Rhytidectomy

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Rod J Rohrich - One of the best experts on this subject based on the ideXlab platform.

  • perioperative approach to reducing hematoma during Rhytidectomy what does the evidence show
    Plastic and Reconstructive Surgery, 2021
    Co-Authors: Roger W Cason, Yash J Avashia, Ronnie L Shammas, Ira L Savetsky, Rod J Rohrich
    Abstract:

    BACKGROUND Postoperative hematoma remains the most common complication in Rhytidectomy, prompting surgeons to use a multitude of adjunctive measures to prevent its occurrence. The goal of this systematic review was to determine which of these measures are supported by strong evidence, and to highlight those that remain unsubstantiated and require further investigation. METHODS A systematic search was performed of the PubMed and Embase databases for English literature from 1975 to March of 2020 containing designated keywords, and focusing specifically on adjunctive measures aimed at preventing hematoma in Rhytidectomy. The resultant articles were then systematically screened according to predefined inclusion and exclusion criteria to determine eligibility for inclusion in the study. RESULTS The keyword search yielded a total of 2391 articles. Title and abstract screening resulted in 103 articles that were eligible for full-text review. Ultimately, 48 articles met final inclusion criteria. The articles were categorized into their particular mode of intervention: fibrin tissue sealants, perioperative medications (anesthetics, antihypertensives, miscellaneous medications), and intraoperative maneuvers (hemostatic agents, preinfiltration, intraoperative maneuvers, and drains). Nine studies were indexed as evidence Level II and 24 as evidence Level III. The remainder of studies constituted Level IV evidence. CONCLUSIONS Adjunctive interventions have been borne out of necessity in efforts to reduce postoperative hematoma after Rhytidectomy. Although many of these interventions have promising results, the current literature supports the senior author's (R.J.R.) experience that an evidence-based, multimodal approach is ideal to minimize the rates of hematoma after Rhytidectomy.

  • the modern male Rhytidectomy lessons learned
    Plastic and Reconstructive Surgery, 2017
    Co-Authors: Rod J Rohrich, Christopher R Costa, Smita Ramanadham, James M Stuzin, Phillip B Dauwe
    Abstract:

    Background:Cosmetic surgery among male patients has become increasingly popular. The face-lift technique is different in male patients, specifically regarding preservation of hair follicles, restoration of a youthful and well appearance, and reduction of the risk of hematoma.Methods:A retrospective

  • laser resurfacing at the time of Rhytidectomy
    Plastic and Reconstructive Surgery, 2015
    Co-Authors: Jack F Scheuer, Christopher R Costa, Phillip B Dauwe, Smita Ramanadham, Rod J Rohrich
    Abstract:

    Background:Laser resurfacing with simultaneous Rhytidectomy has been used to augment aesthetic results and decrease overall patient recuperative time, yet presents a potential dual insult to the microvasculature supply of facial skin flaps. This study describes the authors’ experience with rhytidect

  • randomized controlled phase 3 study to evaluate the safety and efficacy of fibrin sealant vh s d 4 s apr artiss to improve tissue adherence in subjects undergoing Rhytidectomy
    Aesthetic Surgery Journal, 2013
    Co-Authors: Roderick T Hester, Davis B. Nguyen, James R Shire, Zachary E Gerut, Achih H Chen, Jason Diamond, Julian C Desmond, Laura Silvatifidell, Steve Zvi Abrams, Rod J Rohrich
    Abstract:

    Background: Suction drains are commonly placed after Rhytidectomy to avoid seroma formation that may result from dead spaces between skin layers. Fibrin sealants promote tissue adherence by crosslinking with extracellular matrix proteins, which may reduce the dead space under skin flaps. Objectives: The authors evaluate the safety and efficacy of the fibrin sealant (FS) VH S/D 4 s-apr (Artiss; Baxter Healthcare Corp, Deerfield, Illinois), added to standard-of-care (SoC) treatment, in improving flap adherence and reducing dead space in patients undergoing Rhytidectomy. Methods: Patients with planned facial Rhytidectomy were enrolled in this phase 3, prospective, controlled, randomized, patient-blinded, multicenter trial. They received SoC treatment on 1 side of the face and adjunctive FS VH S/D 4 s-apr on the other. Results: Seventy-five patients completed the trial. The mean (SD) drainage volume was 7.7 (7.4) mL from the sides treated with sealant and 20.0 (11.3) mL from the SoC-only sides ( P < .0001). Rates of hematoma and seroma were similar for the 2 treatments, as were changes in postoperative skin sensitivity. Adverse events generally were mild; 2 serious adverse events were reported (wound abscess, dehydration). Conclusions: Adjunct use of FS VH S/D 4 s-apr in Rhytidectomy was proven safe in this study. It significantly reduced drainage volumes without increasing the incidence of hematoma or seroma, which suggests that it eliminates dead space through improved flap adherence. Level of Evidence: 2 ![Graphic][1] [1]: /embed/inline-graphic-1.gif

  • a 20 year experience with secondary Rhytidectomy a review of technique longevity and outcomes
    Plastic and Reconstructive Surgery, 2013
    Co-Authors: Evan W Beale, Yvonne Rasko, Rod J Rohrich
    Abstract:

    Background:The increasingly more common secondary Rhytidectomy patient presents with recurrent soft-tissue descent and stigmata of primary face lift, which can require techniques unique to secondary Rhytidectomy. The senior author's (R.J.R.) experience with secondary Rhytidectomy is reviewed, focusi

Evan W Beale - One of the best experts on this subject based on the ideXlab platform.

William D. Spotnitz - One of the best experts on this subject based on the ideXlab platform.

  • Efficacy and safety of fibrin sealant for tissue adherence in facial Rhytidectomy.
    Clinical cosmetic and investigational dermatology, 2012
    Co-Authors: William D. Spotnitz
    Abstract:

    The purpose of this review is to clarify the present use of fibrin sealant in rhyditectomy procedures and help maximize the appropriate and safe application of this material. A set of terms and definitions for hemostats, sealants, and adhesives based on group, category, and class will be employed to highlight the specific capabilities of fibrin sealant. Fibrin sealant has now emerged as an example of maximizing the usefulness of a surgical agent and is the only product with Food and Drug Administration approval in all three groupings: hemostats; sealants; and adhesives. A variety of manufacturers’ fibrin sealant products are available including multiple liquids and one patch. A single liquid product is now specifically indicated for skin flap adherence during Rhytidectomy. The unique characteristic of this particular two component fibrin sealant adhesive agent is its slower polymerization rate as a result of a low thrombin concentration which when combined with fibrinogen permits adequate time for manipulation of flaps and tissues prior to final fixation. In addition to its flap adherence and potential space elimination capability, fibrin sealant is also an excellent blood clotting agent and can seal tissues to prevent lymphatic leak or serous fluid accumulation. Thus, it is almost ideally suited to reduce the occurrence of fluid accumulation, hematomas, ecchymoses, and swelling, as well as to possibly eliminate the need for drains following Rhytidectomy. A literature review of fibrin sealant in Rhytidectomy is included to help define the current state of its clinical use. The author’s recommendations for the best use of this material during facial procedures are also provided.

Frank M. Kamer - One of the best experts on this subject based on the ideXlab platform.

  • Experience with fibrin glue in Rhytidectomy.
    Plastic and Reconstructive Surgery, 2007
    Co-Authors: Frank M. Kamer, Davis B. Nguyen
    Abstract:

    Background: The authors conducted a large, prospective, controlled trial of fibrin glue in Rhytidectomy using a wide set of variables. Methods: Two hundred consecutive patients undergoing elective Rhytidectomy were studied. One hundred patients received fibrin glue over a 1-year period and were followed prospectively. Another 100 patients from the previous year who had not received fibrin glue had their charts reviewed retrospectively. All patients underwent bilateral face lifts using the deep plane technique. Results: The following data were observed for the glue versus nonglue patients: expanding hematoma rate, 1 percent versus 3 percent (p > 0.05); seroma rate, 1 percent versus 7 percent (p > 0.05); and prolonged induration, edema, and ecchymosis, 0 percent versus 22 percent (p 0.05). The average score for patient satisfaction (scale, 1 to 10, with 10 being best) for glue versus nonglue patients was 9.5 versus 9.0 (p >0.05). Conclusions: The use of fibrin glue was associated with some benefits for Rhytidectomy. Fibrin glue eliminated the use of drains. The difference in expanding hematoma was clinically, but not statistically, significant. The seroma rate was decreased and neared statistical significance. There was an impressive immediate decrease in postoperative swelling. The fibrin glue was most advantageous in eliminating prolonged induration, edema, and ecchymosis. There were no statistical differences between groups for patient satisfaction or pain. The use of fibrin glue has been shown to reduce some of the morbidity and severe complications of face lifting.

  • hematoma formation in deep plane Rhytidectomy
    Archives of Facial Plastic Surgery, 2000
    Co-Authors: Frank M. Kamer, Angie U Song
    Abstract:

    Hematoma formation following Rhytidectomy procedure is unfortunately common and one of the more devastating complications that can occur. Various reports have cited the incidence of hematoma formation using the superficial musculoaponeurotic system–platysma technique; but, to our knowledge, no report has specifically addressed the incidence of hematoma formation following deep plane rhytidectomies. We retrospectively reviewed the medical records and deep plane Rhytidectomy worksheets of 451 consecutive deep plane rhytidectomies preformed at one institution by one surgeon. The incidence of major hematoma was 2.2% (10/451) and of minor hematoma was 6.65% (30/451). All hematomas that did occur did so in the subcutaneous plane of dissection. There were no facial hematomas.

  • smas Rhytidectomy versus deep plane Rhytidectomy an objective comparison
    Plastic and Reconstructive Surgery, 1998
    Co-Authors: Frank M. Kamer, Andrew S Frankel
    Abstract:

    Although there are a multitude of techniques currently used for performing face lifts, there is no general agreement as to which, if any, of these techniques is most effective. There may never be a definitive answer to this issue because of the highly subjective nature of aesthetics, variability among surgeons, differences in patient anatomy, and specific patient desires. In an attempt to evaluate face lift techniques objectively, this study compares the rate of patients undergoing a tuck procedure after traditional SMAS (superficial musculoaponeurotic system) Rhytidectomy to that of patients after deep plane Rhytidectomy. A retrospective chart review was performed on all patients who underwent a tuck procedure following a face lift by the senior author (Kamer) between July of 1990 and January of 1997. There were 634 patients who electively underwent either a SMAS or deep plane type of Rhytidectomy during the 6.5-year period; 48 patients subsequently underwent tuck operations, and adequate information was available on 44 patients. Of these, 43 were women and the average age was 57 years. The overall tuck rate from July of 1990 to January of 1997 was 7.5 percent. The tuck rate following SMAS Rhytidectomy was 11.4 percent, and that following deep plane Rhytidectomy was 3.3 percent. Therefore, a tuck was required 71 percent less frequently after a deep plane lift than after a SMAS lift. This was found to be a statistically significant difference with a p value of .0001 (Fisher's exact test, 2-tail). If the assumption is made that the need for a tuck procedure implies a less than optimal face lift, then the data of this study suggest that the deep plane technique is more effective than the SMAS technique.

Yvonne Rasko - One of the best experts on this subject based on the ideXlab platform.

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