Editor's Choice: February 2013

Dear Readers,

This month, I’ve selected five articles from the February issue that I hope will pique your attention as much as they did mine. They cover techniques and research in eyelid surgery, nasal surgery, outpatient intravenous anesthesia for breast surgery patients, and experimental tissue engineering.

First is “Concepts in Eyelid Biomechanics With Clinical Implications,” which is an article I co-wrote with Drs. McCord and Walrath. This paper from our Atlanta practice describes the important role of the inner orbicularis in eyelid biomechanics.  We emphasize that innervation through the buccal branches is almost always preserved during skin-muscle flap elevation, maintaining eyelid closure. We trust that this paper will put to rest the concept that any incision in the orbicularis results in denervation of the orbicularis.

My second choice is an anatomical study entitled “The Lower Nasal Base:  An Anatomical Study,” by Dr. Rollin Daniel and several esteemed international co-authors. This excellent paper sheds further light on the nasal musculature and nasal superficial muscular aponeurotic system (SMAS).  Perhaps most importantly, the authors present new information is presented that challenges previously-published studies. A Commentary by Dr. Ron Gruber sheds further light on the clinical implications of this anatomical study.

The third selection this month is a paper by Drs. Grewal and Fisher entitled, “Why Do Patients Seek Revisionary Breast Surgery?” This review of 134 patients who underwent revisionary breast surgery evaluates the reasons they presented for revision. I was intrigued that, contrary to our common assumption that the need for revision is a result of surgical decision-making and technique, this report demonstrates that other, independent (not surgically-related) factors play a much greater role.

My fourth selection documents the safety and efficacy of total intravenous anesthesia in outpatient plastic surgery.  Dr. Faley and his co-authors, in “Office-based Outpatient Plastic Surgery Utilizing Total Intravenous Anesthesia,” report on their series of 2,611 procedures, of which 642 were undertaken with total intravenous anesthesia (TIVA).  The results clearly establish the safety and efficacy of TIVA, with only 1 documented case of deep venous thrombosis and no deaths.

My final selection for the February 2013 issue is a bench research paper by Drs. Sterodimas and de Faria entitled, “Human Auricular Tissue Engineering in an Immunocompetent Animal Model.”  This experimental work demonstrates the rapid pace of development in tissue engineering. These types of articles are essential for furthering the science behind the art of our clinical techniques.

I hope you will find the articles in this issue informative, inspiring, and interesting. I am looking forward to hopefully seeing each of you at The Aesthetic Meeting in New York City in April, where we will be distributing copies of the latest issue of ASJ and providing demonstrations of the impressive RADAR Resource (ASJ’s interactive iPad app).

Dr. Foad Nahai
Editor-in-Chief, Aesthetic Surgery Journal
Atlanta, GA

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