rule of halves, 5–6
running stitches, 202–204, 203f
elliptical excision, 243
subcuticular, 204, 204f, 243
subdermal, 205–206
S
saddle bags, 341
safety
botulinum toxin type A (BT-A), 445
calcium hydroxylapatite, 382
foam sclerotherapy, 585
hyaluronic acid, 380–381
intense pulsed light, 575
laser therapy, 575
laser treatment of pigmented lesions, 539
local anesthesia/anesthetics, 279
microdermabrasion, 532
salicylic acid, as a chemical peel agent, 396b,
399–400
saline, local anesthesia, 58–59
saphenous nerve block, 54–55, 58f
sarcopenia, 351
saucerization biopsy, 172
S-Caine patch, 48
scalp
blood supply, 491
flap elevation plane, 280–281
incisional surgery, 186
laxity in follicular unit hair transplantation,
490–491
layers, 6–7, 6f
lymphatic drainage, 21–22
regions, 501, 501f
skin, 6f
skin biopsies, 175
undermining plane, 280t
vascular supply, 7
scalpel handles and blades, 65, 66f
SCALP mnemonic, 6–7
scaphoid fossa, 23f
scar revision, 327–336
cosmetic units, 328
dermabrasion and ablative lasers, 334, 335f
ectropion repair, 333–334, 334f
flap refinements, 327–328
fractional resurfacing lasers
atrophic scars, 329
hypopigmented scars, 329
fusiform elliptical excision, 329, 329f–330f
geometric broken-line closure, 330, 331f
intralesional steroids, 328
non-ablative lasers, 328
pitfalls and their management, 335
postoperative care, 334
preoperative preparation, 327–328
relaxed skin tension lines, 327
suturing technique, 327
technical aspects, 328–334
timing of, 328
trapdoor deformity, 333, 333f
V-Y and Y-V repair, 332–333, 333f
W-plasty, 329–330, 330f
Z-plasty, 330–332, 331f–332f
scar(s)
acne see acne scars
atrophic see atrophic scars
blepharoplasty, 647
chemical peel complications, 411, 412f
elliptical excision, 249
endovenous ablation for varicose veins, 599
erythematous see erythematous scars
explaining to patients, 240
follicular unit hair transplantation, 509t
hypertrophic see hypertrophic scars
hypopigmented see hypopigmented scars
keloids see keloids
removal by dermabrasion, 530
revision see scar revision
skin biopsies, 176b
schizophrenia, 340
sciatic nerve, 54–55
scissors, 65–67, 66f–67f
scleral show after blepharoplasty, 646, 648
sclerosis, 581
sclerotherapy of varicose veins, 581–589
contraindications, 581–583
diagnosis before, 583, 583f
foam sclerotherapy, 584–585
assessment of treatment outcomes, 586t
duplex ultrasound in, 584–585
foam generation, concentrations and
volumes, 584, 585t
puncture and injection, 584
safety measures for, 585
indications, 581
liquid sclerotherapy, 583–584
concentration and volume, 583t
duplex ultrasound in, 584
equipment, 583
pitfalls and their management, 585–587
technical aspects, 583–585
scrotal cysts, 186–187
scrotum, 24, 26f
scrub suits, 33
Sculptra, 366, 369t–374t, 383–384
sebaceous carcinoma, 730
sebaceous hyperplasia, cryosurgery, 157t
seborrheic keratosis, cryosurgery, 157t, 158,
158f
segmental cryosurgery, 163, 163f
selective photothermolysis see
photothermolysis, selective
self-esteem inventory (SEI), 456
senescent cells, 45e4

843
Index
senile alopecia, 488t
sensory innervation of the head and neck, 20,
607f
sentinel lymph node biopsy, 704f
advantages of, 43e13
melanomas, 703–704, 727, 727f–728f,
4312e–4313e
serotonin, 101
SGS (silicone gel sheeting), 677–678
sharp debridement, 125, 131f, 745–746, 745f
shave biopsy, 167–168, 172f
shave therapy, venous leg ulcers, 750
shaving
aseptic technique, 35, 35f, 37, 39b
excess hair, 515
laser hair removal preparation, 523
shoes see footwear
short saphenous vein
foam sclerotherapy, 584
reflux, 593
short-term mole monitoring (STMM),
435e–436e
side weighting, follicular unit hair
transplantation, 501–502, 502f
signature nevus pattern, 693–696
Silastic chin implants, 420–421, 421f
silicone
as an injectable filler, 363–364
chin implants, 420–421, 421f
commercially available fillers, 366t
products, keloid management, 677–678
suture coating, 189–190
silicone gel sheeting (SGS), 677–678
silk sutures, 69, 69t, 193
properties, 194t
SilkTouch, 550
Silon-TSR, after lower eyelid blepharoplasty,
645
silver, leg ulcers, 743
silver-impregnated dressings, 125
silver nitrate, 229, 232t
silver sulfadiazine, 89
simple interrupted stitches, 198–200, 200f
sink, surgical, 800
sizer implants, 422, 424f
skeletal muscle wastage with age, 351
skin
appendages, 3 (see also specific skin
appendages)
assessment, random pattern cutaneous
flaps, 253
biomechanical responses, 5–6
biopsy see skin biopsy
cancer see skin cancer
cooling see cooling
dermis see dermis
elasticity, 5, 5f, 190, 356–357
epidermis see epidermis
flora, 30
functional biomechanics, 3–26, 4f
grafting see skin grafting
head and neck, 6–7 (see also facial skin)
intrinsic elasticity, 5, 5f
laxity, random pattern cutaneous flaps, 253
markings see skin markings
optimal elasticity, 356–357
resurfacing see ablative laser skin
resurfacing; non-ablative laser skin
remodeling
structure, 3–26, 4f
substitutes see skin substitutes
tension, and keloids, 670
tension lines, 9–11, 10f, 106 (see also
wrinkles)
texture changes after follicular unit hair
transplantation, 509t
thickness, 4
types see skin types
skin biopsy, 167–176
aftercare, 175
anesthesia, 170–171
antibiotic prophylaxis, 170
best and worst sites, 167
biology, 167–168
choosing, 171, 171t
culture, 169
cytology, 169
definition, 167
electron microscopy, 169
excisional, 167
formalin, 168
immunopathology, 169
incisional, 167
informed consent, 170
pitfalls and their management, 175–176,
176b
polymerase chain reaction, 169
preoperative evaluation, 169–171, 169t
processing and the request form, 168
site preparation, 170
technical aspects, 167–169
techniques, 171–175
anatomic danger areas, 175
curettage, 172, 172f–173f
general points, 171
incisional ellipse, 175
incision and enucleation, 175
punch biopsy, 172–175, 174f
shave, 171–172, 172f
snip, 171
special sites, 175
uses, 167
skin cancer
axial pattern flaps, 289
growth, 712
see also melanomas; non-melanoma skin
cancer (NMSC); specific types
skin closure tapes, 196
skin grafting, 121–122, 309–325
cartilage grafts, 316–320 (see also
composite grafts)
composite grafts see composite grafts
definitions, 309
delayed, 320
dermal grafts, 321
failure, 323
full-thickness skin grafts see full-thickness
skin grafts
imbibition, 309
inosculation, 309
leg ulcers, 746–749, 748f
neovascularization, 310
physiology, 309–310
pitfalls and their management, 323
porcine xenografts, 321
postoperative care, 321–323
preoperative preparation, 310, 310t
skin substitutes see skin substitutes
split-thickness skin grafts see split-thickness
skin grafts
survival, 321–322
technical aspects, 310–321
see also skin substitutes; specific types
skin hooks, 65, 67
skin markings
lower eyelid blepharoplasty, 643, 645
minimum incision face lift, 604–605, 605f
neck liposuction, 653, 653f
upper eyelid blepharoplasty, 640, 640f
vertical vector face lift, 618
skin/muscle interaction, 351–352, 352f
skin preparation
lower eyelid blepharoplasty, 643, 645
upper eyelid blepharoplasty, 640–641
skin substitutes, 122, 215–216, 320–321
classification, 320–321
composite, 124–125, 124f
cultured epidermal grafts, 122
dermal replacements, 123–124, 124f
indications, 321
leg ulcers, 749f, 749t, 45e5
shelf life, 321
skin tension lines, relaxed, 327
skin types
ablative laser skin resurfacing, 554
and laser treatment of pigmented lesions,
528
non-ablative laser skin remodeling, 557
see also Fitzpatrick skin phototype
classification
sliding flaps, 327
SmartLipo, 655, 656f
SmartXide DOT, 662–663, 664f
smile
alterations after chin implants, 428
asymmetric, 442, 442f
smokers lines, 438t, 440–441, 441f
smoking
after follicular unit hair transplantation, 508b
and chemical peels, 396
effect on surgery, 82
Mohs micrographic surgery, 723
random pattern cutaneous flaps, 253–254
surgical site infection risk, 86
snap test, 629, 632f
snip, 167
sociopathic patients, 341
sodium bicarbonate
addition to local anesthetics, 45t, 46
tumescent anaesthesia, 50t
Sofsilk, 194t
Softform, 365, 369t–374t
soft tissue augmentation, 363–391
commercially available fillers, 366t
commonly used fillers, 367t, 368–388
autologous collagen, 388
bovine collagen see bovine collagen
calcium hydroxylapatite see calcium
hydroxylapatite
human collagen, 364, 368–376
hyaluronic acid see hyaluronic acid
isolagen, 388
poly-L-lactic acid see poly-L-lactic acid
polymethylmethacrylate see
polymethylmethacrylate (PMMA)
porcine collagen cross-linked with
Glymatrix technology, 382–383
fillers available worldwide, 369t–374t
historical aspects, 363–366
indications, 366–367
new products, 364
optimizing outcomes, 388–389
pitfalls, 367b
preoperative preparation, 367–368
technical aspects, 368–388
see also fillers; specific fillers

844
Index
solar lentigo, cryosurgery, 158
sole biopsies, 175
sorafenib, 43e15
spark-gap units, 139, 140f, 141
speech alterations after chin implants, 428
spinal accessory lymph nodes, 21–22
spinal accessory nerve, 17f, 20
identification, 23
injury, 20, 23, 27b
in vertical vector face lift, 624
S-plasty, 244, 246f
splinter forceps, 67
splinting, finger, 757–758
split earlobes, 781–786
optimizing outcomes, 784
pitfalls and their management, 784
postoperative care, 784
preoperative preparation, 781
repair of completely split, 782–784
interlocking V-incisions, 783, 785f
L-plasty, 783, 785f
with preservation of the pierced canal,
783–784, 786f
rotational flaps, 783
V-plasty, 783, 785f
without preservation of the pierced
canal, 782–783, 784f–786f
Z-plasty, 783, 785f
repair of partial split, 781–782
parallel opposed flaps, 781–782, 783f
punch technique, 781, 783f
side-to-side closure, 781, 782f–783f
technical aspects, 781–784
split-thickness skin grafts, 121, 314–316
advantages and disadvantages, 314
definition, 309
donor sites, 316
harvesting, 314–316, 314f–315f
preparation, 316
dressings, 316
equipment, 314, 314f–315f
leg ulcers, 747–749, 748f
optimizing outcomes, 748–749
performance of, 316, 317f
pitfalls and their management, 323,
749
postoperative care, 322–323
preoperative preparation, 747–748
techniques, 748
vitiligo, 423e–425e, 42e9f, 42e10f, 689f,
690, 42e6f
vs. full-thickness skin grafts, 121t
Spongostan, 232t
spot size
laser hair removal, 519, 519f
laser-tissue interaction principles, 565
squamous cell carcinoma
advanced, 726
arising from other lesions, 726
cryosurgery, 157t, 162, 162f
elliptical excision, 241
histology, 725
margins, 241
metastases, 726
Mohs micrographic surgery, 724–725
nail, 773, 774f
presentation, 725
recurrence, 726
squamous cell carcinoma in situ, 726
square knot, 198, 198f
square suture, 235f
S-100 staining, melanomas, 728
stainless steel sutures, 69t, 70, 196
see also staples
Staphylococcus aureus infection, 30
after elliptical excision, 249
antibiotic resistance, 85
intranasal colonization, 87
liposuction risk, 454
methicillin-resistant see methicillin-resistant
Staphylococcus aureus (MRSA)
in microdermabrasion/dermabrasion, 531
surgical site infections, 85–87
wound infection, 284
Staphylococcus epidermidis, 30
Staphylococcus infection, postoperative
ablative laser skin resurfacing, 552–553
autologous fat transfer, 480–481
chemical peels, 410–411
staples, 196
follicular unit hair transplantation, 496,
497f
state legislation and regulation, 811–817
state licensing and certificate need, 810–811
steam under pressure (autoclave) sterilization,
36, 71
steatocystoma, incisional surgery, 183,
185–186
steatocystoma multiplex, cryosurgery, 157t
stem cells
autologous fat transfer, 481
non-cycling, 3–4
Stensen’s duct, 13–14, 13f
step-off, 198, 205f, 207t
correction, 202, 202f
sterile field maintenance, 38–39, 38f–39f
sterile folliculitis, 509t
sterile surgical gowns, 34
sterilization, instrument, 36–38, 38f
see also specific methods
Steri-Quick ear-piercing kit, 787
Steri-Strips, elliptical excision, 243
sternocleidomastoid muscle, 14, 23
steroids see corticosteroids
Stevens-Johnson syndrome, 89
stick and place, follicular unit hair
transplantation, 502
stimulatory fillers, 366
stomion inferius, 12f
stomion superius, 12, 12f
storage, surgical suite, 799–800
strain, 5
stratum germinativum, 3–4
Streptococcus infection
after autologous fat transfer, 480–481
after chemical peels, 410–411
antibiotic resistance, 85
group A streptococci, 30
stress, 5
stress relaxation, 5, 212
stress-strain curve, 5
stress-strain relationship, 5, 5f
stretch-back, 5–6
striae, liposuction, 341
striae distensae, 574
striae rubra, 574
strip excision, follicular unit hair
transplantation, 496, 496f
stromelysins, 109t
structural fat remodeling with age, 352–353,
353f–354f
subcutaneous fat, 4f
subdermal implants, 369t–374t
subdermal plexus, 254
subfacial endoscopic perforator surgery
(SEPS), 45e5–45e6
submandibular gland, position in neck
rejuvenation, 653
submandibular lymph nodes, 22, 22f
submental line, 416t
submental lymph nodes, 21–22, 22f, 26b
subnasale, 12, 12f
suborbicularis oculi fat (SOOF), 628
lift, 218–220, 220f
subungual exostosis, 772, 772f
subungual filamentous tumor, 771
subungual glomus tumor, 772–773, 772f
subungual hematomas, 762, 762f
subungual infection, 771
suction, 800
suction blister epidermal grafting (SBEG),
686–687, 687f–688f, 689t
suicide, body dysmorphic disorder, 345
sun avoidance
after follicular unit hair transplantation,
508b
laser hair removal, 516–517
laser treatment of pigmented lesions, 546
photodynamic therapy, 559
sun damage and chemical peeling, 394
sun protection
after laser hair removal, 524
melanoma risk, 43e10
sunscreens, chemical peel pretreatment, 395
supercut scissors, 67
superficial fibular nerve, 58f
superficial musculoaponeurotic system
(SMAS), 20
anatomy, 212, 213f, 601–602
facial aging, 601
facial expression, 14–15
fascial component, 20
flap, 218, 218f
function, 20
head/face, 6f
history, 211
influence on facial appearance, 615
minimum incision face lift, 601
plication/suspension, 218, 218f–219f
minimum incision face lift, 601,
608–610, 608f–611f
neck rejuvenation, 651, 659f
in vertical vector face lift, 619, 621f
superficial peroneal nerve, 54–55, 58f
superficial temporal artery, 13f–14f, 14, 16f,
294
superficial topography, 3
superficial venous system, 582f
superior crura, 23f
superior labial artery, 14, 16f
superior palpebral sulcus, 8f
supply carts, 800, 800f
supranatant fractions, autologous fat transfer,
471–472, 472f
supraorbital arteries, 294
supraorbital foramen, 11–12, 11f
supraorbital nerve block, 51–52, 51t, 52f
supraorbital transposition flaps, 215
supratip, 12f
supratrochlear artery, 294–295
inadvertent injection of, 380
supratrochlear nerve block, 51–52, 51t, 52f
sural nerve, 54–55, 58f
block, 55, 58f
surface landmarks, 3
surgical attire, 33–34

845
Index
surgical debridement, 125, 131f, 745–746,
745f
surgical diathermy, 137–138, 138f
surgical footwear, 34
surgical gloves, 34, 37, 38f
surgical glove tourniquet, 230f
surgical gowns, 33–34
surgical gut, 68–69, 69t, 191
chromic, 191, 192t
fast-absorbing, 191, 192t
properties, 192t
random pattern cutaneous flaps, 282
surgical history
chemical peels, 396
liposuction, 451
surgical instruments see instruments
surgical personnel preparation, 31–34
attire, 33–34
hand scrub, 31–33, 32f
surgical planning
follicular unit hair transplantation,
487–490
random pattern cutaneous flaps, 277–278
surgical site infection, 30–31
categories at risk, 30–31
Center for Disease Control definition, 30
factors involved in the potential
development of, 85–87
management, 90
prevention, 88–89, 88t
risk, 86–87
surgical technique, 92
surgical site preparation, 35, 37
surgical suite, 795–803
design, 797–798
ceilings, 798
doors, 798
equipment, 798–802, 798t, 799f
floors, 798
infrastructure, 797–798
monitoring and emergency equipment,
801–802, 801f–802f
operating room lights, 799, 799f
operating tables, 798–799
patient privacy, 798
planning, 797
plumbing, 797–798
room structure, 798
size, 797
storage and cabinet, 799–800, 800f
suction, 800
supply carts, 800, 800f
surgical sink, 800
surgical tray stands, 801, 801f
walls, 798
waste disposal, 800–801
wiring, 797–798
liposuction, 341–342, 344f–345f
office-based surgery practice, 795–796, 796f
pitfalls and their management, 803
practical applications, 795–803
reimbursement, 802–803
room and equipment maintenance, 802
room arrangement, 802
technical aspects, 795–803
types of outpatient surgical facilities,
795–797
surgical tray stands, 71, 801, 801f
Surgicel, 232t
Surgilene, 70
Surgilon, 194t
Surgipro, 194t
suspension sutures, 5–6, 216–220
bone anchoring points, 216f
placement technique, 216, 216f
random pattern cutaneous flaps, 282, 283f
regional applications, 216–220
forehead, 216–217
lower eyelid, 217, 217f
mid-face and preauricular zone,
217–220, 218f–220f
nasolabial junction, 220
suture-cutting scissors, 67, 67f
sutures/suturing, 189–209
absorbable, 68–69, 69t, 191–193, 192t
incompletely dissolved, 250
absorption, 190–191
allergic reactions, 190
capillarity, 190
chin implants, 423, 423f
coating, 189–190
commonly used, 191–195
composite grafts, 318–320
configuration, 68, 189
elasticity, 68, 190
elliptical excision, 243
follicular unit hair transplantation,
496–497, 497b, 497f
full-thickness skin grafts, 312–313, 313f
hemostasis, 233, 233f
keloids surgery, 675
knots
slippage, 207t
strength, 190
tying, 198, 198f–199f
marks after skin biopsies, 176b
materials, 68–70 (see also specific materials)
choosing, 189–197
memory, 68, 190
monofilament, 68–69
needles, 195, 195f–196f, 196t–197t
non-absorbable, 68–69, 69t, 193–195, 194t
optimizing outcomes, 206
physical properties of, 189–190
pitfalls and their management, 207–208,
207t
placement, 26b
plasticity, 68, 190
polyfilament, 68–69
postoperative care, 206–207, 207f, 207t
preoperative evaluation, 189
random pattern cutaneous flaps, 282
removal, 206–207, 207f, 207t
random pattern cutaneous flaps, 284
scar revision, 327, 335b
size, 190
spitting, 250
suspension see suspension sutures
techniques, 198–206
buried butterfly suture, 205
buried vertical mattress suture, 205,
205f
half-buried horizontal mattress (tip)
stitch, 201–202, 202f
horizontal mattress stitches, 200–201,
201f
knot tying, 198, 198f–199f
pulley stitch, 206, 206f
purse string suture, 205
running stitches, 202–204, 203f
running subcuticular stitch, 204, 204f
running subdermal stitch, 205–206
simple interrupted stitches, 198–200,
200f
step-off correction, 202, 202f
traditional buried stitches, 204–205
vertical mattress stitches, 200, 201f
temporary retention, 5–6
tensile strength, 68, 190
tissue reaction, 190, 190t
tissue reactivity, 68
tracks, 206–207, 207t
upper eyelid blepharoplasty, 643
sweat gland neoplasms, 729–730
sweating, excessive see hyperhidrosis
sweet clover, 80t
swelling, postoperative
follicular unit hair transplantation, 508b
hyaluronic acid injections, 380
vertical vector face lift, 622–623
syncope
follicular unit hair transplantation, 509t
in Mohs micrographic surgery, 722
synthetic implants, 366t
anesthesia, 368
available worldwide, 369t–374t
chin see chin implants
most commonly used, 367t
preoperative preparation, 368
syringes, autologous fat transfer, 473, 473f
syringomas, cryosurgery, 157t
systemic complications of chemical peels,
411
T
TAC, topical anesthesia, 48
tachycardia, after liposuction, 466
tacking sutures see suspension sutures
tamarind, 80t
tapes, skin closure, 196
tattooing, vitiligo, 42e6–42e7, 426e–427e
tattoo removal
dermabrasion, 530
laser treatment, 542f–543f, 542t (see also
pigmented lesions, laser treatment)
optimizing outcomes, 545, 545f–546f
technical aspects, 542
taxotere, 730
Teflon, 189–190, 193, 365
telangiectasias, 567b
elliptical excision, 250
laser and light treatment, 572–573,
572f–573f
sclerotherapy, 586
Telfa, 116–117
temozolomide, melanoma metastases, 43e15
temple, undermining plane, 280t
temporal brow lifting, 638, 639f–640f
temporal depression, fillers for, 366
temporal fossa, 14
temporalis, 18f–19f, 20
temporoparietalis, 19f
tensile strength, sutures, 190
tension
random pattern cutaneous flaps, 254
vertical vector face lift, 624
Tenzel rotation flaps, 264–268, 266f–267f
terminal hairs, 514
Tessari foam sclerotherapy, 584
testes, 24
tetracaine, 44t
history, 43
topical anesthesia, 47t, 48–49
thalidomide, melanoma metastases, 43e15
thenar eminence, 24f

846
Index
Thermage NXT Thermacool, 659, 659f,
662f–663f
thermal burns, local anesthesia-associated, 57
thermal damage time (TDT), 519
thermal relaxation time (TRT), 517–519,
518t, 565
thermolysis, 516
thermometry, 153
thighs, liposuction
medial, 462
outer, 460–462, 462f
thought processing ability, 340
thrombin, 98–99, 105, 225, 232t
formation, 225
thrombocytopenia, 226
thromboembolism risk
liposuction, 451
sclerotherapy, 586–587
thrombophilia, sclerotherapy risk, 586–587
thrombosis, herbs causing, 453t–454t
thumb interphalangeal crease, 24f
tibialis posterior tendon, 25f
tibial nerve, 25f, 54–55, 58f
block, 55
Ticlid, 79, 227t
ticlimumab, 43e15
ticlopidine, 79, 227t
Ticron, 193, 194t
tie-over bolsters, full-thickness skin grafts, 313
tie-over sutures, full-thickness skin grafts, 313,
313f
Tisseel, 232t
tissue adhesives, 92, 196–197
tissue engineering see skin substitutes
tissue expansion, intra-operatives, 5–6
tissue factor (TF), 99, 225
tissue load management, 130
tissue reaction, sutures, 190, 190t
tissue remodeling, 109–110
T lymphocytes, 100t
tobacco see smoking
toluidine blue, specimen staining, 718
topicaine, topical anesthesia, 47t, 48
topical anesthesia/anesthetics, 47t
benzocaine, 47, 47t
betacaine, 47t
cocaine, 46–47, 47t
cryoanesthesia, 49
EMLA, 47–48, 47t
iontophoresis, 49
laser hair removal, 521–523
lidocaine, 47, 47t
LMX, 47t, 48
ophthalmic, 49
pneumatic skin flattening, 49
practical applications, 61
proparacaine, 47t
pulsed-dye laser treatment, 569
technical aspects, 46–49
tetracaine, 47t, 48
topicaine, 47t, 48
toxicity, 48–49
vitiligo surgery, 685
topical antibiotics, 89
topical hemostatics, 229, 232t
topical negative pressure wound therapy, leg
ulcers, 743
torsion, random pattern cutaneous flaps, 254
total body peels, 408–409
total body photography (TBP), 435e–436e
tourniquets, hemostasis, 230f–231f
towel clips, 68
T-plasty, 256–257, 256f
traction, load cycling, 5–6
traditional buried stitches, 204–205, 205f
tragus, 23f
tramadol, 58–59
tranexamic acid, 232t
transconjunctival lower eyelid blepharoplasty
see blepharoplasty, lower eyelid,
transconjunctival
transcutaneous lower eyelid blepharoplasty see
blepharoplasty, lower eyelid,
transcutaneous
Transcyte, 123
transformers, 139
transforming growth factor (TGF), 99–100,
102, 106–107, 107t, 115–116
wound healing, 738t
transient flora, 30
transition zones, follicular unit hair
transplantation, 502–503, 503f
transpalpebral browpexy, 632–637, 637f
transposition flaps, 268–276
banner, 272, 275f–276f
bilobed, 270–272, 273f
multiple, 215
nasolabial, 272–276, 279f–280f, 282
pedicled, 276
pivotal restraint, 268
rhombic/rhomboid, 214–215, 268–270,
270f
modified, 270, 271f–272f
pivotal restraint, 272f
popularity, 270
tension, 268–270
uses, 268–270
supraorbital, 215
transverse cervical lymph nodes, 21–22
transverse cervical nerve, 20
block, 51t, 53
trapdoor deformity
Abbe cross-lip flap, 305
nasolabial transposition flap, 276, 280f
paramedian forehead flap, 304
random pattern cutaneous flaps, 285
revision, 327–328, 328f, 333, 333f
rhomboid transposition flap, 268–270
Trasylol, 232t
trauma
and keloids, 670
nails, 762, 762f
travel, leg ulcers history, 739
tretinoin
before ablative laser skin resurfacing, 549
atypical moles prevention, 43e10
as a chemical peel agent, 396b, 400
pretreatment for chemical peels, 394–395,
397
triamcinolone acetonide, 387, 673
triangular fossa, 23f
trichilemmal cysts, 182, 182b, 183f
trichion, 12, 12f
trichloroacetic acid (TCA)
chemical peels, 396b, 398, 402–404,
402f–403f, 405f–407f (see also
chemical peels, medium-depth)
total body peels, 408–409
Trichometer, 487–488
trichophytic donor closure, 507
triclosa, 92
tricyclic antidepressants, drug interactions, 58
trigeminal nerve (V), 20
block, 51
trigeminal neuralgia, cryosurgery, 157t
triseptin, 32
tropocollagen, 108
tubercle of helix, 23f
tubular bandages, leg ulcers, 742t
tumescent anaesthesia, 50–51, 50t, 61
follicular unit hair transplantation, 496
liposuction, 447, 457–459, 459t
microdermabrasion/dermabrasion, 531
minimum incision face lift, 601, 604–606,
605t
neck liposuction, 653–654
random pattern cutaneous flaps, 278
vertical vector face lift, 618, 618f–619f
tumescent liposuction, 89–90, 465
tumor necrosis factor (TNF), 99–100, 738t
tunica albuginea, 24
tunneling technique, polymethylmethacrylate
injections, 388
tweezing, excess hair, 515
Tyndall effect, 183, 379
U
ulcerated hemangiomas, 571
ulcers, 98f
arterial see arterial ulcers
definition, 96
diabetic foot see diabetic foot ulcers
pressure, 96, 97f
venous see venous ulcers
ulnar nerve, 23, 24f
block, 54, 56f–57f
Ultrapulse 5000, 550–552
Ultrapulse CO2 laser
blepharoplasty, 627–628
keloid management, 676
lower eyelid blepharoplasty, 645, 645f
upper eyelid blepharoplasty, 642–643, 642f
Ultrasoft, 365, 369t–374t
ultraviolet (UV) light
and atypical moles, 696–697
facial aging, 351
melanoma risk, 43e10
precautions in melanomas, 702t
sun damage from see sun damage
UVA, 394
UVB, 394
undermining
blunt, 280
composite grafts, 320
elliptical excision, 242–243
random pattern cutaneous flaps, 280–281,
280t
sharp, 280
see also specific procedures
ungual fibrokeratomas, 771, 771f
ungual melanoma, 773–774, 775f
unhappy patients seeking cosmetic surgery,
348
unilateral advancement flaps, 255–256, 255f,
257f
Unna boot
chronic wounds, 128, 129f
leg ulcers, 741, 742t
Unna’s resorcinol paste, modified, 396b
UPCO2 laser see Ultrapulse CO2 laser
upper eyelid, 8f
blepharoplasty see blepharoplasty, upper
eyelid
cross-sectional anatomy, 630f
fat pads, 631f

847
Index
urethral meatus, 26f
urethral orifice, 26f
Urgent QR powder, 229, 232t
urticaria, follicular unit hair transplantation,
509t
U-suture, 235f
V
vacuum-assisted closure, leg ulcers, 743
vacuum-tube units, 139–141, 140f
vagina, 26f
vaginal vestibule, 24–26
vancomycin-resistant enterococci, 85, 125
vapocoolants, 49, 49t
varicella zoster virus, liposuction risk, 454
varicose veins
endovenous ablation see endovenous
ablation for varicose veins
sclerotherapy see sclerotherapy of varicose
veins
vascular endothelial growth factor (VEGF),
106–107, 107t
wound healing, 738t
vascular lesions
cryosurgery, 157t
laser and light treatment, 563–579, 564t
laser-tissue interaction principles,
563–566
electromagnetic radiation, 563
fluence and epidermal protection,
565
pulse duration and thermal
relaxation time, 565
selective photothermolysis, 563–566
spot size, 565
wavelength, 564–565, 564f
pitfalls and their management, 576
postoperative care, 575–576
practical applications, 566–574
techniques, 575–576
vascular malformations
cryosurgery, 157t, 160–161
mixed, 161
vascular occlusion, after autologous fat
transfer, 481
vascular response, 98–99
Vaseline gauze, 116–117
vasoconstriction, wounding, 98
vasoconstrictors, addition to local anesthetics,
45–46, 45t
vasodilatation, wounding, 97
vasovagal reaction, liposuction, 466
Vater-Pacini bodies, 755–756
vellus hairs, 514, 524
venous clinical severity score (VCSS), 585
venous disease classification, 45e6
venous drainage, random pattern cutaneous
flaps, 254
venous hypertension, 741
venous insufficiency, 735, 45e5
venous lake, 567b
cryosurgery, 157t, 160, 161f
venous malformations, 567b
venous system, 582f
venous ulcers, 128
compression therapy, 128t
bandages, 128
compression bandages, 128
elastic bandages, 128
four-layer bandage, 129
orthotic device, 129
pneumatic compression, 129
stockings, 128
Unna boot, 128, 129f
etiology, 735, 737f
pain, 737–739
physical findings in, 740t
prevention, 45e3
shave therapy, 750
wound dressings, 129
ventricular ectropy, 466
venulectasia, 572–573, 573f
verapamil, intralesional, 679
vermilion border, 7, 7f
vermilion-cutaneous junction, 9f
verrucae, cryosurgery, 156
vertical mattress stitches, 200, 201f, 243
buried, 205, 205f, 282
vertical palmar crease, 24f
vertical vector face lift, 615–625
anatomy, 615–616
cosmetic consultation, 617–618
facial aesthetics, 616–617
goals of, 616–617
incision, 618
liposuction in, 618, 619f
patient selection, 617
pitfalls and their management, 623–624
postoperative care, 622–623, 623f
preoperative appointment, 617–618
skin marking, 618
technical aspects, 618–620, 618f–622f
tumescent anaesthesia, 618, 618f–619f
vestibular fossa, 26f
vestibule, vaginal, 24–26
Vicryl, 69, 191, 192t, 282
video-densitometry, 487
visible light lasers, skin remodeling, 555
Vistabel, 435t
visual analogue scales (VASs), 585
vitamin A deficiency, 110
vitamin C
deficiency, effect on wound healing, 110
leg ulcer healing, 45e3
vitamin E
anticoagulant effect, 79, 80t
autologous fat transfer, 470–471
effect on hemostasis, 227t
keloid management, 679
vitiligo
concept of stability in, 42e2
surgery see vitiligo surgery
vitiligo disease activity (VIDA) score,
42e2t
vitiligo disease activity (VIDA) score, 42e2t
vitiligo surgery, 683–692
anesthetic techniques, 685
basic principles, 683–684
case selection, 684
historical vignette, 42e1
laser and light therapy, 687–688,
688f–689f
optimizing outcomes, 690
acral areas, 690
areola, 690
eyebrows and beard area, 690
eyelids, 690
genitals, 690
lips, 690
overview of surgical procedures, 688, 689t
patient assessment and documentation,
684–685, 684f
patient counseling and information, 684
pitfalls and their management, 688–690
failure of graft uptake, 688
incomplete pigmentation, 688–690
poor cosmetic color match, 690
recurrence and reactivation of disease,
690
scarring at the donor site, 690
uneven texture, 690
postoperative care, 688
rationale for, 683
surgical techniques, 685–687
autologous non-cultured epidermal
cell suspension, 689t, 42e3,
42e6f
cellular grafts, 42e3–42e5
chemabrasion, 42e7
cultured melanocyte grafting, 42e3–
42e5, 689t
dermabrasion, 42e7
excision and closure, 42e7
micropigmentation, 42e6–42e7
minipunch grafting, 685–686, 685f–
686f, 42e10f, 689t
non-grafting techniques, 42e6–42e7
suction blister epidermal grafting,
686–687, 687f–688f, 689t
tattooing, 42e6–42e7, 426e–427e
thin split-thickness skin grafts,
424e–426e, 689t, 42e3, 42e9f,
42e10f
technical aspects, 683–688
VNUS Closure procedure, 591, 596f–597f
voltage, 139
volumetric aging, 601
von Willebrand factor (vWF), 225–226
V-plasty, split earlobe repair, 783, 785f
V-Y advancement flap, 257–258
V-Y repair
ectropion, 333–334
scar revision, 332–333, 333f
W
warfarin, 79
effect on hemostasis, 227t
and skin biopsies, 169
warming, surgical site infection risk, 87
warts
cryosurgery, 156–157, 157t
laser treatment, 574
nails, 771
waste disposal, 800–801
water, contaminated, in the operating theatre,
33
waveforms, 139–141, 140f–141f
wavelength, 537
laser hair removal, 518, 518t
laser-tissue interaction principles, 564–565,
564f
wax, suture coating, 189–190
waxing, excess hair, 515
Webster needle holder, 67–68
Weck blade, 314–315, 314f
wedge excision, earlobe reduction, 788
weight cycling, 454
Westcott scissors, 66
wet technique liposuction, 447
Whitnall’s ligament, 628
Whitnall’s tubercle, 15f, 20
willow bark, 80t
women, non-androgenetic causes of hair loss
in, 488–489, 489b

848
Index
wound care
acute wounds, 125–127
arterial ulcers, 129
chronic wounds, 127–130
diabetic foot ulcers, 129–130
optimizing outcomes, 130
paramedian forehead flap, 299
postoperative, 125–130
pressure ulcers, 130
random pattern cutaneous flaps, 282
skin grafting, 322
venous ulcers, 128
wound closure
complex layered facial closures see complex
layered facial closures
elliptical excision, 243
epidermal cysts, 181
layered, 214
lower eyelid blepharoplasty, 646
materials, 68–70
partial, elliptical excision, 244, 246f
upper eyelid blepharoplasty, 643
without tension, 5–6
see also sutures/suturing
wound healing, 95–113
ablative laser skin resurfacing, 549
after liposuction, 466
dressings see dressings; specific dressings
factors affecting, 110
inflammatory phase, 96f, 97–102, 98f,
45e1, 738f, 738t
cellular response, 99–101
chemical mediators of inflammation,
101–102
chronic inflammation, 102
complement system, 102
growth factors, 102
vascular response, 98–99
microdermabrasion/dermabrasion, 534
moist, 743
optimizing outcomes, 110–111, 130
phases, 96f, 97–110
inflammatory phase, 97–102
proliferative phase, 102–107
remodeling phase, 107–110
physiology, 45e1–45e2
pitfalls and their management, 111
primary intention, 96–97, 126
proliferative phase, 96f, 102–107, 45e1
basement membrane zone restoration,
103–104
dermis reconstitution, 104
fibroplasia, 104–105
integrin receptors, 105
keratinocyte migration, 103
mechanism of wound contraction,
105–106
re-epithelialization, 102
wound angiogenesis, 106–107
remodeling phase, 45e1–45e2, 96f,
107–110, 107f
collagen, 108
elastic fibers, 109
extracellular matrix, 108
proteinases and tissue remodeling,
109–110
scar revision, 335b
second intention, 96–97, 126–127
types of wound, 95–97
acute, 95, 97
chronic, 95
erosion, 96, 96f, 97t
full-thickness, 95–96, 96f, 97t
partial-thickness, 95–96, 96f–97f,
97t
primary intention healing, 96–97
second intention healing, 96–97
ulcers see ulcers
wound(s)
acute, 95
classification, 96
dressings, 115–116
methods of creating, 97
postoperative care, 125–127
angiogenesis, 106–107, 106f
bed preparation, leg ulcers, 743–744
care see wound care
chronic, 95
classification, 96
dressings, 116
postoperative care, 127–130
classification, 87–92, 88t
closure see wound closure
contamination, 30–31
contraction, 105–106
culturing, 744t
debridement see debridement
dehiscence see dehiscence
dressings see dressings
full-thickness, 95–96, 127
healing see wound healing
infection
random pattern cutaneous flaps,
284
surgical site see surgical site infection
location and risk, 86
partial-thickness, 95–96, 127
tension
and keloids, 670
keloids surgery, 675
W-plasty, scar revision, 329–330, 330f
wraparound keloids, 672, 675–676, 676f
wrinkles, 9–11, 10f
autologous fat transfer, 470
categorization, 357–358
dermabrasion, 530
facial contour lines, 7
fillers for, 378, 386–387
management, 357–358
photodynamic therapy, 558–559
upper face, botulinum toxins, 437–439
see also specific wrinkles
wrist blocks, 54, 56f
X
xanthelasma, cryosurgery, 157t
xenografts, 121
definition, 309
porcine, 321
Xeomin, 435t
Xeroflo, 116–117
Xeroform, 116–117
xerophthalmia, after Mohs micrographic
surgery, 723
X-suture, 235f
Y
Yoruba tribe, 669–670, 670f
Young’s modulus, 5
yttrium-aluminium-garnet (YAG) lasers,
402
yttrium-scandium-gallium-garnet (YSGG)
laser, 539
Y-V repair, scar revision, 332–333
Z
zaleplon, microdermabrasion/dermabrasion,
531
Zimmer electric dermatome, 315, 315f
Zimmer meshing device, 315–316, 315f
zinc chloride, 711b–712b, 712f
zinc chloride paste, 229, 232t
zinc oxide, 130b, 131f
zolpidem tartrate, microdermabrasion/
dermabrasion, 531
Z-plasty
earlobe reduction, 788
multiple, 330–332, 332f
random pattern cutaneous flaps correction,
285
scar revision, 330–332, 331f–332f, 335b
split earlobe repair, 783, 785f
Zyderm, 364, 365f
Zyderm I, 368, 369t–374t
Zyderm II, 368, 369t–374t
zygomatic arch, 11, 11f, 217–218
zygomatic bone, 11
zygomatic ligament, 602, 602f
zygomaticus major, 16–18, 17t, 18f–19f
fat autograft muscle injection, 476f–477f
zygomaticus minor, 16–18, 17t, 18f–19f
fat autograft muscle injection, 476f–477f
Zyplast, 364, 365f, 368, 369t–374t
key publications, 377–378

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