Renato Saltz

Minimally Invasive Facial Rejuvenation Endolaser Mid-Face Lift

Abstract. Endolaser mid-face lift was performed on patients in a multi-center study over a 36-month period (Feb. 1998 to Feb. 2001). It permits significant facial rejuvenation through small incisions. This technique achieves aesthetic results and wider rejuvenation while being less traumatic and creating minimal morbidity. Combined with other procedures, it rejuvenates the face by three strategic methods: soft tissue suspension, reversal of photo aging, and correction of the depletion of volume. To achieve this triple result, the mid-face lift is performed by endoscopic approach, and in every case is combined with the endoscopic lift of the frontal area. Laser resurfacing was used to reverse skin photo damage. The Ultrapulse CO2 laser and/or the Ultrafine Erbium YAG(Coherent, Inc, Palo Alto, CA) were used. The third combined procedure was the introduction of fat graft to compensate the atrophy/ptosis of fat and the depletion of bone mass (other filling materials besides fat may be used, depending on the preference of the surgeon). Our method of fixation using the Casagrande Needle (an evolution of Reverdin Needle) makes the mechanical purchase on the tissues to be suspended much easier, permitting the intra-oral and/or infra-orbital incisions to be eliminated. The present study of the technical evolution of the endolaser mid-face lift method allows us to conclude that a very satisfactory outcome has been reached, offering patients a minimally invasive procedure, which can be performed under local anesthesia, with low morbidity, imperceptible incisions, and an excellent long-term result.

Clinical and Radiographic Poland Syndrome Classification: A Proposal

BACKGROUND Many chest wall deformities have a characteristic radiologic appearance that can be the basis for a definitive diagnosis. Consequently, imaging techniques have fundamental roles in the detection, location, and characterization of these disorders. OBJECTIVE The authors propose a clinical and radiographic Poland syndrome (CRPS) classification system and possible treatment algorithm for the thoracic manifestations of Poland syndrome (PS) in women, based on both clinical examinations and imaging studies. METHODS A retrospective study was conducted of 28 female patients evaluated over 17 years in the 28th Infirmary, Plastic and Reconstructive Surgery Division of the Hospital Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil. After clinical examination, all patients underwent radiographic examination with chest radiographs, conventional computed tomography scans, magnetic resonance imaging and, in some cases, additional imaging studies. All clinical and radiologic variables were compiled in a database and used in the classification system, which included three levels of disease severity. RESULTS Based on the CRPS classification of the 28 female patients, 10 patients had first-degree PS, 14 patients had second-degree PS, and four patients had third-degree PS. Eighteen patients underwent surgical correction; a total of 39 surgical procedures were performed using the CRPS algorithm. CONCLUSIONS Identification of the severity of PS using the proposed classification system provided an accurate study of each patient and enabled better planning for the surgical correction of functional and aesthetic deformities.

Endoscopic Temporal-Incision Only Midface Lift is Enhanced by Endotine Technique

The Endotine midface technique, through an endoscopic temporal-incision only approach, is the authors preferred method of malar fat pad suspension and fixation. The bioabsorbable Endotine device avoids an intraoral incision, eliminates sutures, offers multipoint fixation, and the leash fixation mechanism provides fast and simple adjustability for optimal control of midface elevation and volume.

Endoscopic brow lift for visual field correction and aesthetic improvement in the elderly bald male

We have performed endoscopic brow lift in 25 men (63 to 77 years old). Sixteen had male pattern baldness, ranging from class IV to VII of the Norwood classification, and 14 had associated eyelid ptosis. Elderly male patients with male pattern baldness require special consideration in terms of brow fixation and placement of incisions. The techniques used are described and the results reviewed. The effects of these procedures on visual field deficits are discussed.

Tissue Sealants in Plastic Surgery

The search for the perfect surgical “glue” is ongoing. Throughout the centuries surgeons and scientists have sought an ideal surgical sealant and adhesive—that is, one that is safe, biologically compatible, effective, and affordable. A tissue sealant with these attributes would have unlimited applications, including simple wound closure, sealing of cavities, and control of massive hemorrhage, and would reduce morbidity and health care costs, thus providing significant benefit to patients undergoing plastic surgery. In the last 30 years a variety of fibrin sealant products made from a commercially developed material derived from pooled human plasma (Tissel, Immuno AG) have emerged in Europe. Although these products have been very popular in Europe, they have …

The common principles of effective breast reduction techniques

Abstract Background: The evolution of breast reduction surgery is discussed to shed light on the various principles and techniques used in this 4-step procedure. Objective: The purpose of this article is to simplify planning for breast reduction and help teach the essential elements of an effective procedure to young surgeons while avoiding confusion about the many personal techniques being used today. Methods: The 4-step surgical approach to breast reduction, common to more than 70 different techniques, consists of vertical resection, horizontal resection, development of medial and lateral flaps, and development of the nipple areola flap. Results: This procedure effectively reduces the diameter and profile projection of the breast, provides better contour, and repositions the nipple. Conclusions: An in-depth understanding of the 4 basic principles involved in breast reduction will make the procedure easier to perform and lead to more predictable results.

Book Review: Aesthetic Plastic Surgery

Sherrell J. Aston, Douglas S. Steinbrech, Jennifer L. Walden, editors. Aesthetic Plastic Surgery, Philadelphia: Saunders, 2009. ISBN-10: 0702031682 This elegantly written book is the product of many years of aesthetic surgery experience by world-renowned New York plastic surgeon Dr. Sherrell Aston. He leads his coeditors, Drs. Douglas Steinbrech and Jennifer Walden, and a superb group of authors through their coverage of the topic in this concise and practical text. With excellent illustrations and a helpful DVD, this is a resource that both novice and senior aesthetic surgeons must have in their libraries. Aesthetic Plastic Surgery is based on concepts adopted at the annual aesthetic surgery symposium hosted by the Manhattan Eye, Ear, and Throat Hospital (MEETH). I was honored to be invited as a faculty member for the 2010 symposium and witnessed firsthand the value of converting the lessons of the symposium into this textbook. The book is divided into 13 different sections … Corresponding Author: Dr. Renato Saltz, 5445 South Highland Drive, Salt Lake City, UT 84117, USA. E-mail: rsaltz{at}saltzplasticsurgery.com