2.7: Facial Aesthetics

Question 1

What are the indications for facial surgery?

Answer 1

• Cosmetic (Against affects of ageing)
• Congenital Deformity
• Reconstruction after tumour removal
• Trauma

Question 2

Describe the rule of thirds?

Answer 2

For a face to be visually attractive, all three thirds of the face must be the same size
If they are different, this leads to the face looking different

Question 3

What is Rhinoplasty?

• Why?
• Procedure?

Answer 3

Nasal Reshaping
Can be carried out for cosmetic reasons - functionally there is nothing wrong but patient is unhappy with shape of nose
Often removes an extra ‘hump’ of the nose?

Question 4

What is Mentoplasty?

- Why?

Answer 4

Chin Reshaping
Done for cosmetic reasons
Brings all parts of the face into the correct proportions

Question 5

What is Otoplasty?
This is reshaping/pinning back of the ears?
- Why?

Answer 5

Done for cosmetic reasons
Free in some regions
Commonly done in scotland before the age of 16

Question 6

Describe the effect of ageing on the skin?

Answer 6

Causes the skin to sag/droop

Causes wrinkles

Question 7

Treatment for ageing skin?

Answer 7

Botox
Injections of Botulism Toxin into the skin

Skin peel/laser to resurface the skin and remove wrinkles

Face lift to correct sagging skin

Fillers

Question 8

What is Blepharoplasty?

Answer 8

This is surgery on the eyelids (upper and lower)
Can be done for cosmetic or functional reasons:
Cosmetic; Droopy eyelids due to ageing, bags under the eyes
Functional: Can droop so much they cause visual disturbance

Question 9

What are the options for reconstruction?

Answer 9

Primary Closure
Healing By Secondary Intention
Skin Graps
Skin Flaps

Question 10

Describe primary closure?

Answer 10

This is simply closing the wound with stitches

Suitable for simple, clean wounds that have plenty of lax skin - the scar won’t show

Question 11

Describe healing by secondary intention?

Answer 11

This is allow the wound to close naturally
Used in dirty, untidy wounds. Cannot be primary closed as infection would remain under the skin.
- Debride
- Treat/Clean (once infection has cleared)
- Then Close
EG; Chainsaw wound

Question 12

What are skin grafts?

Answer 12

This is skin tissue from a devascularised area
Can be classified as
- Partial Thickness
- Full Thickness

Question 13

What are skin flaps?

Answer 13

These are vascularised areas of tissue that have been moved from a local area of lax tissue
Still attached to blood vessels (has its own blood supply)

Question 14

Which are more successful - flaps or grafts?

Answer 14

Flaps - have their own blood supply

Question 15

Why would you not give a skin flap?

Answer 15

Unsure if all cancer has been resected and second operation may be required
Short operation time - elderly or infirm

Question 16

Why do grafts fail?

Answer 16

Wrong colour

Not enough subcutaneous tissue to support the skin (especially in tumour resection)

Question 17

Describe why total nasal reconstruction (following cancer removal) is difficult

Answer 17

Needs to be aesthetically acceptable
Needs to be functional
Needs skin from three areas - Inner lining, cartilage scaffolding and skin covering