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Filleting the lobule in otoplasty

The correction of lobular deformities continues to represent a challenge during otoplasty, due to its three major anatomic components: the axial angular protrusion, the coronal angular protrusion and the inherent shape. These aspects make controlled lobule repositioning less predictable. The...

Lateral crura reinforcement with the sandwich technique

Maintaining nasal tip structure and contour is an important goal during rhinoplasty surgery. Tip deformities can occur due to lateral crura malposition, trauma or sometimes due to excess of lateral crura triming during previous surgeries. The consequences of lateral crura...

Prostaglandin-associated periorbitopathy

This is a masked study of 33 patients who had been taking a prostaglandin analogue in one eye only for at least a year, to look for signs of prostaglandin-associated periorbitopathy (PAP). The investigators devised a new grading system to...

Revision of orbital fracture repairs

This is a retrospective review of 13 patients with sub-optimal outcomes following primary orbital fracture repairs who underwent revision surgery. All had fractures of the orbital floor, with four involving other orbital walls, and six also involving other facial bones....

‘Split’ earlobe repair

Surgical repair of the earlobe is an increasingly sought-after procedure for patients of all ages. The most common reason for those wanting definitive surgical repair of their earlobe deformity is due to a ‘split’ or elongated earlobe piercing. The resultant...

How I Do It - Treatment of rheumatoid arthritis in the hand: addressing the cosmetic and functional deficit using joint replacements

In his work Orthopaedia Nicholas Andry was one of the first to define the ideal hand, in terms of ideal proportions and appearance [1]. Rheumatoid arthritis (RA) is a chronic, erosive inflammatory arthritis thought to affect approximately 1% of the...

Non-surgical rhinoplasty

Some patients would like to alter the appearance of their nose without surgery or make further subtle changes after a rhinoplasty. Lydia Badia explains how this can be done, thanks to injectable fillers.

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...

Traumatic split earlobe repair using double triangular skin flaps

Split earlobes are a common secondary deformity of the ear. Numerous techniques have been described to repair a traumatic split earlobe and break the linear scar. However, most of the techniques require elevation of additional flaps from normal surrounding tissue...

Correcting lower lateral cartilage absence

Congenital absence of the lower lateral nasal cartilage is rare. The authors discuss correcting the absence using an open approach technique to harvest septal cartilage. This is then fashioned into a shield graft and a supporting strut graft to define...

One-point tear trough correction

The authors provide an expert guide to the use of hyaluronic acid dermal fillers to rejuvenate the periorbital area. One of the early signs of periorbital ageing are dark circles around the eye, with patients complaining of a fatigued appearance....

How I Do It - Otoplasty: Anterior scoring technique

Standard intraoperative preparation and draping is carried out. The ear is folded back and the intended antihelix (antihelical fold) is marked (Figure 1). Tattooing of the new antihelix, using a blue needle and ink, is done. It is inserted through...