Issue #11 summary - GO BACK TO ARCHIVE

Ivo Pitanguy on the facelift after 40 years and 8,000 patients
Interestingly, an increase in male patients has been noted. In the 1970s, male patients represented 6% of face-lifting procedures; in the 1980s, approximately 15%; currently,almost 20% of face-lift patients are men.
   Face-lifting may be performed under general anesthesia or, more frequently, by local infiltration and endovenous sedation. In either case, the patient is carefully monitored throughout the procedure by the anaesthesiology team. Although some surgeons undertake face-lifting as an outpatient procedure, we prefer to keep the patient for one or two days in the clinic.
   The standard incision is demarcated, beginning in the temporal scalp, proceeding in the pre-auricular area in such a way as to be ‘broken’ by anatomical curves. A straightincision is unsightly and will call attention to the scar. The incision then follows around the ear-lobe, and, in a curving fashion, finishes in the cervical scalp. In patients who have previously undergone this operation (that is, secondary rhytidoplasties), variations of this incision are chosen depending on each case, with the following goals in mind: treatment of specific regions, resection of previous scars, and maintenance of anatomical landmarks.
   Advantages of each different incision have been mentioned in previous publications.

The effectiveness of fixation plates used with breast implants
Mammary implants made of silicone elastomer and filled with silicone gel were introduced for breast augmentation in 1963 by Cronin and Gerow. Several other fillers have subsequently been tried: silicone oil, saline, polyvinylo-propylene, soya oil and, since 1993, very cohesive silicone gel.
    Polyvinylo-propylene has been discarded because of its hygroosmotic properties, and soya oil because of the allergic reactions. Anatomically formed, or round silicone implants filled with the cohesive silicone gel have, during the past decade, proved to be the major step towards attaining consistently good breast enlargements. This has been appreciated by many patients and surgeons alike.
    Are the cohesive, anatomically formed breast implants really superior to the conventional implants filled with normal cohesive gel or saline? Time will tell.

Radiosurgery compared with the scalpel, laser and electrosurgery
The purpose of this study was to evaluate our results in aesthetic surgical procedures and the removal of superficial skin lesions with radiosurgery and compare them with the scalpel, electrosurgery and laser.
   Reviewed were 949 cases of aesthetic surgical procedures and the removal of 350 superficial skin lesions performed with radiosurgery from November 1995 to November 2000. Evaluated were bleeding, operating time, healing time, post-operative edema and ecchymosis and quality of the scars. Also examined were complications: infections, dehiscense, skin necrosis, haematomas and seromas.
   In 12 skin specimens, a double- blind histological study of lateral thermal damage was conducted comparing incisions made with the same Vari-Tip electrode with radiosurgery and electrosurgery.
   To perform the incisions, a high radio-frequency 3.8 Mhz. Surgitron-Ellman was used. The radiowaves generated travel from the electrode tip to the patient and intracellular boiling fluid. Expansion and rupture of the cell membrane is produced without or with very minimal damage to adjacent tissues.

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