What are some uses of facial plastic surgery?
- Aesthetic anxiety
- Effect of ageing
- Congenital conditions
- Trauma
- Following tumour excision
What are the 5 main components of the facial complex?
- Forehead
- Nose
- Eyes
- Lips
- Chin
What creates beauty?
The balance of the 5 components of the facial complex
What is the divine proportion?
1.618:1
- Length vs breadth of face
- Width of nose to mouth
- Length of nose to nasal projection
- width of eye to facial width
What are some common plastic surgery procedures?
- Rhinoplasty
- Mentoplasty
- Face lift
- Neck lift
- Blepharoplasty
- Brow lift
- Skin rejuvination
- Otoplasty
- Tumour surgery
What is rhinoplasty?
Nose reconstruction
What is mentoplasty?
Chin reconstruction
What is blepharoplasty?
Eye lid reconstruction
What is required in rhinoplasty?
- Full assessment of the nose and face
- Psychological assessment
- Multiple consultations
- Endonasal surgery to open up the nose from the septum
- Shaving of the nasal humps
What is otoplasty?
Ear reconstruction
What are some conditions that require otoplasty?
Congenital problem such as:
- Loss of helical fold
- Prominent conceal bowl
- protruding lobule
What is the 123 rule of assessing in otoplasty?
- 1cm from the most superior point of the pinna to the mastoid
- 2cm from Frankfort (Top of tragus) posterior part of pinna to mastoid
- 30 degree mastoid and helix
What are some surgical options in otoplasty?
Ear moulds (Birth - 3 months)
Mustarde suturing
Anterior scoring
Conchal reduction
Furness conchamastoid cave rotation sutures
What is involved in mustarde suturing?
Section of post-auricular skin taken out to pull the ear back
What is usually involved in mentoplasty?
Usually involves fillers but may be more permanent with bone reshaping
What are some intrinsic factors of ageing?
- Genetically determined pace
- Build up of damaging products and increasing biological ageing of the cells
- Oestrogen levels influence skin integrity
What re some extrinsic factors of ageing?
Insults from the environment add to the signs of ageing (E.g. sun exposure)
Describe changes in skin in ageing
- Skin thinning at accelerated rate
- Melanocyte count decreases leading to uneven pigmentation
- Skin flattens at the demo-epidermal junction
- Decrease in collagen and elastin turnover
- Volume of sub-cutaneous fat diminishes in face, hands and feet
- Relative increase in sub-cutaneous fat in thighs, waist and abdomen
What are some management options for skin ageing?
- Botulinum toxin
- Fillers
- Blepharoplasty
- Skin rejuvination
- Face lift
- Skin peeling and laser resurfacing (Reduces pigmentation)
How do eyelids change with age?
- Accumulation of loose skin forms deepening creases in the lower eyelids
- Slackening of muscles around the eye allow protective fat to protrude forward causing bagginess
What is involved in blepharoplasty?
Reshaping by removing extra-fat, excess skin and sagging muscle
What are the 4 forms of reconstruction?
- Healing by secondary intervention
- Healing by primary closure
- Skin grafts
- Skin flats
What is involved in healing by secondary intention?
Involves leaving the wound open to heal from the top itself as the epithelium grows over the scar
When is healing by secondary intention used?
- Used in infected tissue and tumour margins
- Can give better cosmetic outcomes and less scarring
-
ENT anatomy100
-
Ear pathology basics4
-
Otalgia99
-
Hearing loss38
-
Vertigo51
-
Ear emergency and trauma30
-
Pure tone audiometry and tympanometry37
-
Rhinitis30
-
Sinusitis12
-
Nasal polyps10
-
Nasal tumours18
-
Nasal emergencies23
-
Orofacial pain7
-
Facial trauma9
-
Oral pathology68
-
Salivary gland pathology31
-
Sore throats85
-
Adenotonsillar disease and malignancy46
-
Throat and mouth emergencies26
-
Facial plastic surgery27
-
ENT histology4
-
Physiology of hearing and balance27
-
Physiology of taste and smell46
-
Anatomy of the palate and pharynx12
