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How I Do It - Reduction ­thyroplasty

Introduction Male to female transgender patients often undergo reduction thyroplasty – a procedure to reduce the external appearance of the thyroid cartilage of the larynx, and feminisation of the voice. Reduction thyroplasty, often erroneously called ‘tracheal shave’, is one of...

Subcutaneous botox

The authors of this paper performed a double blind, randomised, prospective trial on 19 patients receiving intramuscular botulinum toxin injections on one side of the forehead and subcutaneous injections on the other. Objective assessment of brow elevation and subjective self-evaluation...

Rejuvenation of the forehead: correction of the frontal concavity

During the ageing process, many different anatomical changes contribute to the aged appearance of the face [1]. Focusing on the forehead, typical age-related changes are regression of the hairline, solar damage, skin laxity, dynamic wrinkles, reduction of fat and bone...

Progressive peri-orbital swelling over three years: a rare complication of HA dermal filler injection treated successfully by hyaluronidase

The term ‘tear trough’ was first introduced by Flowers in 1969 to describe the deformity that leads to lower eyelid depression. It was proposed that the defect was due to a muscular defect between the angular head of the quadrates...

History of fat grafting

Fat grafting was first described in 1893 by Gustav Neuber, who transplanted adipose tissue from the arm to the orbit to correct depressed scars resulting from osteomyelitis. In 1895, Czerny reported excising a lipoma and grafting it into a breast...

Cautions, contraindications and complications in aesthetics

All aesthetic practitioners will face complications during their career. It is therefore vital to be prepared. Dr Nestor Demosthenous provides a comprehensive guide to potential complications when treating patients with fillers. A complication during or following a treatment carried out...

Classification and assessment of midfacial fractures: no more Le Fort facial fractures

There is some evidence that severe or complex midfacial or orbital fractures have declined over the last decade. Interestingly there is also evidence of an increase in road traffic accidents but a decrease in facial injuries. This is possibly attributed...

How I Do It - Postoperative care following aesthetic breast surgery – augmentation, reduction / mastopexy and augmentation mastopexy

The first aspect of postoperative care is to prevent or pre-empt potential problems; two main concerns are bleeding and infection. Towards the end of the procedure, I always undertake an antiseptic or saline washout before closing and check the blood...

The importance of nitric oxide in medicine

The harmful effects exerted upon living and injured tissues by free radicals have been explored since the 1980s. Now in 2021 the free radical nitric oxide (NO) is not just a figment of imagination; it is known as one of...

The importance of skin preparation

With both aesthetic procedures and antibiotic resistance on the rise, good skin disinfection to reduce the risk of infection is more vital than ever. Anna Baker takes us through the evidence behind commonly used skin preparation formulations for aesthetic injectable...

Nutraceuticals and skin health

An interesting discussion on the evidence surrounding nutraceuticals. The author describes nutracosmetics to be one of the fastest growing subsections of the nutraceutical industry. A comprehensive analysis of topical and dietary antioxidant protection is conveyed with conclusive evidence to demonstrate...

How I Do It - Congenital midline cervical cleft excision and reconstruction

Congenital midline cervical cleft (CMCC) is an extremely rare malformation comprising: a cranial soft tissue protuberance and a caudal blind-ending sinus connected by a vertical defect of absent or atrophic skin with an underlying subcutaneous fibrous cord that can extend...