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Chapter 132 - Aesthetic facial plastic surgery

from Section 25 - Otolaryngologic Surgery

Published online by Cambridge University Press:  05 September 2013

Michael F. Lubin
Affiliation:
Emory University, Atlanta
Thomas F. Dodson
Affiliation:
Emory University, Atlanta
Neil H. Winawer
Affiliation:
Emory University, Atlanta
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Summary

Facial plastic surgery is conceptually divided into aesthetic and reconstructive disciplines. Indications for aesthetic surgery include the sequelae of facial aging: rhytidosis, facial and cervical skin laxity and redundancy, brow ptosis, dermatochalasis and generalized periorbital aging, and cervical fat excess. Additional indications include refinement of nasal, ear, or chin deformities as well as cheekbone and lip enhancement. Reconstructive procedures are indicated for correction of nasal airway obstruction, deformities following facial trauma or cancer resection, and birth defects. Surgical interventions vary in complexity and duration based on the indications and goals of the procedure. Regardless of the indication, facial plastic surgery is most often an elective procedure done to improve the patient's quality of life. Knowledge of relevant complications and sequelae is essential to enlighten the patient so that an informed decision can be made. Realistic expectations including surgical limitations should be thoroughly addressed with each patient preoperatively to avoid postoperative psychological distress and dissatisfaction.

The choice of anesthetic techniques for these procedures is evenly divided between general anesthesia and a combination of local anesthesia with intravenous sedation. Patient preference, surgical expertise, and expected procedure duration should all be considered in the choice of anesthesia. Blood loss from facial plastic and reconstructive procedures is usually minimal and cases requiring transfusions are the rare exception.

Type
Chapter
Information
Medical Management of the Surgical Patient
A Textbook of Perioperative Medicine
, pp. 767 - 769
Publisher: Cambridge University Press
Print publication year: 2013

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References

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