International Textbook of Aesthetic Surgery
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laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice
and information in this book are believed to be true and accurate at the date
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The registered company is Springer-Verlag GmbH Berlin Heidelberg
Introduction
This textbook represents the collaboration of two close friends from
separate continents who felt there was a need for a true International
Textbook of Aesthetic Surgery . Such an idea is not a new one. Italian and
American plastic surgeons have been meeting on a biannual basis sharing
ideas as well as formulating new ones. At our first meeting in 1988, it was a
surprise for both of us that although we agreed most of the time, frequently
different approaches led to similarly satisfactory results. These meetings
became a forum for presenting new ideas as well as novel surgical
techniques. Included in this book are many who participated in these
collaborations as well as their pupils. We used this as a starting point to
transfer this experience into a book form in order to share with others what
we think represents aesthetic surgery today.
Surgery has changed dramatically over the past 20 years, and nowhere
is that more evident than in cosmetic surgery. Expectation is high and the
relationship between plastic surgeons and patients has become almost a
commodity with a seller and a buyer. Today’s patient is unwilling to accept
long hospitalizations, lengthy periods of recovery, or unattractive scarring.
The expectation of a “natural look” post surgery is now the cornerstone of
modern aesthetic surgery. The role of nonsurgical treatments for the skin,
i.e., fillers, Botox®, and the like has complemented what we are able to do
surgically.
In this textbook, we present a panorama of surgical techniques and share
with you what we consider contemporary aesthetic surgery to be. And it is
in this vein that the intent of this book is not to present an encyclopedia of
surgical techniques but rather an approach from those who we feel are on
the cutting edge, both medically and surgically. As you can note from the
index we have invited not only Italian and American authors but trusted
friends whose work and approach we admire.
Since the Italian publication of this book, we have lost two shining stars
in our world of aesthetic surgery, Dr. Fernando Ortiz-Monasterio and Dr.
Daniel Marchac. Their two chapters, the first two of the book, lay the
cornerstone for this publication and also represent their last contributions to
the literature. We all owe a great debt to them for their innovations, skill,
and their willingness to be mentors and teachers to many of us.
We would like to thank all of those who have contributed to this project
including our families, office staff, and fellow authors. Most importantly,
we would like to thank our patients who have provided the surgical
challenges as well as the continual inspiration we have enjoyed as plastic
surgeons.
Nicolo Scuderi and Bryant Toth
Nicolò Scuderi
Bryant A. Toth
Contents
Part I Introduction to Aesthetic Surgery
The Concept of Beauty in Different Cultures
Fernando Ortiz Monasterio
Is There a Frontier Between Aesthetic and Reconstructive Surgery?
Daniel Marchac
Indications, Psychological Issues and Selection of Patients in Aesthetic
Surgery
Nicolò Scuderi, Bryant A. Toth, Stephen P. Daane and Diego Ribuffo
How to Manage an Aesthetic Surgery Practice
Karen Evind
Photography in Plastic Surgery
Maurizio Valeriani and Francesco S. Madonna Terracina
Anaesthesia in Cosmetic Surgery:European Prospective
Pierangelo Di Marco, Gianni Sampietro and Riccardo Bellucci
Anesthesia for the Cosmetic Patient:An American Perspective
A. Roderick Forbes
Post-operative Pain Therapy
Gabriele Finco, Gian Nicola Aru and Mario Musu
The American Legal System
Neal R. Reisman, Gerald F. Kaplan and Steven M. Gonzalez
Part II The Breast
History of Aesthetic Breast Surgery
Thomas M. Biggs
Augmentation Mastoplasty
Andrea Grisotti, Massimo Callegari and Domenico De Fazio
Cosmetic Breast Augmentation with Fat Grafting
Daniel Del Vecchio and Roger Khouri
Mastopexy Without Implants
Louis Benelli, Michele Pascone and Charles Benelli
Mastopexy with Implants
Francesco Stagno D’Alcontres, Flavia Lupo, Gabriele Delia and
Michele R. Colonna
Secondary Breast Augmentation
Pietro Berrino
Inverted-T Scar Reduction Mammoplasty
Michele Pascone and Andrea Armenio
Vertical Breast Reduction
Diego Ribuffo, Matteo Atzeni and Francesco Serratore
Gigantomastia
Francesco Moschella, Adriana Cordova and Francesca Toia
Aesthetic Surgery for Breast Asymmetry
L. Franklyn Elliott and J. Nicolas Mclean
Tuberous Breast:Different Morphological Types and Corresponding
Correction Flaps
Egle Muti
Gynecomastia
Carlo Cavina
Reoperative Aesthetic Breast Surgery
James C. Grotting and Michael S. Hanemann Jr.
Part III Trunk and Extremities
History of Aesthetic Surgery of the Trunk and the Extremities
Giovanni Di Benedetto, Davide Talevi, Luca Grassetti and
Aldo Bertani
Aesthetic Abdominoplasty
Carlo D’Aniello and Giuseppe Nisi
Evolution of Lipoplasty Then, Now, and the Future
Peter B. Fodor
Tridimensional Liposculpture
Marco Gasparotti and Paolo Iannitelli
Lipoabdominoplasty:Saldanha’s Technique
Osvaldo R. Saldanha, Sérgio F. D. Azevedo, Octávio A. L. Luz,
Osvaldo R. Saldanha Filho and Cristianna B. Saldanha
Lipofilling and Correction of Postliposuction Deformities
K. Ning Chang
Plastic Surgery in Massive Weight Loss Patients
Dennis J. Hurwitz and Siamak Agha-Mohammadi
Brachioplasty
Richard J. Zienowicz and Erik A. Hoy
Hand Rejuvenation
Cristina Spalvieri and Francesco Brunelli
Medial Dermolipectomy of the Thigh
Flavio Saccomanno
Gluteoplasty
Constantino Mendieta
Male Genital Aesthetic Surgery
Giovanni Alei, Piero Letizia and Lavinia Alei
Aesthetic Surgery of the Female Genitalia
Malcolm A. Lesavoy and Catherine Huang Begovic
Ancillary Nonsurgical Treatments:Trunk and Abdomen
David S. Chang
Part IV The Scalp
General Concepts and Indications
Marco Toscani and Mariangela Ciotti
Hair Transplantation
Marco Toscani and Mariangela Ciotti
Scalp Reduction
Martin G. Unger and Marco Toscani
Skin Extenders
Ciro De Sio and Marco Toscani
The Suture of Nordstrom
Manfredi Greco, Tiziana Vitagliano and Rolf E. A. Nordstrom
Part V The Nose
Historical Overview of Rhinoplasty
Carmine Alfano and Salvatore Di Cristo
Basic Rhinoplasty
Carmine Alfano, Stefania Tenna, Virginia Ciaravolo, Antonio Rusciani
and Stefano Chiummariello
Septoplasty and Treatment of Turbinate Hypertrophy
Andrea Gallo, Giulio Pagliuca and Salvatore Martellucci
Full- and Semi-open Rhinoplasty
H. Holmstrom
Secondary Rhinoplasty
Ronald P. Gruber, Kamakshi Zeidler and Drew Davis
Rhinoplasty in Patients with Malformations of the Head and Neck
Gian Vittorio Campus, Carmine Alfano and Federico De Gado
The Twisted Nose
Wolfgang Gubisch and J. Eichhorn-Sens
Profiloplasty
Carlo Cavina
Part VI The Eyelids
History of Cosmetic Eyelid Surgery
Isabella C. Mazzola
Anatomy of the Orbitopalpebral Region
Paolo Persichetti, Stefania Tenna and Annalisa Cogliandro
Upper Eyelid Blepharoplasty
Bryant A. Toth and Stephen P. Daane
Asian Upper Blepharoplasty
Hop Le
Lower Eyelid Blepharoplasty
Kristin A. Boehm and Foad Nahai
Blepharoplasty:Minimally Invasive Approach
Nicolò Scuderi and Luca A. Dessy
Lateral Canthal Surgery in Blepharoplasty
Glenn W. Jelks and Elizabeth B. Jelks
Complications of Aesthetic Blepharoplasty and Revisional Surgeries
Richard D. Lisman and Christopher I. Zoumalan
Part VII The Ear
Otoplasty
Corrado Rubino, Francesco Farace and Pietro Mulas
Part VIII The Face: Surgical Treatment
History of Facial Rejuvenation
Riccardo F. Mazzola and Isabella C. Mazzola
The Aging Face
Bryan C. Mendelson and Justin X. O’Brien
Forehead and Brow Rejuvenation
Erik A. Hoy, Benjamin Z. Phillips and Patrick K. Sullivan
Suspension Techniques in Aesthetic Surgery of the Face
Ithamar Stocchero
Rejuvenation of the Midface
Brunno Ristow
The Minimal Access Cranial Suspension (MACS) Lift
Marco Mazzocchi and Nicolò Scuderi
The Suprazygomatic (High SMAS) Facelift
Bryant A. Toth
Surgical Treatment of Ageing in the Neck
Mario Pelle Ceravolo
Reoperative Surgery of the Face
Bruce F. Connell and Michael J. Sundine
Suspension Sutures
Franco R. Perego
3D Facial Volumization with Anatomic Alloplastic Implants
Edward O. Terino
Facial Lipofilling
Domenico De Fazio and Laura Barberi
Cheiloplastics
Flavio Saccomanno
Part IX The Face: Non-surgical Treatment
Botulinum Toxin:BOTOX®
Ina A. Nevdakh, Bryant A. Toth and Stephen P. Daane
Filler
M. Greco, T. Vitagliano and A. Greto Ciriaco
Chemical Peel
A. Tedeschi, D. Massimino, G. Fabbrocini and G. Micali
Advances in Facial Plastic Rejuvenation with Ablative Laser
Technology:Can Clinical Results Be Tailored Based on Histology
Effects?
Mario A. Trelles
Laser Resurfacing
Franco R. Perego
Intense Pulsed Light Systems
M. G. Onesti and P. Fioramonti
Lasers and Intense Light Systems as Adjunctive Techniques in
Functional and Aesthetic Surgery
Mario A. Trelles
Noninvasive Physical Treatments in Facial Rejuvenation
Luca A. Dessy
Mechanic Resurfacing, Needling, Dermoabrasion and
Microdermoabrasion
Nevena Skroza, Ilaria Proietti, Concetta Potenza and Luca A. Dessy
Antiaging Cosmeceuticals
Lily Talakoub, Isaac M. Neuhaus and Siegrid S. Yu
Part X The Future
Preventive Medicine and Healthy Longevity:Basis for Sustainable
Anti-Aging Strategies
Giovanni Scapagnini, Calogero Caruso and Giovanni Spera
Anti-Aging:An Overview
Alfred P. Yoon, Stephen P. Daane, Bryant A. Toth and Ina A. Nevdakh
Aesthetic Regenerative Surgery
Claudio Calabrese, Tulc Tiryaki, N. Findikli and D. Tiryaki
Index
Contributors
Siamak Agha-Mohammadi, BSc, MB BChir, PhD, FACS
University of Pittsburgh Medical School, Pittsburgh, PA, USA
Giovanni Alei, MD
Professore Associato di Urologia, Dipartimento di Chirurgia, Università di
Roma “Sapienza”, Rome, Italy
Lavinia Alei, MD
Dipartimento di Dermatologia, Università di Roma “Sapienza”, Rome, Italy
Carmine Alfano, MD
Dipartimento di Scienze Chirurgiche, Università di Perugia, Perugia, Italy
Andrea Armenio, MD
U.O.C. di Chirurgia Plastica e Ricostruttiva Universitaria, Azienda
Ospedaliero-Universitaria Policlinico di Bari, Bari, Italy
Gian Nicola Aru, MD
Cattedra di Anestesia, Dipartimento di Scienze Mediche “M. Aresu”,
Università di Cagliari, Cagliari, Italy
Matteo Atzeni, MD
Unità di Chirurgia Plastica, Dipartimento di Chirurgia, Università di
Cagliari, Cagliari, Italy
Sérgio F. D. Azevedo, MD
Department of the Plastic Surgery, Santa Cecília University, Santos, São
Paulo, Brazil
Laura Barberi, MD
Chirurgia Plastica e Ricostruttiva, Università di Siena, Siena, Italy
Riccardo Bellucci, MD
Dipartimento di Anestesia e Rianimazione, Polo Ospedaliero Rivoli, ASL
Torino 3, Turin, Italy
Charles Benelli, MD
Plastic Reconstructive & Aesthetic Surgery, Hôpital Privé d’Athis Mons,
Athis Mons, France
Louis Benelli, MD
Plastic Reconstructive & Aesthetic Surgery, Hôpital Privé d’Athis Mons,
Athis Mons, France
Pietro Berrino, MD
Private Practice, Chirurgia Plastica Genova S.r.l., Genoa, Italy
Aldo Bertani, MD, PhD
Professore Ordinario di Chirurgia Plastica, Dipartimento di Scienze
Mediche e Chirurgiche, Università Politecnica delle Marche, Ancona, Italy
Thomas M. Biggs, MD
Baylor University College of Medicine, Houston, TX, USA
Kristin A. Boehm, MD
Private Practice, Paces Plastic Surgery, Atlanta, GA, USA
Francesco Brunelli, MD
Institut de la Main, Paris, France
Claudio Calabrese, MD
U.O.S. di Chirurgia Oncologica e Rigenerativa, Breast Unit, Azienda
Ospedaliero Universitaria Careggi, Florence, Italy
Massimo Callegari, MD
Private Practice, Milan, Italy
Gian Vittorio Campus, MD
Professore Ordinario di Chirurgia Plastica, Dipartimento di Dermatologia,
Università di Sassari, Sassari, Italy
Calogero Caruso MD
Unità di Immunosenescenza, Dipartimento di Patobiologia e Metodologie
Biomediche, Università di Palermo, Palermo, Italy
Carlo Cavina, MD
Dipartimento di Scienze Chirurgiche Specialistiche, Anestesiologiche,
Università di Bologna, Bologna, Italy
David S. Chang, MD, FACS
Private Practice, San Francisco, CA, USA
K. Ning Chang, MD
Private Practice, California Pacific Medical Center, San Francisco, CA,
USA
Stefano Chiummariello, MD, PhD
U.O.C. di Chirurgia Plastica, Dipartimento di Scienze Chirurgiche,
Università di Perugia, Perugia, Italy
Virginia Ciaravolo
Psicologa, Chirurgia Plastica e Ricostruttiva, Università di Roma
“Sapienza”, Rome, Italy
Mariangela Ciotti, MD
U.O.C. di Chirurgia Plastica, Università di Roma “Sapienza”, Rome, Italy
Annalisa Cogliandro, MD
U.O.C. di Chirurgia Plastica, Università “Campus Bio-Medico”, Rome,
Italy
Michele R. Colonna, MD
Professore Associato di Chirurgia Plastica, Dipartimento di Specialità
Chirurgiche, Università di, Messina, Azienda Ospedaliera Universitaria “G.
Martino”, Messina, Italy
Bruce F. Connell, MD
Private Practice Plastic Surgery, Santa Ana, CA, USA
Adriana Cordova, MD
Sezione di Chirurgia Plastica e Ricostruttiva, Dipartimento di Discipline
Chirurgiche e Oncologiche, Università di Palermo, Palermo, Italy
Ernesto d’Aloja, MD
Professore Ordinario di Medicina Legale, Dipartimento di Scienze
Giuridiche e Forensi, Università di Cagliari, Cagliari, Italy
Carlo D’Aniello, MD
Professore Ordinario di Chirurgia Plastica, Dipartimento di Chirurgia,
Università di Siena, Siena, Italy
Stephen P. Daane, MD
Private Practice, San Francisco and San Ramon, CA, USA
Drew Davis, MD
Department of Plastic and Reconstructive Surgery, Santa Clara Valley
Medical Center, San Jose, CA, USA
Domenico De Fazio, MD
Divisione di Chiurgia Plastica, Clinica San Pio X, Milan, Italy
Federico De Gado, MD, PhD
Private Practice, Rome, Italy
Ciro De Sio, MD
U.O.C. di Chirurgia Plastica, Istituto Dermopatico dell’Immacolata (IDI),
Rome, Italy
Daniel Del Vecchio, MD MBA
Private Practice, Boston Back Bay Plastic Surgery, Boston, MA, USA
Gabriele Delia, MD
Ricercatore Universitario di Chirurgia Plastica, Dipartimento di Specialità
Chirurgiche, Università, di Messina, Azienda Ospedaliera Universitaria “G.
Martino”, Messina, Italy
Luca A. Dessy, MD
Dipartimento di Chirurgia, Università di Roma “Sapienza”, Rome, Italy
Giovanni Di Benedetto, MD, PhD
Professore Associato di Chirurgia Plastica, Dipartimento di Scienze
Mediche e Chirurgiche, Università Politecnica delle Marche, Ancona, Italy
Salvatore Di Cristo, MD
Private Practice, Naples, Italy
Pierangelo Di Marco, MD
Dipartimento di Scienze Anestesiologiche, Medicina Critica e Terapia del
Dolore, Università di Roma “Sapienza”, Rome, Italy
J. Eichhorn-Sens, MD
Department of Facial Plastic Surgery, Marienhospital Stuttgart, Stuttgart,
Germany
L. Franklyn Elliott, MD
Atlanta Plastic Surgery, Emory University Partner, Atlanta, GA, USA
Karen Evind
Toth Plastic Surgery, San Francisco, CA, USA
Gabriella Fabbrocini, MD
Dipartimento di Patologia Sistematica, Sezione di Dermatologia, Università
di Napoli Federico II, Naples, Italy
Francesco Farace, MD
Dipartimento di Scienze Chirurgiche, Microchirurgiche e Mediche,
Università di Sassari, Sassari, Italy
Gabriele Finco, MD
Dipartimento di Scienze Mediche “M. Aresu”, Università di Cagliari,
Cagliari, Italy
N. Findikli, MD
Department of Tissue Engineering, Yildiz Technical University, Istanbul,
Turkey
