Pearls and pitfalls in cosmetic oculoplastic surgery

Part I Preoperative Evaluation 1 Preoperative Evaluation of the Cosmetic Patient . . . . . . . 3 Jemshed A. Khan 2 Evaluation of the Cosmetic Patient . . . . . . . . . . . . . . . . . . . 6 Rona Z. Silkiss 3 Preoperative Patient Counseling for Cosmetic Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 William P.D. Chen Part II Anesthesia 4 Guide to Local Anesthetic Medications . . . . . . . . . . . . . . . 15 Vivian Schiedler and Bryan S. Sires 5 Motor Nerve Blocks in Oculofacial Surgery . . . . . . . . . . . . 18 Vivian Schiedler and Bryan S. Sires 6 Regional Nerve Blocks in Oculofacial Surgery . . . . . . . . . 22 Vivian Schiedler and Bryan S. Sires 7 Procedural Sedation in Oculofacial Surgery . . . . . . . . . . . . 27 Vivian Schiedler and Bryan S. Sires 8 Preoperative Preparation and Anesthesia . . . . . . . . . . . . . . 30 William P.D. Chen 9 “Digital Diffusion” Technique for the Administration of Local Anesthetic in Eyelid Surgery . . . . . . . . . . . . . . . . . 32 Rona Z. Silkiss 10 Anesthesia for In-Offifi ce Oculoplastic Surgery: How We Do It . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33 Brent R. Moody and John B. Holds x Contents Part III Upper Lid Blepharoplasty Section One Preoperative Evaluation 11 Upper Eyelid Blepharoplasty: The Evaluation . . . . . . . . . . 41 Evan H. Black, John D. Siddens, Frank A. Nesi, Shoib Myint, and Geoffrey J. Gladstone 12 Preoperative Examination Checklist for Upper Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 Philip L. Custer 13 Preoperative Evaluation and Documentation in Upper Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 Cat Nguyen Burkat Section Two Incision Planning 14 Marking Strategies for Upper Blepharoplasty . . . . . . . . . . 51 Guy G. Massry 15 Orbit Size and Lid Marking in Upper Blepharoplasty . . . 53 Philip L. Custer 16 Incisional Guidelines When Marking the Skin in Upper Eyelid Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . 56 Sheri L. DeMartelaere, Todd R. Shepler, Sean M. Blaydon, Russell W. Neuhaus, and John W. Shore 17 Marking the Proposed Upper Eyelid Crease: Determining the Safe Amount of Skin Removal— The Pinch Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58 Jemshed A. Khan 18 Preoperative Measurements in Upper Blepharoplasty: Patient Selection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61 Jemshed A. Khan 19 Keys to Success When Marking the Skin in Upper Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 John R. Burroughs and Richard L. Anderson 20 Skin Marking in Upper Blepharoplasty— Avoiding Pitfalls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 Cat Nguyen Burkat Section Three Upper Blepharoplasty Procedure Pearls 21 Upper Blepharoplasty: Pearls for the Procedure . . . . . . . . 71 Evan H. Black, John D. Siddens, Frank A. Nesi, Shoib Myint, and Geoffrey J. Gladstone 22 Fat Excision in Upper Blepharoplasty . . . . . . . . . . . . . . . . . 73 Sheri L. DeMartelaere, Todd R. Shepler, Sean M. Blaydon, Russell W. Neuhaus, and John W. Shore Contents xi 23 Mobilizing and Excising the Nasal Fat Pad in Upper Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 Jemshed A. Khan 24 Tissue Removal Considerations in Blepharoplasty Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Rona Z. Silkiss 25 Fewer Hematomas in Upper Blepharoplasty . . . . . . . . . . . 76 Martin H. Devoto 26 Blepharoplasty Incisional Modalities: 4.0 Radiowave Surgery vs. CO2 Laser . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81 Joseph Niamtu, III 27 Fat Preservation and Other Tips for Upper Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 Cat Nguyen Burkat 28 Asian Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87 Samuel M. Lam Section Four Adjunctive Procedures in Upper Blepharoplasty 29 Internal Brow Elevation with Corrugator Removal . . . . . 95 John R. Burroughs and Richard L. Anderson 30 Excision of ROOF During Upper Blepharoplasty . . . . . . . 99 Jemshed A. Khan 31 Addressing the Brow During Upper Blepharoplasty . . . . 100 Philip L. Custer 32 Transblepharoplasty Incision Lower Lid Canthopexy . . . . 102 John R. Burroughs and Richard L. Anderson 33 Lower Lid Canthopexy Through Upper Lid Incision . . . . 104 Guy Ben Simon and John D. McCann Section Five Wound Closure and Postoperative Care 34 Avoiding Dog Ears During Upper Blepharoplasty Closure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 Peter S. Levin 35 Crease Formation in Upper Blepharoplasty . . . . . . . . . . . . 109 Philip L. Custer 36 Use of Tissue Adhesive for Oculoplastic Incision Closure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111 Charles B. Slonim 37 Avoiding or Minimizing Postoperative Swelling . . . . . . . . . 112 John R. Burroughs and Richard L. Anderson 38 Management of Postblepharoplasty Dry Eye . . . . . . . . . . . 114 Morris E. Hartstein xii Contents Part IV Lower Lid Blepharoplasty Section One Preoperative Considerations 39 Lower Eyelid Blepharoplasty: The Evaluation . . . . . . . . . . 121 John D. Siddens 40 Lower Eyelid Blepharoplasty Evaluation: Avoid the Cookie Cutter Approach . . . . . . . . . . . . . . . . . . . . . . . . . 125 Sheri L. DeMartelaere, Todd R. Shepler, Sean M. Blaydon, Russell W. Neuhaus, and John W. Shore Section Two Lower Blepharoplasty Procedure Pearls 41 Three-Step Technique for Lower Lid Blepharoplasty . . . . 129 Joseph A. Mauriello, Jr. 42 Lower Eyelid Blepharoplasty: Procedure Pearls and Pitfalls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137 John D. Siddens 43 Lower Blepharoplasty: The Bilamelar Approach . . . . . . . . 139 Guy G. Massry 44 The Skin in Lower Lid Blepharoplasty: General Principles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140 Guy Ben Simon and John D. McCann 45 Incising the Septum over the Nasal, Central, and Lateral Fat Pads in Lower Blepharoplasty . . . . . . . . . 141 Jemshed A. Khan 46 Prolapsing the Inferior Fat Pads and Fornix in Lower Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143 Jemshed A. Khan 47 Identifying the Inferior Oblique in Transconjunctival Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145 Jemshed A. Khan 48 Achieving Symmetry in Lower Blepharoplasty Fat Removal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147 Jemshed A. Khan 49 Hemostasis in Lower Blepharoplasty . . . . . . . . . . . . . . . . . . 150 Erin L. Holloman and Sterling S. Baker 50 The Treatment of Festoons in Lower Blepharoplasty . . . . 151 Sheri L. DeMartelaere, Todd R. Shepler, Sean M. Blaydon, Russell W. Neuhaus, and John W. Shore Section Three Fat Repositioning in Lower Blepharoplasty 51 Fat Repositioning in Lower Blepharoplasty: Less Is More . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157 Sheri L. DeMartelaere, Todd R. Shepler, Sean M. Blaydon, Russell W. Neuhaus, and John W. Shore Contents xiii 52 Fat Repositioning in Lower Lid Blepharoplasty: General Principles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158 Guy Ben Simon and John D. McCann 53 Transconjunctival Lower Lid Blepharoplasty with and Without Fat Repositioning . . . . . . . . . . . . . . . . . . . . . . . 159 Guy G. Massry and Paul S. Nassif 54 Transconjunctival Lower Blepharoplasty with Intra-SOOF Fat Repositioning . . . . . . . . . . . . . . . . . . . . . . . 167 Yasaman Mohadjer and John B. Holds 55 Lower Lid Blepharoplasty with Fat Repositioning Using a Foam Bolster . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171 Eric A. Steele and Roger A. Dailey 56 Use of Tisseel in Lower Eyelid Blepharoplasty with Fat Repositioning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173 Asa D. Morton 57 Lower Blepharoplasty with Fat Repositioning Without Sutures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176 John R. Burroughs and Richard L. Anderson Section Four Management of Postblepharoplasty Lid Retraction 58 Managing Postblepharoplasty Lower Eyelid Malposition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183 Michael T. Yen 59 Retroauricular Dermal Spacer Graft for Lower Lid Retraction Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187 Francesco P. Bernardini 60 Mid-Lower Eyelid Tarsoconjunctival Flap-Skin Graft: Treatment of Cicatricial Lower Lid Retraction . . . . . . . . . 190 John Pak 61 Treatment of Postblepharoplasty Lower Eyelid Retraction with Dermis Fat Spacer Grafting . . . . . . . . . . . 198 Bobby S. Korn and Don O. Kikkawa Part V Forehead Rejuvenation Section One Preoperative Considerations 62 Which Browlift to Do? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205 Andrea N. Hass 63 Browlifting: Patient Evaluation . . . . . . . . . . . . . . . . . . . . . . . 206 Andrea N. Hass 64 Preoperative Botox for Endoscopic Browlifting . . . . . . . . 208 Andrea N. Hass xiv Contents Section Two Endoscopic Forehead Rejuvenation 65 Five Tips for Endoscopic Browlift . . . . . . . . . . . . . . . . . . . . 211 Sheri L. DeMartelaere, Todd R. Shepler, Sean M. Blaydon, Russell W. Neuhaus, and John W. Shore 66 Anesthesia Options in Endoscopic Forehead Lifting . . . . 212 Andrew S. Eiseman 67 Endoscopic Forehead Rejuvenation: How to Set Up the Operating Room and Trouble Shooting . . . . . . . . . . . . 215 Asa D. Morton 68 Endoscopic Forehead Rejuvenation: Equipment and Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217 Asa D. Morton 69 Incision Technique for Endoscopic Forehead Elevation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 220 Andrew S. Eiseman 70 Endoscopic Forehead Elevation: Patient Marking and Preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223 Geva Mannor 71 Endoscopic Midforehead Techniques: Improved Outcomes with Decreased Operative Time and Cost . . . . 224 Asa D. Morton 72 Fifteen Principles of Enhanced Success in Endoscopic Browlift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 228 Guy G. Massry 73 Dissection of Central Forehead and Temporal Pocket with Periosteal Release . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231 Don O. Kikkawa 74 Endoscopic Forehead Lifting: Dealing with the Central Brow Depressors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234 Asa D. Morton 75 Elevation and Fixation of the Lateral Brow and Canthus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 236 Robert G. Fante 76 Fixation Methods in Endoscopic Browlifting . . . . . . . . . . . 237 Andrea N. Hass 77 Endosocopic Browlift with Deep Temporal Fixation Only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238 Paul S. Nassif 78 Tridimensional Brow, Glabella, and Temple Enhancement with Micro Fat Injection During Endoscopic Forehead Rejuvenation . . . . . . . . . . . . . . . . . . . 247 Oscar M. Ramirez and Camilo O. Reyes Contents xv 79 Scalp Fixation in Endoscopic Browlift . . . . . . . . . . . . . . . . . 254 Robert G. Fante 80 Closing and Dressing the Wounds in Endoscopic Browlift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257 Robert G. Fante 81 Endoscopic Forehead Rejuvenation: Avoiding and Managing Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . 259 Asa D. Morton Section Three Nonendoscopic Browlifting 82 The Direct Browlift: Focus on the Tail . . . . . . . . . . . . . . . . . 263 John B. Holds 83 Soft Tissue Augmentation of the Temporal Brow in Browlifting Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267 David E.E. Holck, Jill A. Foster, Manuel A. Lopez, and Kevin A. Kalwerisky Part VI Mid-Face Lift 84 Mid-Face Lift: General Considerations and How I Do It . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275 Guy G. Massry 85 Ten Rules for Mid-Face Lifting for the Repair of Lid Retraction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277 Morris E. Hartstein and Guy G. Massry 86 The Subperiosteal Mid-Face Lift Using Bioabsorbable Implants for Fixation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 278 David E.E. Holck, Jill A. Foster, Kevin A. Kalwerisky, and Manuel A. Lopez 87 Cheeklifting Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285 Clinton D. McCord, Jr. 88 Mid-Face Implants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287 Joseph Niamtu, III Part VII Botox 89 Introduction to Botox . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 293 John R. Burroughs and Richard L. Anderson 90 Evaluating Potential Botox Patients . . . . . . . . . . . . . . . . . . . 294 Samuel M. Lam 91 Botox: General Principles of Treatment . . . . . . . . . . . . . . . 296 Samuel M. Lam xvi Contents 92 Botox: Where It Works Best . . . . . . . . . . . . . . . . . . . . . . . . . 298 Jemshed A. Khan 93 Preparation of Botox . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 300 Jemshed A. Khan 94 Documentation of Treatment: Botox . . . . . . . . . . . . . . . . . . 301 Jemshed A. Khan 95 Botox Injection Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . 303 John R. Burroughs and Richard L. Anderson 96 Cosmetic Botox Applications: General Considerations and Dosing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305 John R. Burroughs and Richard L. Anderson 97 Botox: Avoiding Pitfalls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307 John R. Burroughs and Richard L. Anderson 98 Botox Injection Techniques: Minimizing Bruising and Discomfort . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 309 Jemshed A. Khan 99 Botulinum Toxin Injections Pearls . . . . . . . . . . . . . . . . . . . . 311 Rona Z. Silkiss 100 Botox Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 312 Jemshed A. Khan 101 Glabella Treatment with Botox . . . . . . . . . . . . . . . . . . . . . . . 314 Samuel M. Lam 102 Corrugator and Procerus Rhytid Treatment with Botox . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 316 Jemshed A. Khan 103 Frontalis Injection with Botox . . . . . . . . . . . . . . . . . . . . . . . . 318 Jemshed A. Khan 104 Frontalis Treatment with Botox . . . . . . . . . . . . . . . . . . . . . . 320 Samuel M. Lam 105 Shaping of the Eyebrows with Botox . . . . . . . . . . . . . . . . . . 322 David F. Horne and Thomas E. Rohrer 106 Botox Injection Techniques: Crow’s Feet . . . . . . . . . . . . . . 326 Jemshed A. Khan 107 Orbicularis Oculi Treatment with Botox . . . . . . . . . . . . . . . 328 Samuel M. Lam 108 Perioral Botox Injections . . . . . . . . . . . . . . . . . . . . . . . . . . . . 330 Jemshed A. Khan 109 Botox Injection to the Lacrimal Gland for the Treatment of Epiphora . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 332 R. Jeffrey Hofmann Contents xvii 110 Botox Therapy for Hyperhydrosis: How I Do It . . . . . . . . 335 Charles B. Slonim 111 Other Uses of Botox . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 336 John R. Burroughs and Richard L. Anderson 112 Botox for Axillary Hyperhydrosis . . . . . . . . . . . . . . . . . . . . 338 R. Jeffrey Hofmann Part VIII Fillers 113 Optimizing Outcome from Facial Cosmetic Injections and Promoting Realistic Expectations . . . . . . . . . . . . . . . . . 341 Leslie Baumann 114 Filler Pearls: General Considerations . . . . . . . . . . . . . . . . . . 344 John R. Burroughs and Richard L. Anderson 115 List of Fillers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 345 Bradley T. Kovach 116 Dermal Filler Pearls: the Hyaluronic Acids . . . . . . . . . . . . 352 John R. Burroughs and Richard L. Anderson 117 Radiesse Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 354 John R. Burroughs and Richard L. Anderson 118 Juvederm Pearls: Fine and Superfifi cial Lines . . . . . . . . . . . . 356 John R. Burroughs and Richard L. Anderson 119 Achieving Beautiful Lip Augmentation . . . . . . . . . . . . . . . . 357 Kimberly J. Butterwick 120 Restylane Injection for the Lower Eyelid Tear Trough . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 362 R. Jeffrey Hofmann 121 Liquid Injectable Silicone for the Upper Third of the Face . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 364 Derek H. Jones 122 Periocular Injectables with Hyaluronic Acid and Calcium Hydroxyapatite . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369 Robert A. Glasgold and Samuel M. Lam 123 Pearls and Pitfalls of Botox and Filler Substances in the Upper Third of the Face . . . . . . . . . . . . . . . . . . . . . . . . . 373 Seth L. Matarasso 124 Periorbital-Facial Volume Rejuvenation for Focal Defifi cits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 379 John R. Burroughs and Richard L. Anderson 125 Pearls for Periorbital Fat Transfer . . . . . . . . . . . . . . . . . . . . 381 Lisa M. Donofrio xviii Contents 126 Complementary Fat Grafting in the Periorbital Region . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 384 Samuel M. Lam, Mark J. Glasgold, and Robert A. Glasgold 127 Autogenous Orbicularis and Fat as a Filler . . . . . . . . . . . . . 386 John R. Burroughs, Michael T. Yen, and Richard L. Anderson Part IX Skin Rejuvenation Section One Skin Care 128 Skin Care 101: The Basics . . . . . . . . . . . . . . . . . . . . . . . . . . . 391 Diane S. Berson 129 Retinoids for the Cosmetic Patient . . . . . . . . . . . . . . . . . . . 393 Kenneth R. Beer 130 Evaluation of Skin Lesions in the Cosmetic Patient Made Simple: Actinic Keratosis . . . . . . . . . . . . . . . . . . . . . . 396 Brent R. Moody Section Two Nonablative Therapy 131 Chemical Peels for Facial Rejuvenation . . . . . . . . . . . . . . . 401 Andrew J. Kaufman 132 Nonablative Laser and Light Facial Rejuvenation . . . . . . . 404 Jeffrey S. Dover 133 Mesotherapy for Cosmetic Periocular Enhancement . . . . 409 Samuel M. Lam and Gustavo H. Leibaschoff Section Three Ablative Therapy 134 Skin Rejuvenation Techniques: General Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 413 Erin L. Holloman and Sterling S. Baker 135 CO2 Laser Skin Resurfacing Prophylaxis . . . . . . . . . . . . . . 416 Jemshed A. Khan 136 CO2 Laser Resurfacing Immediate Postoperative Care Prior to Complete Epithelialization . . . . . . . . . . . . . . 417 Jemshed A. Khan 137 Products Used in CO2 Laser Resurfacing Wound Care: Late Postoperative Care After Complete Epithelialization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 418 Jemshed A. Khan 138 Monopolar Radiofrequency Tissue Tightening . . . . . . . . . . 419 Elizabeth F. Rostan Contents xix 139 Dual-Mode Erbium-YAG Laser Skin Resurfacing . . . . . . 424 John B. Holds 140 Fraxel Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 428 Howard Conn Part X Thread Lift 141 Pros and Cons of Contour Threads for Upper Facial Rejuvenation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 433 Michael S. Kaminer 142 Periocular Suture Lifts: Brow and Malar Repositioning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 435 Samuel M. Lam 143 Contour Threads Technique Pearls . . . . . . . . . . . . . . . . . . . . 438 Michael S. Kaminer 144 Combined Modalities for the Correction of Asymmetric Brow Position . . . . . . . . . . . . . . . . . . . . . . . . . . 440 William P. Mack Part XI Other Cosmetic Procedures 145 Repair of the Torn Earlobe . . . . . . . . . . . . . . . . . . . . . . . . . . 445 Yoash R. Enzer 146 Upper Lip Lift as a Complementary Technique in Facial Rejuvenation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 452 Oscar M. Ramirez and Camilo O. Reyes 147 SMAS Malar Fat Pad Lift with Short Scar Face Lift . . . . . 457 Paul S. Nassif and Guy G. Massry 148 Ten Tips for a Reliable and Predictable Deep Plane Facial Rhytidectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460 David E.E. Holck, Jill A. Foster, Kevin A. Kalwerisky, and O. Bailey Robertson Part XII Functional Lid Malpositions Section One Ptosis: Anterior Approach 149 Advantages of Sequential Versus Simultaneous Bilateral Levator Advancement Surgery . . . . . . . . . . . . . . . 475 Herbert J. Glatt 150 Considerations in Simultaneous vs. Sequential Bilateral Levator Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . 476 Robert A. Mazzoli xx Contents 151 Unilateral Levator Resection for Jaw-Winking Ptosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 478 Stuart R. Seiff 152 Ten Steps to Making Ptosis Surgery More Predictable . . . 479 Russell S. Gonnering 153 Adjustable Suture Technique for Levator Surgery . . . . . . 481 Morris E. Hartstein and John J. Woog 154 Tarsal Switch Levator Resection for the Treatment of Myopathic Blepharoptosis . . . . . . . . . . . . . . . . . . . . . . . . 484 Sheri L. DeMartelaere, Todd R. Shepler, Sean M. Blaydon, Russell W. Neuhaus, and John W. Shore 155 Modififi ed Levator Advancement Ptosis Technique . . . . . . . 490 Rona Z. Silkiss 156 Minimally Invasive Ptosis Repair . . . . . . . . . . . . . . . . . . . . . 491 Francesco P. Bernardini 157 Small Incision External Levator Repair . . . . . . . . . . . . . . . 494 Mark J. Lucarelli 158 Ptosis Repair by a Single-Stitch Levator Advancement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 497 Don Liu 159 Postoperative Care in Ptosis Surgery . . . . . . . . . . . . . . . . . . 500 Edsel Ing Section Two Ptosis: Posterior Approach 160 Pearls for Müller’s Muscle–Conjunctival Resection–Ptosis Procedure Combined with Upper Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 503 Allen M. Putterman 161 Müller’s Muscle–Conjunctival Resection Pearls: Phenylephrine and Resection Considerations . . . . . . . . . . 506 Melanie H. Erb and Steven C. Dresner 162 Avoiding Lid Contour Abnormalities in Müller’s Muscle–Conjunctival Resection: Recognizing the Lateral Shift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 508 Michael E. Migliori 163 Müller’s Muscle–Conjunctival Resection Procedure Tips . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 509 Melanie H. Erb and Steven C. Dresner Section Three Entropion 164 Minimally Invasive, Three-Step, Transconjunctival Entropion Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 513 Francesco P. Bernardini Contents xxi 165 Simple Entropion Repair Using the Orbicularis Strip . . . 515 Don Liu 166 Simple “Bedside” Cautery Entropion Repair . . . . . . . . . . . 517 David J. Singer Section Four Ectropion 167 “Simple-Dimple” Lateral Tarsus Fixation . . . . . . . . . . . . . . 521 William L. Walter 168 Lower Lid Retractor Dissection . . . . . . . . . . . . . . . . . . . . . . 524 Jeffrey P. Edelstein 169 Simple Lower Lid Tightening Without Tarsal Strip . . . . . . 525 Don Liu 170 Technique for Medical Canthal Flap to Correct Lid Retraction/Medial Ectropion . . . . . . . . . . . . . . . . . . . . . 526 Kathleen M. Duerksen 171 Medial Canthorraphy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 528 Francesco P. Bernardini 172 Myocutaneous Flaps and Canthopexy for Repair of Severe Cicatricial Ectropion . . . . . . . . . . . . . . . . . . . . . . . . . 531 James Leong and Raf Ghabrial