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Flashcards in Complex layered facial closures Deck (19):
1

The superficial musculoaponeurotic system (SMAS) begins in the forehead as a continuation of the galea aponeurotica

T

2

The skin is both viscoelastic and anisotropic

T
This means its stretchability is non-linear

3

‘Creep’ refers to the skin’s ability to stretch over time

T

4

Suspension sutures should be placed between the deep fascia or periosteum and the overlying superficial dermis

F
Overlying reticular dermis
get dimpling if too superficial

5

The supraorbital transposition flap for closure of complex upper eyelid defects allows the wound to be closed without tension on the eyelid

T

6

Lateral canthopexy involves attaching single or multiple suspension sutures from the conjoined tendon of the lower lid travelling superiorly and laterally to anchor in to the periosteum of the inner aspect of the lateral orbital rim

T

7

Suspension of the lower eyelid to counteract downward forces and prevent or correct ectropion can be accomplished by placement of a suspension suture at the medial canthus

F
Lateral canthus
this is a Lateral canthopexy

8

The face lift or rhytidectomy is the hallmark procedure for repositioning the mid-face

T

9

Facial rhytidectomy involves developing a skin flap that has the SMAS as its floor and the subcutaneous fat and skin as the roof

T
the tissue is undermined lifitng the fat off the SMAS
called a 'SMAS flap' although this is misleading

10

For facial rhytidectomy, plication of the SMAS is accomplished by placing interrupted suspension sutures from the SMAS overlying the cheek to the superficial temporal muscle

F
To the deep temporal or preauricular fascia

11

Mid-face suspension lifting sutures can be used to elevate the malar fat pad

T

12

Suspension sutures cannot be used to minimise tenting of flaps across natural concavities

F
good for this - needed in cheek advancement flaps to recreate the NLF by tacking the flap to the periosteum of the maxilla

13

Incisions crossing lines of demarcation between geometric units disrupt the natural contour and facial symmetry

T

14

A suspension suture that is placed under too much tension can lead to dimpling of the skin flap, focal tissue necrosis and poor cosmetic outcome

T

15

The second pass of a suspension stitch proceeds blindly through deeper tissue structures

T
Must have good knowledge of anatomy
takes a bite of underlting deep fascia, tendon, muscle and periostium depending on site
(first pass is through the reticular dermis of the flap)

16

Downward migration of the malar fat pad that accentuates the nasolabial fold and jowling is due to HIV drugs

F
this is a normal part of aging
HIV drugs cause lipoatrophy of this fat pad

17

Imbrication involves excising the redundant SMAS followed by suturing the two free ends together

T
rarely performed technique for face lift as risks damaging facial nerve - SMAS plication performed insetad

18

A tacking suture is different to a suspension suture

F
same thing
AKA anchoring or pexing suture

19

Closure of large cheek defects such as the cervicofacial rotation flap benefit from the same type of tacking sutures used in face lifts

T
attach the flap to the temporal or preauricular fascia