Sách phẫu thuật thẩm mỹ (Grabb and Smiths: plastic surgery)

EditorinChiefCharles H. Thorne, MDAssociate Professor of Plastic SurgeryNYU Medical CenterNew York, New YorkEditorsRobert W. Beasley, MDProfessor of Surgery, New York University, New York, New YorkDirector of New York University Hand Surgery Services, Institute of ReconstructivePlastic Surgery and Bellevue Hospital Center, New York, New YorkHand Surgery Consultant, Veteran’s Administration, New York, New YorkConsulting Surgeon, Hackensack University Hospital, Hackensack, New Jerseyand Impartial Advisor to Chairman, New York State Workers’ Compensation BoardSherrell J. Aston, MDProfessor of Surgery (Plastic)New York University School of MedicineChairman, Department of Plastic SurgeryManhattan Eye Ear and Throat HospitalNew York, New YorkScott P. Bartlett, MDProfessor of Surgery, University of PennsylvaniaMary Downs Endowed Chair in Pediatric Craniofacial Treatment and Research,Children’s Hospital of PhiladelphiaPhiladelphia, PennsylvaniaGeoffrey C. Gurtner, MD, FACSAssociate Professor of Surgery, Department of Surgery, Division of Plastic SurgeryStanford University School of MedicineStanford, CaliforniaScott L. Spear, MD, FACSProfessor and ChiefDivision of Plastic SurgeryGeorgetown University Medical CenterWashington, DCAcquisitions Editor: Brian BrownDevelopmental Editor: Cotton Coslett and Keith Donnellan, Dovetail Content SolutionsManaging Editor: Julia SetoProject Manager: Alicia JacksonSenior Manufacturing Manager: Benjamin RiveraAssociate Director of Marketing: Adam GlazerDesign Coordinator and Cover Designer: Terry MallonProduction Service: TechbooksPrinter: Edwards Brothers©2007 by LIPPINCOTT WILLIAMS WILKINS, a WOLTERS KLUWER BUSINESS530 Walnut StreetPhiladelphia, PA 19106 USALWW.com5th edition ©1997 By LippincottRaven PublishersAll rights reserved. This book is protected by copyright. No part of this book may bereproduced in any form by any means, including photocopying, or utilized by any information storage and retrieval system without written permission from the copyright owner,except for brief quotations embodied in critical articles and reviews. Materials appearing inthis book prepared by individuals as part of their official duties as U.S. government employeesare not covered by the abovementioned copyright.Printed in the USALibrary of Congress CataloginginPublication DataGrabb and Smith’s plastic surgery.—6th ed. editorinchief, Charles H. Thorne . . . et al..p. ; cm.Includes bibliographical references and index.ISBN 9780781746984ISBN 07817469811. Surgery, Plastic. I. Thorne, Charles, 1952 II. Grabb, William C. III. Title: Plasticsurgery.DNLM: 1. Surgery, Plastic. 2. Reconstructive Surgical Procedures. WO 600 G72652007RD118.G688 2007Care has been taken to confirm the accuracy of the information presented and to describegenerally accepted practices. However, the authors, editors, and publisher are not responsiblefor errors or omissions or for any consequences from application of the information in thisbook and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of the information in a particular situation remains the professional responsibility of the practitioner.The authors, editors, and publisher have exerted every effort to ensure that drug selectionand dosage set forth in this text are in accordance with current recommendations and practiceat the time of publication. However, in view of ongoing research, changes in governmentregulations, and the constant flow of information relating to drug therapy and drug reactions,the reader is urged to check the package insert for each drug for any change in indicationsand dosage and for added warnings and precautions. This is particularly important when therecommended agent is a new or infrequently employed drug.Some drugs and medical devices presented in the publication have Food and DrugAdministration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in their clinical practice.To purchase additional copies of this book, call our customer service department at(800) 6383030 or fax orders to (301) 2232320. International customers should call (301) 2232300.Visit Lippincott Williams Wilkins on the Internet: at LWW.com. Lippincott Williams Wilkins customer service representatives are available from 8:30 am to 6 pm, EST

GRABB AND SMITH’S PLASTIC SURGERY S I X T H E D I T I O N Editor-in-Chief Charles H Thorne, MD Associate Professor of Plastic Surgery NYU Medical Center New York, New York Editors Robert W Beasley, MD Professor of Surgery, New York University, New York, New York Director of New York University Hand Surgery Services, Institute of Reconstructive Plastic Surgery and Bellevue Hospital Center, New York, New York Hand Surgery Consultant, Veteran’s Administration, New York, New York Consulting Surgeon, Hackensack University Hospital, Hackensack, New Jersey and Impartial Advisor to Chairman, New York State Workers’ Compensation Board Sherrell J Aston, MD Professor of Surgery (Plastic) New York University School of Medicine Chairman, Department of Plastic Surgery Manhattan Eye Ear and Throat Hospital New York, New York Scott P Bartlett, MD Professor of Surgery, University of Pennsylvania Mary Downs Endowed Chair in Pediatric Craniofacial Treatment and Research, Children’s Hospital of Philadelphia Philadelphia, Pennsylvania Geoffrey C Gurtner, MD, FACS Associate Professor of Surgery, Department of Surgery, Division of Plastic Surgery Stanford University School of Medicine Stanford, California Scott L Spear, MD, FACS Professor and Chief Division of Plastic Surgery Georgetown University Medical Center Washington, DC Copyright © 2007 by Lippincott Williams & Wilkins, a Wolters Kluwer business Grabb and Smith's Plastic Surgery, Sixth Edition by Charles H Thorne Acquisitions Editor: Brian Brown Developmental Editor: Cotton Coslett and Keith Donnellan, Dovetail Content Solutions Managing Editor: Julia Seto Project Manager: Alicia Jackson Senior Manufacturing Manager: Benjamin Rivera Associate Director of Marketing: Adam Glazer Design Coordinator and Cover Designer: Terry Mallon Production Service: Techbooks Printer: Edwards Brothers ©2007 by LIPPINCOTT WILLIAMS & WILKINS, a WOLTERS KLUWER BUSINESS 530 Walnut Street Philadelphia, PA 19106 USA LWW.com 5th edition ©1997 By Lippincott-Raven Publishers All rights reserved This book is protected by copyright No part of this book may be reproduced in any form by any means, including photocopying, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews Materials appearing in this book prepared by individuals as part of their official duties as U.S government employees are not covered by the above-mentioned copyright Printed in the USA Library of Congress Cataloging-in-Publication Data Grabb and Smith’s plastic surgery.—6th ed / editor-in-chief, Charles H Thorne [et al.] p ; cm Includes bibliographical references and index ISBN 978-0-7817-4698-4 ISBN 0-7817-4698-1 Surgery, Plastic I Thorne, Charles, 1952- II Grabb, William C III Title: Plastic surgery [DNLM: Surgery, Plastic Reconstructive Surgical Procedures WO 600 G7265 2007] RD118.G688 2007 617.9 5—dc22 2006033593 Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication Application of the information in a particular situation remains the professional responsibility of the practitioner The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with current recommendations and practice at the time of publication However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precautions This is particularly important when the recommended agent is a new or infrequently employed drug Some drugs and medical devices presented in the publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in their clinical practice To purchase additional copies of this book, call our customer service department at (800) 638-3030 or fax orders to (301) 223-2320 International customers should call (301) 223-2300 Visit Lippincott Williams & Wilkins on the Internet: at LWW.com Lippincott Williams & Wilkins customer service representatives are available from 8:30 am to pm, EST 10 Copyright © 2007 by Lippincott Williams & Wilkins, a Wolters Kluwer business Grabb and Smith's Plastic Surgery, Sixth Edition by Charles H Thorne CONTRIBUTING AUTHORS Valerie J Ablaza, MD, FACS Bruce S Bauer, MD, FACS, FAAP Assistant Professor Department of Surgery Columbia University College of Physicians and Surgeons New York, New York Professor of Surgery Department of Surgery Division of Plastic Surgery The Feinberg School of Medicine Northwestern University Chief Division of Plastic Surgery Children’s Memorial Hospital Chicago, Illinois Al Aly, MD, FACS Attending Department of Plastic Surgery Iowa City Plastic Surgery Coralville, Iowa P.G Arnold, MD Professor of Plastic Surgery Department of Surgery, Division of Plastic Surgery Mayo Clinic Rochester, Minnesota Christopher E Attinger, MD Professor Department of Plastic Surgery Georgetown University Medical Director The Limb Center Georgetown University Hospital Washington, District of Columbia John D Bauer, MD Assistant Professor, Division of Plastic Surgery Department of Surgery UTMB at Galveston Galveston, Texas Robert W Beasley, MD Professor of Surgery, New York University Director of New York University Hand Surgery Services, Institute of Reconstructive Plastic Surgery and Bellevue Hospital Center Hand Surgery Consultant, Veteran’s Administration Impartial Advisor to Chairman, New York State Workers’ Compensation Board, New York, New York Consulting Surgeon, Hackensack University Hospital, Hackensack, New Jersey Michael S Beckenstein, MD, FACS Birmingham, Alabama Alberto Aviles, MD Resident in Plastic Surgery Department of Plastic Surgery Medical College of Wisconsin Milwaukee, Wisconsin Stephen B Baker, MD, DDS, FACS Associate Professor Associate Program Director Department of Plastic Surgery Georgetown University Hospital Washington, District of Columbia Co-Director, Craniofacial Clinic Inova Fairfax Hospital for Children Falls Church, Virginia Scott P Bartlett, MD Professor of Surgery University of Pennsylvania Mary Downs Endowed Chair in Pediatric Craniofacial Treatment and Research Children’s Hospital of Philadelphia Philadelphia, Pennsylvania Steven J Bates, MD Chief Resident Division of Plastic Surgery Stanford University Medical Center Stanford, California Sean Boutros, MD Attending Surgeon Houston Plastic and Craniofacial Surgery Hermann Hospital and Children’s Memorial Hermann Hospital Houston, Texas James P Bradley, MD Associate Professor, Sarnat Craniofacial Chair Division of Plastic Surgery UCLA David Geffen School of Medicine Chief Pediatric Plastic Surgery Division of Plastic Surgery Mattel Children’s Hospital Los Angeles, California Lawrence E Brecht, DDS Clinical Assistant Professor of Surgery Department of Surgery New York University School of Medicine Co-Director of Craniofacial Prosthetics Institute of Reconstructive Plastic Surgery New York University Medical Center Clinical Associate Professor of Prosthodontics Director of Maxillofacial Prosthetics Advanced Education Program in Prosthodontics New York University College of Dentistry New York, New York Copyright © 2007 by Lippincott Williams & Wilkins, a Wolters Kluwer business Grabb and Smith's Plastic Surgery, Sixth Edition by Charles H Thorne vii viii Contributing Authors Arnold S Breitbart, MD, FACS Mihye Choi, MD Assistant Professor of Clinical Surgery Adjunct Assistant Professor of Surgery Columbia University College of Physicians and Surgeons Weill Cornell University Medical College New York, New York Assistant Professor Department of Surgery New York University New York, New York Mark A Codner, MD Duc T Bui, MD Department of Surgery Stony Brook University Medical Center Stony Brook, New York Clinical Assistant Professor Department of Plastic and Reconstructive Surgery Emory University Atlanta, Georgia Charles E Butler, MD Associate Professor The University of Texas M.D Anderson Cancer Center, Department of Plastic Surgery, Houston, Texas Sydney R Coleman, MD Assistant Clinical Professor Department of Plastic Surgery New York University School of Medicine New York, New York Peter E M Butler, MB, BSc (Hons) Consultant Plastic Surgeon Royal Free Hospital University College London London, England Grant W Carlson, MD Professor Department of Surgery Emory University Chief of Surgical Services Crawford W Long Hospital Atlanta, Georgia Peter G Cordeiro, MD Professor of Surgery Department of Surgery Weill Medical College of Cornell University Chief, Plastic & Reconstructive Surgery Service Department of Surgery Memorial Sloan-Kettering Cancer Center New York, New York Alfred Culliford IV, MD Division of Plastic, Reconstructive and Hand Surgery Staten Island University Hospital Staten Island, New York Benjamin Chang, MD, FACS Associate Professor of Clinical Surgery Division of Plastic Surgery University of Pennsylvania School of Medicine Attending Surgeon Division of Plastic Surgery Hospital of the University of Pennsylvania Philadelphia, Pennsylvania Court Cutting, MD Professor of Surgery-Plastic Surgery Director, Cleft Lip and Palate Program Institute of Reconstructive Plastic Surgery NYU Medical Center New York, New York Genevieve de Bese, MD James Chang, MD Associate Professor Division of Plastic Surgery Stanford University Medical Center Attending Surgeon Lucile Packard Children’s Hospital at Stanford Stanford University Medical Center Palo Alto, California Raymond R Chang, MD Assistant Professor of Surgery Department of Surgery, Division of Plastic Surgery George Washington University Attending Department of Surgery, Division of Plastic Surgery George Washington University Hospital Washington, District of Columbia James J Chao, MD, FACS Associate Professor of Plastic Surgery Department of Surgery University of California, San Diego School of Medicine San Diego, California General Manager and Director of Research American Hand Prostheses New York, New York Mark DeLacure, MD Associate Professor of Otolaryngology and Surgery (Plastic Surgery) New York University Medical Center New York, New York Joseph J Disa, MD, FACS Associate Attending Surgeon Plastic and Reconstructive Surgery Service Memorial Sloan-Kettering Cancer Center New York, New York Matthias B Donelan, MD Associate Clinical Professor of Surgery Harvard Medical School Chief of Plastic Surgery Shriners Burns Hospital Boston, Massachusetts Copyright © 2007 by Lippincott Williams & Wilkins, a Wolters Kluwer business Grabb and Smith's Plastic Surgery, Sixth Edition by Charles H Thorne Contributing Authors Ivica Ducic, MD, PhD Robert D Galiano, MD Associate Professor Chief–Peripheral Nerve Surgey Department of Plastic Surgery Georgetown University Hospital Washington, District of Columbia Institute of Reconstructive Plastic Surgery New York University New York, New York Gregory A Dumanian, MD, FACS Associate Professor of Surgery Department of Surgery, Division of Plastic Surgery Feinberg School of Medicine, Northwestern University Associate Professor of Surgery Department of Surgery, Division of Plastic Surgery Northwestern Memorial Hospital Chicago, Illinois Roy G Geronemus, MD, PC Laser and Skin Surgery Center of New York Clinical Professor Department of Dermatology New York Medical Center New York, New York Giulio Gherardini, MD, PhD Rome, Italy Mary K Gingrass, MD, FACS Charles J Eaton, MD Hand Surgeon Department of Surgery Jupiter Medical Center Jupiter, Florida Charles R Effron, MD Rochelle Park, New Jersey L Franklyn Elliott II, MD Atlanta Plastic Surgery, P.C Atlanta, Georgia Gregory R D Evans, MD, FACS Professor of Surgery and Biomedical Engineering Chief Aesthetic Plastic Surgery University of California Irvine Professor of Surgery and Biomedical Engineering Chief Aesthetic Plastic Surgery UCI Medical Center Orange, California Maryam Feili-Hariri, PhD Assistant Professor Surgery and Immunology University of Pittsburgh Pittsburgh, Pennsylvania Assistant Clinical Professor Department of Plastic Surgery Vanderbilt University School of Medicine Chief of Plastic Surgery Department of Plastic Surgery Baptist Hospital Nashville, Tennessee Cornelia N Golimbu, MD Professor of Radiology Department of Radiology New York University Medical Center New York, New York Arun K Gosain, MD Professor Department of Surgery Case Western Reserve University University Hospital (Lakeside) Chief Section of Craniofacial and Pediatric Plastic Surgery Rainbow Babies and Childrens Hospital Cleveland, Ohio Barry Grayson, DDS Derek T Ford, MD, FRCSC Private Practice Toronto, Ontario, Canada M Felix Freshwater, MD Miami, Florida David W Friedman, MD Assistant Professor Department of Surgery-Plastic New York University Fellowship Director Hand Surgery New York University Medical Center New York, New York Associate Professor of Surgery (Orthodontics) Institute of Reconstructive Plastic Surgery New York University School of Medicine Tisch Hospital New York, New York Arin K Greene, MD, MMSc Craniofacial Fellow Department of Plastic Surgery Children’s Hospital Boston, Harvard Medical School Boston, Massachusettes Geoffrey C Gurtner, MD, FACS Associate Professor of Surgery Department of Surgery, Division of Plastic Surgery Stanford University School of Medicine Stanford, California Jeffrey D Friedman, MD J Joris Hage, MD, PhD Assistant Professor Department of Plastic Surgery Baylor College of Medicine The Methodist Hospital Houston, Texas Chief Department of Plastic and Reconstructive Surgery Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital Amsterdam, The Netherlands Copyright © 2007 by Lippincott Williams & Wilkins, a Wolters Kluwer business Grabb and Smith's Plastic Surgery, Sixth Edition by Charles H Thorne ix x Contributing Authors Elizabeth J Hall-Findlay, MD, FRCSC John N Jensen, MD Plastic Surgeon Mineral Springs Hospital Banff Alberta, Canada Department of Plastic Surgery Medical College of Wisconsin Milwaukee, Wisconsin Dennis C Hammond, MD Center for Breast & Body Contouring Grand Rapids, Michigan Michael Hausman, MD Assistant Professor Department of Orthopaedics Chief, Hand Service Mount Sinai Hospital New York, New York Neil F Jones, MD, FRCS Professor Division of Plastic & Reconstructive Surgery Department of Orthopedic Surgery University of California Los Angeles Chief of Hand Surgery UCLA Hand Center UCLA Medical Center Los Angeles, California Robert J Havlik, MD Professor Department of Surgery-Section of Plastic Surgery Indiana University School of Medicine Chief Section of Plastic Surgery Riley Hospital for Children Indianapolis, Indiana Michael A C Kane, MD, BS Alexes Hazen, MD Nolan S Karp, MD Attending, Plastic Surgery Department of Plastic Surgery NYU Medical Center Chief Plastic Surgery Manhattan Veterans Administration Hospital New York, New York David A Hidalgo, MD New York, New York Larry Hollier, Jr., MD Associate Professor/Residency Program Director Department of Plastic Surgery Baylor College of Medicine Texas Children’s Hospital Ben Taub General Hospital Houston, Texas Richard A Hopper, MD, MS Associate Professor Department of Surgery University of Washington Surgical Director The Craniofacial Center Seattle Children’s Hospital Seattle, Washington Christopher J Hussussian, MD Plastic Surgery Associates Waukesha, Wisconsin Alamgir Isani, MD Clinical Assistant Professor Plastic Surgery New York University Medical Center New York, New York Jeffrey E Janis, MD Assistant Professor Chief of Plastic Surgery Parkland Health Hospital System Co-Director Plastic Surgery Residency Program University of Texas Southwestern Medical Center Dallas, Texas Attending Surgeon Department of Plastic Surgery Manhattan Eye, Ear & Throat Hospital New York, New York Associate Professor of Plastic Surgery NYU School of Medicine New York, New York Armen K Kasabian, MD Assistant Professor of Plastic Surgery Department of Plastic Surgery New York University Medical Center Chief, Section of Microsurgery Institute of Reconstructive Plastic Surgery New York, New York Henry Kawamoto, Jr., MD, DDS Clinical Professor Department of Surgery, Division of Plastic Surgery UCLA Los Angeles, California Patrick Kelley, MD Medical Director Craniofacial Center Children’s Hospital of Austin Austin, Texas Amy Kells, MD, PhD Microsurgery Fellow Department of Plastic Surgery University of Mississippi Jackson, Mississippi Karen H Kim, MD Director of Research Laser and Skin Surgery Center of New York New York, New York Arnold William Klein, MD Professor of Medicine and Dermatology Department of Medicine and Dermatology David Geffen School of Medicine at UCLA Beverly Hills, California Copyright © 2007 by Lippincott Williams & Wilkins, a Wolters Kluwer business Grabb and Smith's Plastic Surgery, Sixth Edition by Charles H Thorne Contributing Authors Matthew B Klein, MD Otway Louie, MD Assistant Professor Department of Plastic Surgery University of Washington Associate Director University of Washington Burn Center Harborview Medical Center Seattle, Washington House Staff Institute of Reconstructive and Plastic Surgery NYU Medical Center New York, New York David M Knize, MD Associate Clinical Professor of Plastic Surgery Department of Surgery University of Colorado Health Sciences Center Denver, Colorado Former Chief of Plastic Surgery Department of Surgery Swedish Medical Center Englewood, Colorado David W Low, MD Associate Professor of Surgery Division of Plastic Surgery University of Pennsylvania School of Medicine Philadelphia, Pennsylvania Susan E Mackinnon, MD Shoenberg Professor and Chief Division of Plastic and Reconstructive Surgery Washington University in St Louis Barnes-Jewish Hospital St Louis, Missouri James Knoetgen, III, MD Consultant in Plastic Surgery Department of Surgery, Division of Plastic Surgery Mayo Clinic Rochester, Minnesota John S Mancoll, MD Fort Wayne, Indiana Ralph T Manktelow, MD, FRCS(c) Howard N Langstein, MD Department of Plastic Surgery The University of Texas M D Anduson Cancer Center Houston, Texas W P Andrew Lee, MD Professor of Surgery University of Toronto Staff Surgeon Department of Surgery Toronto General Hospital Toronto, Ontario, Canada Professor of Surgery University of Pittsburgh Chief Division of Plastic Surgery University of Pittsburgh Medical Center Pittsburgh, Pennsylvania Stephen J Mathes, MD Salvatore C Lettieri, MD Lawrence D Bell Professor of Plastic Surgery Institute of Reconstructive Plastic Surgery NYU School of Medicine Director Institute of Reconstructive Plastic Surgery NYU Medical Center New York, New York Instructor Department of Plastic Surgery Mayo Graduate School Rochester, Minnesota Chief Department of Plastic Surgery Maricopa Medical Center Phoenix, Arizona Jamie Levine, MD Assistant Professor Division of Plastic Surgery New York University Chief Plastic and Microsurgery Department of Surgery Bellevue Hospital New York, New York J William Littler, MD Professor Emeritus of Clinical Surgery Columbia University Department of Surgery; and Retired Senior Attending Physician, Chief of Plastic and Reconstructive Surgery St Luke’s-Roosevelt Hospital Center New York, New York Institute of Reconstructive Plastic Surgery New York University Medical Center New York, New York Joseph G McCarthy, MD Babak J Mehrara, MD Assistant Professor Department of Surgery Columbia University New York Hospital-Cornell MedicalCenter Assistant Attending Memorial Sloan-Kettering Cancer Center New York, New York Frederick J Menick, MD Associate Clinical Professor Division of Plastic Surgery University of Arizona Staff Surgeon Division of Plastic Surgery St Joseph’s Hospital Tucson, Arizona Copyright © 2007 by Lippincott Williams & Wilkins, a Wolters Kluwer business Grabb and Smith's Plastic Surgery, Sixth Edition by Charles H Thorne xi xii Contributing Authors Timothy A Miller, MD John A Perrotti, MD Professor and Chief Plastic Surgery University of California School of Medicine David Geffen School of Medicine at UCLA Department of Surgery UCLA Medical Center Los Angeles, California Clinical Assistant Professor Department of Surgery New York Medical College Valhalla, New York Attending Surgeon Department of Plastic Surgery Manhattan Eye, Ear and Throat Surgery New York, New York Blake A Morrison, MD Private Practice North Texas Hand Surgery Dallas, Texas Hannan Mullett, MD, FRCS (TR & ORTM) Consultant Orthopaedic Surgeon Department of Orthopaedic Surgery Beaumont Hospital Dublin, Ireland John B Mulliken, MD Professor of Surgery Harvard Medical School Director Craniofacial Centre Department of Plastic Surgery Children’s Hospital Boston, Massachusetts Thomas A Mustoe, MD Professor Department of Surgery, Division of Plastic Surgery Feinberg School of Medicine, Northwestern University Chief Department of Plastic Surgery Northwestern Memorial Hospital Chicago, Illinois Terence M Myckatyn, MD, FRCSC Assistant Professor Department of Plastic and Reconstructive Surgery Washington University School of Medicine St Louis, Missouri Randall Nacamuli, MD Resident Division of Plastic and Reconstructive Surgery Oregon Health Sciences University Portland, Oregon James D Namnoum, MD Atlanta Plastic Surgery, P.C Atlanta, Georgia Peter C Neligan, MB, FRCSC, FACS Wharton Chair in Reconstructive Plastic Surgery Professor and Chair, Division of Plastic Surgery University of Toronto Toronto, Canada Martin I Newman, MD Active Staff Department of Plastic & Reconstructive Surgery Cleveland Clinic Florida Weston, Florida John A Persing, MD Professor and Chief Plastic Surgery, Professor of Neurosurgery Yale University School of Medicine Chief Plastic Surgery Yale-New Haven Hospital New Haven, Connecticut Linda G Phillips, MD Truman G Blocker Distinguished Professor and Chief Division of Plastic Surgery UTMB Galveston Galveston, Texas Michael L Reed, MD Associate Clinical Professor Department of Dermatology New York University School of Medicine Attending Physician Department of Dermatology New York University Medical Center New York, New York Rod J Rohrich, MD, FACS Professor and Chairman Department of Plastic Surgery The University of Texas Southwestern Medical Center Chief of Plastic Surgery Department of Plastic Surgery University Hospital – Zale Lipshy Dallas, Texas Harvey M Rosen, MD, DMD Clinical Associate Professor Department of Surgery University of Pennsylvania Chief Division of Plastic Surgery Pennsylvania Hospital Philadelphia, Pennsylvania George H Rudkin, MD, FACS Clinical Associate Professor Department of Plastic Surgery UCLA Medical Center Chief, Plastic Surgery Department of Plastic Surgery VA West Los Angeles Los Angeles, California Pierre B Saadeh, MD Assistant Professor Attending Physician Department of Surgery, Plastic Surgery New York University School of Medicine New York, New York Copyright © 2007 by Lippincott Williams & Wilkins, a Wolters Kluwer business Grabb and Smith's Plastic Surgery, Sixth Edition by Charles H Thorne Contributing Authors Hrayr K Shahinian, MD, FACS Alisa C Thorne, MD Director Skull Base Institute Cedars-Sinai Medical Office Towers Los Angeles, California Professor of Clinical Anesthesiology Weil Cornell School of Medicine Director of Ambulatory Anesthesia Memorial Sloan Kettering Cancer Center New York, New York Sheel Sharma, MD Faculty Department of Plastic and Reconstructive Surgery Hackensock, New Jersey Joseph H Shin, MD Associate Professor of Surgery Director Yale Craniofacial Center Department of Plastic Surgery Yale University School of Medicine Attending Physician Yale New Haven Hospital New Haven, Connecticut Sumner A Slavin, MD Division of Plastic Surgery Beth Israel Deaconess Medical Center Harvard Medical School Brookline, Massachusetts Hooman Soltanian, MD, FACS Attending Specialties of Plastic Surgery Hartford, Connecticut Scott L Spear, MD Chairman Department of Plastic Surgery Georgetown University Professor and Chairman Department of Plastic Surgery Georgetown University Hospital Washington, District of Columbia Henry M Spinelli, MD Charles H Thorne, MD Associate Professor Department of Plastic Surgery NYU School of Medicine New York, New York John T Tymchak, MD, FACS Clinical Assistant Professor Department of Surgery SUNY Health Science Center at Brooklyn Director, Division of Plastic Surgery and Hand Surgery Services Department of Surgery, Division of Plastic Surgery The Brookdale University Hospital and Medical Center Brooklyn, New York Lok Huei Yap, MD Department of Plastic Surgery The University of Texas M.D Anderson Cancer Center Houston, Texas Michael J Yaremchuk, MD Clinical Professor Department of Surgery Harvard Medical School Chief of Craniofacial Surgery Department of Plastic Surgery Massachusetts General Hospital Boston, Massachusetts Paul Zidel, MD, MS, FACS Clinical Professor of Surgery Department of Surgery Weill Medical College of Cornell University Attending Surgeon Department of Plastic Surgery New York Presbyterian Hospital – Weill Cornell New York, New York Clinical Faculty Department of Surgery Nova Southeastern University Fort Lauderdale, Florida Attending Department of Surgery University Hospital Tamarac, Florida G Ian Taylor, AO Ronald M Zuker, MD, FRCSC, FACS Professor Department of Anatomy and Cell Biology University of Melbourne Senior Consultant Department of Reconstructive Plastic Surgery Royal Melbourne Hospital Parkville, Victoria, Canada Professor of Surgery Department of Surgery University of Toronto Staff Surgeon Division of Plastic Surgery The Hospital for Sick Children Toronto, Ontario, Canada Copyright © 2007 by Lippincott Williams & Wilkins, a Wolters Kluwer business Grabb and Smith's Plastic Surgery, Sixth Edition by Charles H Thorne xiii 916 Index Mandible (contd.) Romberg disease and, 284, 285 surgery, cephalometric tracing, 259 Mandible distraction, 98–101 craniofacial microsomia and, 251f devices, 98f, 99 technique, 99 treatment goals of, 99–101 vectors of, 99f Mandible reconstruction, 426–435 cancer and, 426 complications from, 433–434 free-flap donor-site selection, 427–430, 428f, 428t methods, 426–427 postoperative care, 433 postoperative issues, 434, 435 preoperative planning, 430 resection, 431f surgical technique, 430, 432–433 Mandibular advancement, sagittal splitting procedure for, 258f Mandibular prominences, facial development and, 181 Mandibular ramus augmentation, operative technique, 553 Mandibulofacial dysostosis See Treacher Collins syndrome Mandibulomaxillary fixation (MMF), LeFort I osteotomy and, 263 Mangled extremity initial evaluation of, 677–679 reconstructive plan for, 679 special problems with, 679–680 MAO inhibitors See Monoamine oxidase inhibitors Marcaine See Bupivacaine Marjolin ulcer, 113 burn injuries and, 148 Markings breast amputation with free nipple graft, Spear technique, 598, 601f latissimus dorsi flap breast reconstruction, 632–634, 634f MMS and, 117, 117f nipple reconstruction, 655–659 vertical breast reduction, 604–605 vertical pedicle technique, 592, 592f Marlex mesh midline abdominal wall defects and, 670 skeleton of chest wall reconstruction, 665 Masseter motor nerve identifying, facial paralysis, 422, 422f Moebius syndrome, 424–425 Massive contamination, replantation in upper extremity, 867 Mast cells, infantile hemangioma, 190 Mastectomy defect See also Total mastectomy intraoperative appearance, 624f Mastoid, blood supply to, 357 Mastopexy, mastopexy augmentation and, 583–590 Matrix metalloproteinases (MMPs) palate development and, 187 pressure sores and, 722 Mature bone zone, 97 Maxilla fibrous dysplasia, 280 number Tessier craniofacial clefts and, 267, 269f Maxillary cast anatomy, 262 production, 261, 262f Maxillary constriction, 258 Maxillary defects classification system, 437–438, 437f, 438f reconstruction, 436–442 goals of, 436 restoration, autogenous reconstruction and, 354 trauma and, 352–354 Maxillary distraction, 101 craniofacial microsomia and, 247 Maxillary fractures, 321 Maxillary growth, PSIO and, 204 Maxillary hypoplasia, Apert syndrome and, 236 Maxillary Le Fort I distraction, 101 Maxillary reconstruction, algorithm for, 442f Maxillary surgery, cephalometric tracing, 259, 260f Maxillectomy defects, classification, 438, 440 Maxillofacial prosthetics, 348–355 Maxillomandibular fixation, subcondylar fractures and, 326 McComb method, bilateral cleft, 214 McCune-Albright syndrome, 279 McIndoe technique, reconstruction of absent vagina, 707 McKissock technique, reduction mammoplasty, 594, 594f, 595f MCP See Metacarpophalangeal joint Mechanical creep, tissue expansion and, 84 Mechanical stress, tissue expansion and, 84 Medi-Sol, tar burn and, 137f Medial amputations, 892, 892f Medial antebrachial cutaneous nerve (MABC), harvesting, 80 Medial canthal reconstruction, zone III defects, 401 Medial crural septal sutures, nasal tip projection alteration, 526, 526f Medial epicondylitis (Golfer’s elbow), 827 Medial nasal prominences, head and neck embryology and, 183f, 184 Medial plantar flap, 690, 695f Medial plantar nerve, foot and ankle, 688, 690f Medial platysma, treatment of, 503f Medially based pedicle, vertical breast reduction, 604–612 Median nasal process, palate development and, 187 Median nerve blocks, wrist reconstruction and, 741, 742f compression, 829–830 sensory loss, 80 topography, 76 wrist reconstruction and, 741, 742f Median nerve palsies, tendon transfers for, 850–851 Medicolegal considerations, breast implants, 581–582 Medpor (Porex), 61 auricular reconstruction, 306, 308 facial skeletal augmentation, 550 Medpor (Porex) implant, 63f Medrol See Methylprednisolone Dosepak Medullary carcinoma, 619 Melanin, pigmented lesion lasers and, 171 Melanoblasts, congenital nevi and, 120 Melanocytes malignant melanoma and, 124 skin and, 105 Melanoma See also Advanced melanoma chemotherapy for, 130 CMN to, 120–122 diagnosing, 105, 106f excision margins, 127, 127t lips and, 366 MMS and, technique for, 117–119, 117f, 118f pigmented lesion lasers and, 171 recurrence, 130–131 scalp flap reconstruction, 360f SNB and, 128–129, 128f stage groupings for, 126t Melanoma TNM classification, 124, 125t Melanoma tumorigenesis, 130 Mental retardation, craniosynostosis and, 225 Mentalis muscles, 371 botulinum toxins, 476–477 of lip, 365 Mepivacaine, 91 Merkel cells, skin and, 105 Mersilene mesh, 60, 61 Mesenchymal migration, facial development and, 182, 182f Mesenchymal syndrome, 824 Mesh implants, 61 See also specific type of mesh i.e Prolene mesh Meshed skin grafts dressings for, 143 sheet skin grafts v., Mesial, 254 Metabolic arthritis, radiographic imaging and, 744 Metabolic images, bone scintigraphy and, 752 Metabolism, local anesthetics, 91 Metacarpal base fractures, 793, 795 Metacarpal distraction lengthening, 838–839, 843f Metacarpal head fractures, 790–792 Metacarpal injury, 788 Metacarpal neck fractures, 792, 793 Metacarpal shaft fractures, 793, 794f Metacarpophalangeal joint (MCP), 808, 809f amputation distal to, 835, 839f amputation proximal to, 835, 839f dislocation, 800 Dupuytren disease and, 864 injuries, 798, 799f sagittal band injuries, 811–812 Metal eye shields, periorbital laser therapy and, 172 Metal reconstruction plates, mandible defects, 426, 427f Metallic artifacts, CT and, 756, 757f Metals, implantation and, 58–59 Metastasis, Marjolin ulcer, 113 Metastatic breast cancer, chest wall reconstructions and, 666f Metastectomy, systemic melanoma, 130 Metatarsal head, CAM Walker and, 698–699 Methadone, burn patient, 141 Methamphetamine injury, escharotomy, 134–135 Methicillin-resistant Staphylococcus aureus (MRSA) antimicrobials and, 30 hand infection and, 816 post burn period and, 137 Methotrexate, graft rejection and, 53 Methylprednisolone Dosepak (Medrol), rhinoplasty and, 530 Metoidioplasty, 729, 729f, 730f Metopic suture of skull, craniosynostosis and, 235 Metopic synostosis, 62f, 224, 227–228, 227f operative procedure, 227–228, 228f patient positioning, 227, 228f skull shape abnormalities, 227f Metronidazole, 30 Meyer-Rokitansky syndrome, 707 MHC See Major histocompatibility complex Microanastomotic coupling device, 649, 649f Microdissection procedure (Graft production), hair transplantation and, 563 Microform cleft lip, 200, 201f operative technique, 210–211 postoperative care, 211 Micrognathia, 184 Copyright © 2007 by Lippincott Williams & Wilkins, a Wolters Kluwer business Grabb and Smith's Plastic Surgery, Sixth Edition by Charles H Thorne Index Microneurovascular muscle transfer, dynamic reconstructions, 420 Microstomia, lip-sharing procedures and, 371 Microsurgery equipment and operative preparation, 67 free tissue transfers, indications for, 66 history, 66 lymphedema and, 717 operative technique in, 67–70 patient education and, 66–67 peripheral nerve repair, 73–83 postoperative management in, 70, 72 principles of, 66–72 techniques cheek and, 382–386 nerve repair and grafting, summary, 82 Microtia deformity, 348 anatomy and surgical challenge, 302–303 embryology, 303 in hemifacial microsomia, 303 history, 302 middle ear reconstruction, canaloplasty and, 303 Nagata classification of, 303 surgical reconstruction, 304–308 Microvascular clamps, 68, 68f Microvascular free tissue transfer high-energy lower extremity injuries and, 681, 683 Romberg disease and, 285 Microvascular surgery principles in, oral cavity reconstruction, 447–448 salvage of extremities and, 685 Microvascular transplantation, 48, 48f Middle cranial fossa See Lateral skull base Middle cranial fossa tumors, endoscopic approach, 347f Middle ear reconstruction, canaloplasty and, 303 Middle phalanx, replantation, 875–876, 875f Middle phalanx fractures, proximal phalanx fractures and, 788, 790 Middle-third auricular tumors, 301 Middle-third defects, 300–301 Midface anatomy, 487–488, 487f defects, classification, 438, 440 deficiency, craniosynostosis syndromes and, 241, 241f deformity, surgical correction, 243–244 distraction, 101 distraction devices, 100f hypoplasia, infraorbital rim augmentation, 551–552 osteotomies, craniosynostosis syndromes and, 241, 241f preoperative evaluation of, 489 structure, loss of, 436 Midfoot defects, 701 Midline abdominal wall defects contaminated tissue, 671–672, 671f stable soft tissues and, 670–671 unstable soft tissue and, 671–672, 671f Midline hernia, 672 Midline palatal microcysts, 184 Midline structure deficiency, 266, 268f Midline tissue, 266, 268f Millard technique primary unilateral cleft lip, 206, 207 short upper lip, 220 Mimics of infection, 823 Mini-abdominoplasty abdominal flap elevation, 543f technique for, 541, 543 Minigraft, hair transplantation and, 560 Miniplate fixation, mandible reconstruction, 432f Minor nerve blocks, 92 Minor vascular pedicle, type II pattern of circulation, 44 MMF See Mandibulomaxillary fixation MMPs See Matrix metalloproteinases MMS See Mohs micrographic surgery Moberg flap See Volar neurovascular advancement flap Model block, 261, 262f Model surgery, occlusion casts and, 260 Modified Cutler-Beard advancement flap, upper eyelid reconstruction, zone defects, 399, 399f Modified lateral tarsal strip procedure, 410–412, 412f advantages of, 411 Modified Mahler rotation-advancement repair, 210f microform cleft lip, 210–211 Modified Mohler rotation-advancement repair, operative technique, markings for, 208f Modified Mohler technique, primary unilateral cleft lip and, 207 Moebius syndrome, 280–281, 283 etiology and pathogenesis of, 281, 283, 283f masseter motor nerve and, 424–425 treatment, 283 Mohs chemosurgery, 115 SCCs and, 116 Mohs micrographic surgery (MMS), 115–119 conclusions on, 119 features of, 116t history of, 115 indications for, 115–116, 116t melanoma and, 117–119, 117f, 118f tumors treated with, 116t Molded shoes, plantar heel ulcers, 701 Molecular genetics, vascular malformations, 193, 194t Molecules, biologically active, wound healing and, 18, 18t Moles, types of, 105 excision scar, 3–4 Mondor disease, augmentation mammoplasty, 576 Monitoring, replantation in upper extremity and, 875 Monk head hairline, 564f Monks, G., hand specialization and, 736, 736f Monoamine oxidase inhibitors (MAO inhibitors), topical cocaine and, 94 Monobloc advancement 3-D CT scan, 243f craniosynostosis syndromes and, 240 Monobloc detraction (Frontofacial detraction), 101 Monobloc osteotomy, craniosynostosis syndromes and, 240 Monocryl, traumatic facial wounds, 316 Monocytes/macrophages, wound healing and, 18, 19 Morbidity, skull base resection, 444 Morphine, burn patient, 141 Mortality burn care and, 139 skull base resection, 444 Motion views (Instability series), wrist and, 749, 749f Motivation, tendon transfers and, 846 Motor anatomy, foot and ankle, 687–688 Motor nerve injury See Nerve(s) Motor nerve transfers, applications of, 81 Motor nerves, forehead lift, 509–510, 509f Mouse studies, cranial skeleton, transcription factor Runx2/Cbfa1, 187–188 917 Moving 2PD (Moving two-point discrimination), upper limb surgery and, 739 Moving two-point discrimination See Moving 2PD MRA (Magnetic resonance angiography), vascular channels and, 765, 766f MRI (Magnetic resonance imaging) burn depth, 134 cervical spine injury, 314 chest wall irradiation, 167 contraindications for, 765 demonstrated anatomy, 760 hand and wrist, 757–767 lunotriquetral instability, 782 MMS and, 117 osteomyelitis, 822 parotid mass, 342 pathologic disorders and, 760–765 technique for, hand and wrist, 759–760 titanium and, 58 tumors and, 756 vascular malformations, 194 VMs and, 196 MRSA See Methicillin-resistant Staphylococcus aureus Mucinous carcinoma, 619 Mucocele, skull base defects and, 442 Mucositis, head and neck cancer and, 338 Mucous cyst, 886 Mulliken method, bilateral cleft, 214 Multidisciplinary care cleft lip and palate, 199, 200t craniosynostosis and, 226 Multimodal scar manipulation, burns and, 152f Multiple skin cancers, treatment of, MMS and, 116t Multiple trichoepitheliomas, 109 Mupirocin, 30 Muscle flaps ARC of rotation and, 44 blood supply of, 42–43, 42–51 history of, 42 lower extremity, 688–690 perineum irradiation and, 167 thumb reconstruction, 834, 838f wound reconstruction of foot and ankle, 696, 699f Muscle free flaps, below-knee amputation, 686 Muscle-tendon unit loss, tendon transfers and, 845 Muscle-tendon units, tendon transfers and, 847, 848f, 849f Muscle transfer, facial paralysis and, 421 Muscles circulation, patterns of, 43–44 compartments, of leg, 675–676, 676f, 676t contractures, replantation in upper extremity, 880, 881t forehead lift, 507, 508f, 509f function, upper limb surgery and, 740 head and neck embryology and, 177–178 of nose, 515 power output of, muscle length v., 846f, 847 Muscles of mastication, craniofacial microsomia and, 248–249 Musculocutaneous flaps complex wounds and, 51 perineum irradiation and, 167 random skin flaps v., 9, 9f skin territory and, 44–45 Mustarde sutures, otoplasty and, 298 Mycobacterial infection, 823 Myelinated nerve fibers, upper limb compression and, 828 Copyright © 2007 by Lippincott Williams & Wilkins, a Wolters Kluwer business Grabb and Smith's Plastic Surgery, Sixth Edition by Charles H Thorne 918 Index Myelinated nerves, 73 Myocutaneous flap, ARC of rotation, 44 Nagata classification, microtia, 303 Nagata technique, 306, 307f, 308f complications, 305 microtia, 304, 305 Nail plate, onychomycosis and, 822 NAM See Nasoalveolar molding Nasal base, 519, 520f Nasal cavities anatomy and T staging, 331, 338t head and neck embryology and, 186 malignancy, 336 site locations, 331, 337t Nasal deformity, 213 bilateral, NAM and, 205 cleft lip and palate, 200 NAM and, 204–205 Treacher Collins syndrome and, 287 Nasal dermoid inclusion cysts, 290 Nasal dorsal bone, secondary cleft lip and nose surgery, 222 Nasal dorsal cartilage, secondary cleft lip and nose surgery, 222 Nasal dorsum, rhinoplasty and, 524 Nasal fractures, 321 Nasal length, 520, 520f ideal, 518, 518f Nasal lining release, unilateral cleft lip repair, 209f Nasal pits, head and neck embryology and, 186 Nasal placodes, head and neck embryology and, 182f, 186 Nasal prostheses, 350, 351f Nasal reconstruction facial paralysis and, 420 general repair principles, 388 grafts, 392f lining flaps, 393 planning, 387–388 supporting framework for, 392–393 surgical techniques, 389–394 Nasal splints, rhinoplasty and, 530 Nasal stents, cleft lip repair and, 223 Nasal tip grafts, 527 modification, altering tip projection, 525–527 projection alar base width v., 520, 521f altering, 525–527 rotation, altering, 527–528 Nasal tip cartilage deformity, 214 secondary cleft lip and nose surgery, 222–223 Nasendoscopy, speech bulb appliance, 353 Nasoalveolar molding (NAM) bilateral cleft lip, 205, 206f bilateral nasal deformity, 205 complete bilateral cleft lip, 202 evaluation of, 205–206 nasal deformity correction, 204–205 Nasofacial analysis, rhinoplasty and, 517–523 Nasolabial angle, 522, 522f Nasolabial flap, nasal reconstruction, 389, 390f Nasolabial fold, botulinum toxins and, 476 Nasoorbitoethmoid fractures (NOE fractures), 321–322 Nasopharynx cancer, 333 anatomy and T staging, 331, 334f primary site locations, 331, 333t Neck botulinum toxins and, 475–476 T-staging classification system, 331, 338t Neck burn, management, 144 Neck cancer, management, 336, 338 Neck rejuvenation, 503–504 Necrotizing fasciitis, 821 Negative pressure dressings lower-extremity trauma, 675 wounds and, 683 Negative-pressure wound therapy (NPWT), mechanism of, 27 Negative sculpting, 204 Neoadjuvant chemotherapy, breast cancer, 622 Neomycin, 30 post burn period and, 137 Neonatalhood, infantile hemangioma and, 191 Neoplasms chest wall defects, 663–664 as mimic of infection, 823 Nerve(s) allograft, 82 current transplantation and, 56 autograft, current transplantation and, 56 axons, regeneration, 73, 74f blocks dermabrasion, 461 dosage and duration characteristics, 92t conduction blockade, local anesthetics, 91 conduit characteristics of, 81 synthetic, 82 current transplantation and, 56 damage, orthognathic surgery, 265 grafts, 78–79 facial paralysis and, 421 microsurgery for, 73–83 head and neck embryology and, 177 injury, 73 classifying, 73–74, 75f, 76 facelifting and, 506 mangled extremity and, 680 nerve entrapment and, 79f lesions, median nerve palsies, 850 Moebius syndrome and, 283 regeneration, 82 repair, 80f principles of, 76 replantation in upper extremity and, 873 timing, 77–78 sheath, neurofibromatosis and, 291 supply, breast, 602 topography, 79f transfers, 80–81 vessels and, 39 vessels hitchhiking with, 39 Nervous system, craniofacial microsomia and, 249 Neural crest cellular origin of, 186–187 development interruption, 187 head and neck embryology and, 177, 178f Neural fold formation, 187 Neural plate formation, 186 Neurapraxia, 73, 75f Neurocutaneous melanosis, CMN and, 122 Neurofibromatosis, 290–294, 291f, 292f clinical presentation, 291–292 diagnostic criteria, 290t treatment, 292–293 Neurologic deficits, tendon transfers and, 845 Neurologic injury, facial injuries and, 313 Neuroma in continuity, 79, 81f Neuromuscular retraining, facial paralysis and, 417 Neuropathic ulcers, 31 Neurotized-functional muscle flap, reconstructive surgery and, 46, 46f Neurotmesis, 74, 75f Neurotrophism, 73 Neurovascular compression syndromes, 347 Neurovascular flaps, 39 fasciocutaneous flaps v., 39 Neurovascular island flaps, thumb pulp, 772, 774, 774f Nevi, 105 Nevus cells, 120 Nevus of Ota, 105 pigmented lesion lasers and, 171 Nevus sebaceous of Jadassohn, 109, 109f laser treatments for, 174 New-fill (Sculptra), filler materials and, 470 NF-1 gene, 292 neurofibromatosis and, 291 NICH See Noninvoluting congenital hemangioma Nidus, AVM and, 197 Nipple blood supply, augmentation mastopexy, 589 position, vertical breast reduction, 604 reconstruction conclusions, 659 methods for, 655–659 secondary cases, 659 Nipple-areola reconstruction, prosthetic breast reconstruction with, 630f Nipple-areolar complex, blood supply, 602, 603f Nipple-areolar necrosis, vertical breast reduction, 610, 612 Nodal neck metastases, 336, 338 Node-negative tumors, breast cancer, 622 NOE fractures See Nasoorbitoethmoid fractures Nonablative lasers, 462 Nonablative resurfacing, patient selection for, 464 Noncomedo DCIS, 619 Noninnervated regional flaps, component losses and, 834, 834f Noninvoluting congenital hemangioma (NICH), 191 Nonlaser phototherapy, 171 Nonsteroidal anti-inflammatory agents (NSAIDS), tenosynovitis, 824 Nonsyndromic craniosynostosis, 224 deformational plagiocephaly and, 224–234 history and pathogenesis of, 224 Nonunion replantation in upper extremity, 879, 881t of Scaphoid fractures, CT and, 755, 755f Nose anatomy of, 515–517 cartilaginous framework of, ligamentous support of, 516f characteristics, 387, 388f aesthetic units of, 388f function, 516–517 soft-tissue injury, 317 vascular supply to, 516f Nose tip assessment, 519, 520f Nostril shape, unilateral cleft lip repair and, 209, 210 Nostril stenosis, cleft lip repair and, 223 NPWT See Negative-pressure wound therapy NSAIDs See Nonsteroidal anti-inflammatory agents Number Tessier craniofacial clefts, 266, 268f Number Tessier craniofacial clefts, 266–267, 269f Number Tessier craniofacial clefts, 267, 269f Number Tessier craniofacial clefts, 267, 270f Copyright © 2007 by Lippincott Williams & Wilkins, a Wolters Kluwer business Grabb and Smith's Plastic Surgery, Sixth Edition by Charles H Thorne Index Number Tessier craniofacial clefts, 267–268, 271f, 272f Number Tessier craniofacial clefts, 269–270 Number Tessier craniofacial clefts, 270–271, 272f Number Tessier craniofacial clefts, 271–272, 273f Number Tessier craniofacial clefts, 272–274, 273f Number Tessier craniofacial clefts, 274, 274f Number 10 Tessier craniofacial clefts, 274, 275f Number 11 Tessier craniofacial clefts, 275, 275f Number 12 Tessier craniofacial clefts, 275, 276f Number 13 Tessier craniofacial clefts, 276, 276f Number 14 Tessier craniofacial clefts, 276–277, 277f Number 30 Tessier craniofacial clefts, 277, 278f Nutrition burn injuries and, 140 healing and, 722 Nylamid, 61 Nystatin, onychomycosis, 822 Obese patient, infraumbilical midline hernia and, 672 Obesity, abdominal wall, forces on, 668 Oblique facial cleft, 182, 184f Oblique vector, mandible distraction, 99 Oblique view of hamate, standard radiographs, 748, 748f Occipital arteries, scalp and, 356 Occlusal classification, orthognathic surgery and, 254 Occlusion casts, model surgery and, 260 Occlusion examination, osseous genioplasty and, 556 Occupational exposures, malignant melanoma and, 124 Ocular examination, facial trauma, 314 Ocular motility, craniosynostosis syndromes and, 240 Ocular prosthesis, 350 OMENS classification system, craniofacial microsomia and, 249 Omental flap, soft-tissue reconstruction and, 666–667 On-top plasty, 839–840 damaged finger remnant transfer, 836f Onlay tip graft, 527, 527f Onset of Action, local anesthetic agent and, 91 Onychomycosis (Tinea unguium), 822 Open fractures, free flap coverage, outcome, 679t Open knee wound, 682f Open nerve injuries, algorithm for, 80f Open rhinoplasty approach incision for, 523–524 rationale, 523, 523t, 524 Open tibial fracture, 683f treatment goal, 674 Open wounds See Wound(s) OpSite, donor site, burn injury and, 143 Optic atrophy, 226 Optic disk edema, craniosynostosis and, 226 Oral cavity cancer, 332–333 anatomy and T staging, 331, 333f site locations, 331, 332t facial trauma and, 314 functional anatomy of, 445 Oral cavity reconstruction, 445–451 See also Soft-tissue methods of, 445–446 microvascular surgery principles in, procedure and postoperative management, 447–448 principles of, 445–451 Oral closure, primary cleft palate repair, 216 Oral communication, cervical esophagus reconstruction and, 453 Oral sphincter, 445 Oral tongue, 445 Orbicularis oculi muscle anatomy of, 484, 485f cadaver dissection, 486f innervation of, 484, 485f Orbital dermoid inclusion cysts, 288, 289 Orbital examination, orbital fractures and, 317–318 Orbital fat pads, 487f Orbital floor implants, 318–319 incorrectly placed, 319, 319f maxillary defect reconstruction and, 436, 437f Orbital floor surgery complications of, 319 floor implants, 318–319 incisions/technique in, 318, 318f indications for, 318 Orbital fractures, 317–319 See also Orbital floor surgery orbital examination in, 317–318 Orbital osteotomy, bilateral coronal synostosis and, 231f Orbital prostheses, 350–351, 352f Orbital septum anatomy, 485–486 eyelid and, 395 Orbitomaxillary defects (Type IV maxillary defect), 438, 442f Orbitozygomatic fractures, 319–321 complications, 321 diagnosis/exam, 319 operative techniques, 319–320, 321f Organ allograft transplantation, immunosuppression and, 52 Organ systems injury, response of, 15, 16f Orientation sutures, 69f Orofacial development, defects of, 184f Oronasal fistulas, cleft palate repair, 217 Oropharyngeal tumors, HPV-DNA, 332 Oropharynx cancer, 333–334 anatomy and T staging, 331, 335f site locations, 331, 334t Orthodontic treatment cleft palate repair and, 217 craniofacial microsomia, 253 Orthognathic surgery, 245, 254–265 complications, 264–265 dental terminology in, 254 diagnosis, 254 overview of treatment, presurgical, 261–262 physical examination, 254–255 procedures, 262–264 treatment plan, 256–257, 257f Orthognathic treatment, cleft palate repair and, 217 Orthopedic fixation devices, metallic artifacts and, 756–757, 757f Orthotics, plantar heel ulcers, 701 Orthotopic transplant, 52 Osseocartilaginous framework, of nose, 515 Osseointegrated implant reconstruction, dental restoration and, 434, 434f Osseointegrated implants, metals and, 58 Osseointegration, auricular prostheses, 349 919 Osseous genioplasty, 555–559 alloplastic augmentation v., chin implants and, 555 location and orientation of, 556f patient examples, 557f, 558f, 559 surgical technique, 557–559 Osseous lesions, bone scintigraphy and, 753 Osseous reconstruction, of head and neck, 166 Osteoarthritis, 744 Osteoarthritis at DIP, dorsal synovial cyst and, 886 Osteocalcin, bone remodeling and, 97 Osteochondroma, 663 Osteocutaneous forearm flap, mandible reconstruction and, 429f Osteocutaneous free-flap, mandible reconstruction, 427 Osteocutaneous iliac crest flap, mandible reconstruction and, 429f Osteofasciocutaneous radial forearm flap, 449 Osteogenic sarcoma, mandible reconstruction, 426 Osteoid osteoma, CT and, 756, 757f Osteomyelitis, 49, 50f congenital dermoid inclusion cysts, 290 foot and ankle wound care, 691, 693 musculocutaneous flaps and, 51 Osteoplastic thumb reconstruction, 835–836, 842f Osteoradionecrosis, muscle transposition and, 50, 51f Osteotomies, 528–529 types of, 528–529, 528f Otoplasty ear reconstruction and, 295–312 goals of, 295 postoperative care, 299 procedure, 295–298 technique, 298f choice of, 298–299 timing, 295 Overcorrection, eyelid ptosis correction, 408 Overcorrection/unnatural contours, otoplasty and, 299 Overdose, cocaine, 94 Overgrowth, 859 Overjet, maxillary Le Fort I distraction, 101 Overresection aspiration of fat, 534 of tissue, gynecomastia, 618 Oxycodone, burn patient, 141 Oxygen tension, skin flaps and, 9–10 Oxygenation, wound healing and, 24 PABA, sunscreens and, 114 Paget disease, MMS and, 117 Pain control burn patient, 141 gluteal flap technique and, 651 rhinoplasty and, 530 Palatal closure, maxillary defect reconstruction and, 438, 439f Palatal fistulas, 254 cleft palate repair, 217 Palatal shelves, palate development and, 187 Palate development, 187 facial development and, 182, 182f head and neck embryology and, 184–185 Palatoplasty, techniques, 216 Palmar fascia, normal anatomy of, 862 Palmar space infection, 818–819, 821f Palpebral commissures, eyelid and, 395 Palpebral conjunctiva, eyelid and, 395 Palpebral fissure, eyelid and, 395 Palsies, tendon transfers for, 847–851 Copyright © 2007 by Lippincott Williams & Wilkins, a Wolters Kluwer business Grabb and Smith's Plastic Surgery, Sixth Edition by Charles H Thorne 920 Index Paneva-Holevich two-stage tendon reconstruction, 807 Panniculus, hanging, circumferential lipectomy and, 545 Papaverine, vasospasm and, microsurgery and, 70 Papilledema, craniosynostosis and, 226 Papillomas, names for, 110 Paranasal augmentation, 551, 552f Paranasal sinuses anatomy and T staging, 331, 338t cancer, 336 site locations, 331, 337t Parascapular flap microsurgical techniques and, 382, 385f soft-tissue reconstruction and, 665 Parasymphysis fractures, operative technique, 325 Paratenon, 801 Parathyroid glands, head and neck embryology and, 181 Parenchymal resection design skin resection patterns, 605 vertical breast reduction, 606–607 Parenteral nutrition, burn injuries and, 140 Parkes Weber syndrome, 195, 198 Parkland formula, fluid resuscitation, 138, 138t Paronychia hand and, 816, 818f hand infection, 816, 818f Parotid gland/duct injury, soft-tissue injury and, 317 Parotid gland tumors, treatment, 343–344 Parotid glands, 339 Parotid mass, evaluation, 342 Partial acquired defects, 300–302 Partial calcanectomy, plantar heel ulcers, 701 Partial defect reconstruction, 301f Partial flexor tendon severance, 804 Partial hand prosthesis, 896f, 897 Partial-thickness burns, 133 Passive flexion, flexor tendon continuity, 806 Passive molding, PSIO and, 203 Passive prostheses, hand, 895–896 Pasteurella multocida animal bites, 820 hand infection and, 816 Patch test, hydroquinone and, 114 Patient counseling Dupuytren disease and, 864 electrical injuries and, 147 education, microsurgery and, 66–67 evaluation, liposuction and, 531 history facelifting and, 496–497 forehead lift, 507 initial consultation, rhinoplasty, 517–523 management, burns and, 140–141 positioning hand surgery and, 743 for liposuction, 533–534, 533f microsurgery and, 67 selection cutaneous resurfacing, 457 liposuction and, 531 lower truncal contouring, 541 transport, burn center, 132, 133t Paucity of central lip, bilateral cleft lip, 221 PDGF See Platelet-derived growth factor PDT See Photodynamic therapy Pectoralis major flap, soft-tissue reconstruction and, 665 Pectoralis major myocutaneous flap (PMMCF), cervical esophagus reconstruction, 452 Pediatric intravenous insertion, topical anesthesia, 92 Pediatric patients, deep venous thrombosis, burns and, 141 Pedicle TRAM flap aesthetics, 641f, 642f free flap v., 646 reconstruction, microsurgical options, 647, 648f technical details in, 639, 640f Pedicled digital transfer, to thumb position, 833, 836f Pedicled flaps oral cavity reconstruction, 445 skull base defects reconstruction, 443 wound reconstruction of foot and ankle, 696 Pedicled greater omental flap, chest wall irradiation, 167 Pedicled rectus abdominis musculocutaneous flap, perineum irradiation and, 167 Pedicles design, skin resection patterns, 605 insertion, vertical breast reduction, 607 vertical breast reduction, 602, 603f, 606 Peeling agents, destruction depth of, 459f Pelvic floor, defects of, 712–713 Penicillin G, peripheral nerve allotransplantation, 82 Penile loss, penis reconstruction and, 728 Penile reconstruction, 710–711, 712f, 728–732 See also Total penile reconstruction author comments, 731–732 indications and requirements for, 728 surgical techniques, 728–731 Penny flaps, areolar tattooing and, nipple reconstruction and, 658–659, 658f Perforator flaps, 39, 39f reconstructive surgery and, 48, 49f Perforator TRAM, reconstructive surgery and, 49f Periareolar incision, 574, 574f gynecomastia, 616, 616f Periareolar mastopexy, 583, 584, 584f, 585f, 586f and augmentation, 589f Pericranial flap, 323f Pericranium, 356 Perineal reconstruction, in male patient, 711–712 Perineal structure deformities, causes of, 706 Perineum acquired defects of female, 707–708 burns, 144–145 defects of, 712–713 irradiation, 167 reconstruction female patient, 707–710 general principles of, 706 Periocular defect reconstruction, zone V defects, 402–403 Periocular zones, eyelid reconstruction, 397, 397f, 398f Perioral lines, botulinum toxins and, 476 Periorbital burns, management of, 143 Periorbital dermoid inclusion cysts, 288, 289 Periorbital laser therapy, metal eye shields for, 172 Periorbital region of eye, cross-sectional of, 484, 485f Periosteum, deep fascia and, 38 Peripheral nerve, 73, 74f allotransplantation, candidates for, 82 entrapment, upper limb compression and, 828 injury, nerve allograft, 82 neuromas, organ system regeneration and, 16 reconstruction, vascularized nerve grafts and, 80 repair, microsurgery for, 73–83 sheath tumors, malignant degeneration, 292 tissue, wound healing and, 21 Peripheral nerve blocks, types, 92 Peripheral nervous system (CNS), electrical injuries and, 147 Peripheral neuroma, treatment, 20 Peripheral neuropathy, wounds and, 702 Peripheral tolerance, 54 Peripheral vascular disease, foot ulcers, 703 Peroneal nerves, compression sites, 703, 703f PET scan (Positron emission tomography) head and neck cancer and, 338 malignant melanoma and, 124 Pfeiffer syndrome (Acrocephalosyndactyly type V), 235, 236–237, 237f broad thumbs in, 238f fronto-orbital advancement, 242–243, 242f PGA See Polyglycolic acid PHA See Romberg disease PHACES, 191 Phakomatosis pigmentovascularis, 195 Phalanges injury, 788, 789f Phalangization, 838, 840f Phalen test, FDS and, 829 Phalloplasty, 729, 730f, 731 Pharmacologic therapy, infantile hemangioma, 192 Pharyngeal arches, head and neck embryology and, 177, 178f Pharyngeal endoderm, head and neck embryology and, 177, 178f Pharyngeal flap sphincter pharyngoplasty v., 219 surgery, complications, 218 Pharyngeal pouches adult derivatives of, 180f head and neck embryology and, 178, 178f, 181 migration paths of, 180f Pharyngeal surgery, VPI and, 218–219 Pharyngoesophageal reconstruction goals of, 451–452, 451t options for, 452t Pharynx reconstruction, 451–454 principles of, 451–452 Phenol-croton oil peels, 457, 459–461 Phenol peel, 459–461 Phenol rhizotomy, spasm, 723 Phocomelia, congenital hand abnormalities, 855 Photodynamic therapy (PDT), 171 AK and, 108 Photograph consent, hair transplantation, 560 Photographs forehead lift, 507 hair transplantation, 561 preoperative, facelifting and, 497 Phototherapy devices, lasers and, 171, 171t Physical examination craniosynostosis and, 226 facial skeletal augmentation and, 549 osseous genioplasty and, 555–556 upper limb surgery and, 739–740 Physical therapy, mandible reconstruction, 433 Pierre Robin sequence, head and neck embryology and, 184 Pigmented lesion lasers, 171, 174 Pigmented lesions, 105–106 melanoma and, 122 Pillar closure, vertical breast reduction, 607 Pilomatricoma, 109 Copyright © 2007 by Lippincott Williams & Wilkins, a Wolters Kluwer business Grabb and Smith's Plastic Surgery, Sixth Edition by Charles H Thorne Index Pin tract infection, fractures and, 681 Pinch test, aspiration of fat, 534 PIP joint See Distal interphalangeal joint Pisiforms anterior margin, standard radiographs, 746f, 747 Pivot point, skin flaps and, 10–12, 11f Plantar ulceration, 693 Plasmagel, filler materials and, 470 Plasmapheresis, burn care and, 149 Plastic surgeons dermatology for, 105–114 radiation wounds and, 163 Plastic surgery applications, lasers for, 170t current transplantation in, 54–57 history of, 52 lasers in, 169–176 techniques and principles in, 3–14 Plate fixation, metacarpal shaft fractures, 793, 794f Platelet-derived growth factor (PDGF) clotting cascade, 17 wound healing and, 28 wound reconstruction, foot and ankle, 694 Platysma bands, treatment of, 503f Platysma muscle, facelift anatomy and, 500 Pleomorphic adenoma, 339, 341–342 Plexiform neurofibroma, 292 of face, 293–294 Plum evacuator, CO2 laser, 176 PMMA See Polymethylmethacrylate PMMCF See Pectoralis major myocutaneous flap PMS-350, filler materials and, 471 Pneumatic tourniquets, wrist/hand surgery and, 742 Pneumocystis carinii prophylaxis, peripheral nerve allotransplantation, 82 Pollicization, 836f, 840–841 Polyamide, 61 Polyclonal antithyroglobulin (ATG), immunosuppression and, 54 Polyesters, 60–61 Polyethylene, 61 facial skeletal augmentation, 550 Polyethylene terephthalate See Dacron Polyglycolic acid (PGA), 61 Polymers, bone reconstruction and, 60–63 Polymethylmethacrylate (PMMA) bone replacement and, 60 calvarial reconstruction, 364 Polymyxin B ointment, post burn period and, 137 Polypropylene, 61 Polypropylene mesh, 62 midline abdominal wall defects and, 670–671 Polytetrafluoroethylene polymer (PTFE polymer), 63 facial skeletal augmentation, 549 Polyurethane, FDA and, 63 POPLA group, PSIO and, 204 Porcine submucosa, midline abdominal wall defects and, 671 Porcine xenograft, 54–55 Porex See Medpor Port-wine stains, laser treatments for, 171, 172, 172f Positional plagiocephaly of occiput, craniosynostosis v., 225 Positron emission tomography See PET scan Post radiation fibrosis, chest wall irradiation, 167 Postburn alopecia, tissue expansion and, 159 Posterior cranial fossa See Posterior skull base Posterior interosseous nerve compressions, 831 Posterior lamella, anatomy, 486f, 487f Posterior skull base (Posterior cranial fossa), lesions, 345–346 Posterior thigh flap, vaginal defects and, 710, 710f, 711f Posteroanterior oblique projection, standard radiographs, 746f, 747 Postmastectomy radiotherapy, 621–622 Postoperative adjuvant radiation therapy, parotid gland tumors, 344 Postoperative management, microsurgery and, 70, 72 Potency, local anesthetic agent and, 91–92 Povidine-iodine, wound healing and, 30 Power-assisted liposuction (PAL), 533, 538f PPD skin test See Purified protein derivative skin test Preanesthesia, hair transplantation, 561 Preaxial deficiency, radial club hand as, congenital hand abnormalities, 854–855, 856f Prednisolone, graft rejection, 53 Prednisone, immunosuppression and, 53 Prefabricated flaps, reconstructive surgery and, 49 Pregnancy, silicone, 578 Pregnant patient, bupivacaine and, 94 Prehension, congenital hand abnormalities, 854–855 Prelaminated skin graft and cartilage, lining of forehead flap, nasal reconstruction and, 393 Premalignant skin lesion, 107, 108f Premaxillary setback, bilateral cleft lip, 221 Preoperative counseling, facelifting and, 497 Preoperative cutaneous lymphoscintigraphy, melanoma and, 128 Preoperative nasoalveolar molding, primary unilateral cleft lip and, 207 Pressure distribution, 720, 721f sitting, 720, 721f Pressure relief, wound healing, 723 Pressure sores, 720–727 closure, 723 epidemiology, 720, 721t multiple, 726 nonsurgical treatment, 727 pathophysiology of, 720–722 postoperative care for, 726 preoperative care, 722–723 recurrence, 726 staging, 720, 721t surgical treatment of, 723–726 time/pressure relationship with, 721, 722f treatment complications for, 726–727 wound care of, 31 Pressure-specified sensory device (PSSD), wounds and, 702 Pressurized water jet, debridement with, 27 Presurgical columella elongation, bilateral cleft, 214 Presurgical infant orthopedics (PSIO), 203–206 controversy in, 204 Presurgical nasoalveolar molding, PSIO and, 204–206 Presurgical orthopedics, cleft lip and palate, 202–206 Prilocaine, 91 Primary bilateral cleft lip repair, 211–214, 212f Primary bone tumors of chest, 663 Primary cleft palate repair, 214–217 operative technique, 215–216 timing of, 214–215 921 Primary closure cheek reconstruction and, 374, 374f oral cavity reconstruction, 445 Primary contraction, Primary lymphedema, 715 Primary tip rhinoplasty, unilateral cleft lip repair, 209f Primary unilateral cleft lip, repair, 206–211 anesthesia for, 207 timing and treatment planning, 207 Procaine, 91 Procedural pain, burn patient, 141 Procerus muscle, transblepharoplasty approach, 513f Proclination, 254 Profill, filler materials and, 470 Programmed cell death, head and neck embryology and, 183f, 184 Progressive hemifacial atrophy See Romberg disease Prolabial unwinding flap, bilateral cleft, 214 Prolene, skeleton of chest wall reconstruction, 665 Prolene mesh, midline abdominal wall defects and, 670 Proliferative phase, wound healing and, 19–20, 19f Prominent ears, anatomic causes, 295, 296f Proplast, 63 Prostatectomy, cavernous nerve grafting following, 714 Prostheses See also specific body part i.e Hand aesthetic considerations and, 895 Bio-Chromatic coloring system for, 897 breast reconstruction and, 623–631 hand agenesis, 893, 894f, 895 infected/exposed, wounds and, 51 levels of amputation and, 895, 895f maxillary defect reconstruction, 436 skull base defects reconstruction, 443 specificity of, 893 types of, 895, 897 tissue expansion and, 84 unilateral v bilateral, hand amputations, 893 Prosthetic auricular reconstruction, microtia and, 305–306 Prosthetic breast reconstruction complications, 630–631 patient selection, 623 postoperative care, 629–630 technique, 623–625 timing, 623 Prosthetic mandible replacement, mandible defects, 426 Protective positioning, elements of, hand surgery and, 743 Protein, burn injuries and, 140 Protein binding, local anesthetic agent and, 91 Protein solutions, fluid resuscitation and, 138 Proteus syndrome, 197–198 Proximal forearm median compression neuropathies, 829–830 Proximal forefoot amputation, Lisfranc amputation and, 701 Proximal interphalangeal joint (PIP joint) collateral ligament injuries, 798 dorsal dislocations, 796–797, 797f Dupuytren disease and, 864 volar dislocations, 797–798 Proximal phalanx, replantation, 876–877 Proximal radial nerve compressions, 831 Pruritus, burn management, 145 Pruzansky type III deformity, treatment, 251 Pruzansky’s mandibular deformity classification, 247, 248f Pseudoeschar, 27 Copyright © 2007 by Lippincott Williams & Wilkins, a Wolters Kluwer business Grabb and Smith's Plastic Surgery, Sixth Edition by Charles H Thorne 922 Index Pseudogout, 744 characterization of, 746 Pseudoptosis, augmentation mammoplasty, 576f Pseudosarcomatous lesions, 110 Pseudoxanthoma elasticum, 110 PSIO See Presurgical infant orthopedics Psoriasis isotretinoin, 113 Tazarotene gel for, 113 Psoriatic arthritis, 888 PSSD See Pressure-specified sensory device Psychological considerations breast implants, 580f facelifting and, 497 vertical breast reduction, 612 Psychological problems, replantation in upper extremity, 867 PTFE polymer See Polytetrafluoroethylene polymer Puckers, vertical breast reduction, 612 Pulley system, flexor tendon v., anatomic relationship, 826f Pullthrough resection, gynecomastia, 616, 618f Pulsed-dye laser CM and, 195 facial burn reconstruction, 161 Pulsed lasers, laser-tissue interactions, 170 Punch biopsy, malignant melanoma and, 124 Puncture wound, felon, 818, 819f Purified protein derivative skin test (PPD skin test), typical mycobacterial infections, 823 Pushback technique, primary cleft palate repair, 216 Pyoderma gangrenosum, 111 Pyogenic flexor tenosynovitis, signs of, 819–820, 822f Pyogenic granulomas hemangioma v., 191 laser treatments for, 173 Q-PCR See Quantitative polymerase chain reaction Q-switched YAG laser, tattoos and, 176 Quality-of-Life assessments, cervical esophagus reconstruction and, 453 Quantitative polymerase chain reaction (Q-PCR), wound-healing and, 15 Question mark ears, 295, 299 R115777, melanoma and, 130 R See Roentgen Rad, 162 Radial aplasia, classification of, 854, 855t Radial club hand, congenital hand abnormalities, 854–855, 856f Radial compression neuropathies, 830–831 Radial forearm flap, 774 Radial forearm free flap dissection technique, 448–449 microsurgical techniques and, 382, 384f pertinent anatomy for, 448 total lip defects and, 369 Radial nerve, 808 block, wrist and, 741, 742f compressions, at elbow, 831 fascicular anatomy, 76, 78f repair, 76, 78f upper limb compression and, 828 wrist and, 741, 742f Radial nerve palsies, tendon transfers for, 847–848, 849f Radial polydactyly, 858–859 Radiance/Radiance FN/Radiesse, filler materials and, 470 Radiation, 162–168 breast and, 165–166 exposure, types, 162 injuries, 162–168 melanoma and, 130 Radiation dermatitis of breast, 111f Radiation necrosis, musculocutaneous flaps and, 51 Radiation therapy chest wall defects, 664 delivery, 162 head and neck cancer and, 338 irradiation summary, 167–168 prosthetic breast reconstruction with, 631 skin and, 165 Radiation wound, 49, 51, 51f chest wall, 164f sample, 163f Radiocolloid, lymphoscintigraphy and, 128 Radiofrequency, 171 Radiographic imaging See also Chest radiography craniosynostosis and, 226 of hand and wrist, 744–768 metacarpal head fractures, 790–792 normal hand, 745f, 746f standard, 746–749 Radiologic imaging, vascular malformations, 194 Radionuclide angiogram, bone scintigraphy and, 751, 753 Radionuclide studies, inhalation injury, 139 Radiotherapy basal cell carcinomas and, 112 squamous cell carcinomas and, 113 Radius donor site, mandible reconstruction and, 428–429 Radius free flap, mandible reconstruction and, 429 Ramsay Hunt syndrome, facial paralysis, 423f Ramus, craniofacial microsomia and, 247 Random-pattern flaps, 42 Random skin flaps, 777 blood supply of, 42 musculocutaneous flaps v., 9, 9f Range of motion, tendon transfers and, 846 Rapidly involuting congenital hemangioma (RICH), 191 RARs See Retinoic acid receptors Raynaud syndrome, 765 Raynaud’s disease, wounds and, 703 Recipient site hair transplantation and, 563–566 microsurgery and, 68, 68f Reconstruction of absent vagina, 707 Reconstructive ladder algorithm, 66 wound closure and, 14, 14f Reconstructive surgery See also Burn(s) cosmetic surgery v., flap modifications and, 45–49 free tissue transfers in, indications for, 67t Rectus abdominus flap, 449 microsurgical techniques and, 382–383 soft-tissue reconstruction and, 666 Rectus abdominus myocutaneous flap (VRAM), 713f perineal reconstruction, 711–712 vaginal reconstruction, 709–710, 710f Recurrence, pressure sores, 726 Recurrent pleomorphic adenoma, 340–341 Recurrent tumors, 341 chest wall irradiation, 167 MMS and, 115–116, 116t RED See External head frame Reduction mammoplasty See also Vertical breast reduction indications for, 591 inferior pedicle technique, 593–594, 595f inverted-T technique and, 591–601 Spear technique, 512f, 513f, 595–598, 598f tissue and, 39 Reflex sympathetic dystrophy (RSD), bone scintigraphy and, 753 Regeneration, 15–16, 21, 22 inadequate, abnormal response to injury and, 21 Regional lymph nodes dissection, lymphedema, 715 melanoma and, 127 Regional myocutaneous flaps, oral cavity reconstruction, 445 Regnault grading system, breast ptosis and, 586, 587 Regranex See Becaplermin Regression, infantile hemangioma, 190 Rehabilitation, burn injuries and, 149 Release, burn reconstruction surgery and, 154 Remodeling phase, wound healing and, 20, 20f Remodeling zone, 97 Renova, 113 Reossified bone, craniosynostosis syndromes and, 241 Reperfusion, of amputated part, replantation in upper extremity and, 874 Reperfusion damage, wound healing and, 24–25 Replantation levels of amputation, 875–879 multiple digits, 877 postoperative result, 877f Replantation in upper extremity, 866–881 absolute contraindications for, 866, 867t multiple injuries within amputated part, 866 significant associated injury and, 866 systemic illness, 866 complications, 879, 881t contraindications for, 866 indications for, 866 postoperative care and monitoring, 874–875 re-exploration, 875 relative contraindications for, 866, 867t age, 866 avulsion injuries, 866–867 technique of, 872–874 Replantation service, transfer to, 867, 869 Replantation surgery, evaluation for, 870 Resoplast, filler materials and, 467, 470 Respiratory obstruction, cleft palate repair, 217 Rest, hand infection and, 815 Restylane, 92 filler materials and, 470–471 Resuscitation, decisions, 139–140 Retaining ligaments, facelift anatomy and, 500 Reticular dermis, 105 Retin-A micro, 113 Retin-A (Retinol), 457 Retin-A (Tretinoin), 113 laser abrasion, 464 Retinaculum, dorsal wrist compartments and, 808, 809f Retinal dermatitis, 113 Retinoic acid, acne vulgaris and, 111 Retinoic acid receptors (RARs), 113 Retinoids, 457 skin and, 113 Retinol, vitamin A and, 113 Retrograde sural nerve flap, 689, 692f Retromolar trigone tumors, 333 Copyright © 2007 by Lippincott Williams & Wilkins, a Wolters Kluwer business Grabb and Smith's Plastic Surgery, Sixth Edition by Charles H Thorne Index Revascularization foot ulcers, 703 muscle transplantation and, 50f skin grafting and, burn injury and, 142 Reverse Abbe flap, dip defect and, 366 Reversed cross-finger flap, 771 Reviderm-intra, filler materials and, 471 Rheumatoid arthritis (RA), 887–888 radiographic signs of, 744 Rheumatoid disease of fingers, 888 of thumb, 888 Rheumatoid synovitis, 887–888 Rhinophyma, 111, 111f Rhinoplasty, 515–530 See also Secondary rhinoplasty closure, 529 in infancy, skin envelope, 223 operative technique, 523–529 postoperative management, 530 preoperative assessment, 517–523 Rhizotomy, spasm, 723 Rhomboid defect, Limberg flap and, 12, 12f Rhomboid flap (Limberg flap) cheek reconstruction and, 375–376, 379f transposition flap as, 12, 12f Rhytides See Wrinkles Rib grafts, 363 RICH See Rapidly involuting congenital hemangioma Rigid internal fixation, amputated body part and, replantation surgery, 871 Ring avulsion injuries, classification of, 870t Rodent ulcer, 112 Roentgen (R), 162 Rolando-type fracture, 795, 797f Romberg disease (Progressive hemifacial atrophy; PHA), 283–285, 284f Rosacea, laser treatments for, 173 Rotation advancement flap ARC of rotation and, 44 cheek reconstruction and, 376–378, 379f, 382f Rotation skin flap, planning, 10, 10f RSD See Reflex sympathetic dystrophy Rubens flap, 651 positioning for, 653f preoperatively, 654f Rule of Nines, burns and, 134f Runaround abscess, 816, 818f paronychia and, 816 Russ scaphoid fractures classification, 782–783, 785f S epidermidis, Hydradenitis suppurativa, 111, 111f Sacral pressure sores, 725 flaps for, 725, 725f Saethre-Chotzen craniosynostosis, Twist transcription factor, 188 Saethre-Chotzen syndrome (Acrocephalosyndactyly type III), 237, 238f Safe zone, forehead lift, 510f Sagittal band injuries, 811–812 ruptures, 812 Sagittal split osteotomy, bilateral, 264 Sagittal splitting procedure, mandibular advancement and, 258f Sagittal suture of skull, craniosynostosis and, 235 Sagittal synostosis, 224 operative procedure, 228–229, 229f Sagittal T1-weighted images, MRI and, 759f, 760 SAL See Suction-assisted lipoplasty Salicylic acid (SA), 457, 458 skin and, 113 warts and, 822 Saline breast implants, 628, 628f, 629f augmentation mammoplasty and, 574–575 complications, 580f permanent, 628, 628f Salivary glands, 339 tumors, 339–344 benign v malignant, 340–342 pathology, 340 Saphenous nerve, foot and ankle, 688, 690f SARPE See Surgically assisted rapid palatal expansion Saucer-type deformity, gynecomastia, 618 SC See Sulfur colloid Scald burn, 136f See also Perineum depth of, 132, 133t Scalp anatomic layers of, 356, 357f anatomy, 356–362 autograft for, 143 defect, free latissimus dorsi flap reconstruction, 362f flap, scoring of galea, 358f flap reconstruction melanoma and, 360f posterior skull, 361f lymphatics, 357 reconstruction, 356–364, 358–362 defects to cm, 360–361 defects greater cm, 361–362, 363f defects less than cm, 358 defects less than cm, 358–360 tissue expansion and, 85, 86f–87f scarring, foreheadplasty, 513 SCCs, 116 sensation, foreheadplasty, 513 temporal region, anatomic relationships, 357f vessels, 356 Scaphoid fractures classification, 782, 785f CT and, 754–755, 754f, 755f nonunion of CT and, 755, 755f no degenerative changes, treatment, 784–785 types of, 784, 786t treatment, 783–785 Scaphoid nonunion advanced collapse (SNAC) wrist, treatment, 785 Scaphoid projection, 748, 748f Scapholunate instability radiographic examination, 780, 784f stages of, 780, 783f Scapholunate ligament tears, MRI and, 760f, 761 Scapula donor site, mandible reconstruction and, 429–430 Scapular flap, dissection technique, 450 Scar formation excessive, abnormal response to injury and, 21 inadequate, abnormal response to injury and, 21 tissue regeneration v., 15–16 widening, Scar therapy, wound healing and, 30 Scarpa’s fascia, lower truncal contouring, 540, 541f, 542f Scar(s) See also Hypertrophic scarring; Multimodal scar manipulation appearance of, factors affecting, burn reconstruction surgery and, 150, 153 capsule, osseous genioplasty, 555–559 923 technique and, unfavorable, unilateral cleft lip repair and, 221 vitamin E and, 114 SCCs See Squamous cell carcinomas Schirmer test, canthoplasty, 408, 411f Schuchardt procedure, cheek and lip, 369, 369f Schwann cells, nerve allograft and, 56 Sciatic nerve, foot and ankle, 687 Sclerotherapy LMs and, 196 spider veins and, 174 VMs and, 196–197 Screw fixation metacarpal shaft fractures, 793 shaft fracture of phalanx and, 790, 791f Scrotal reconstruction, 711 Sculptra See New-fill Sebaceous carcinoma, MMS and, 117 Sebaceous epithelioma, 109–110 Sebaceous nevi laser treatments for, 174 Levulan photodynamic therapy, 171 Sebaceous tumors, 109–110 Sebaceus nevus of Jadassohn, 109 Seborrheic keratoses (SKs), 106 actinic cheilitis v., 107, 108f Secondary cleft lip and nose surgery, 219–223, 221–223, 222f indications for, 219 skeletal base of nose, 222 timing, 219–220 Secondary contracture, Secondary facelifting, 504 Secondary lymphedema, 715 Secondary rhinoplasty, 221–223, 222f, 530 Segmental aponeurectomy, Dupuytren disease and, 864 Segmental flaps, reconstructive surgery and, 45 Segmental vascular pedicles, type IV pattern of circulation, vascular anatomy and, 44 Seizure, hyperventilation and, 94 Selective photothermolysis, laser-tissue interactions, 170 Self-retaining spring dental retractors, commissural burns and, 371 Sella-nasion-subspinale (SNA), orthognathic surgery and, 255, 256f Sella-nasion-supramentale (SNB), 255, 256f Semiocclusive dressings, wound healing and, 28 Senile sebaceous hyperplasia, 110 Sensibility restoration, tendon transfers and, 846 Sensory anatomy, foot and ankle, 687–688, 690f Sensory examination, foot and ankle wound care, 691 Sensory flap reconstructive surgery and, 46–47 thumb reconstruction, 834, 837f Sensory groups, 76, 77f Sensory innervation, of lip, 365 Sensory nerves foot and ankle, 687–688, 690f forehead lift, 509, 510f Sensory return, replantation in upper extremity, 880, 881t Sensory testing, nerve injury and, 76, 76t Sentinel node biopsy (SNB) indications for, 129 malignant melanoma and, 124 parotid gland tumors and, 343–344 Sentinel nodes, 128 lymphoscintigraphy of, 129f Copyright © 2007 by Lippincott Williams & Wilkins, a Wolters Kluwer business Grabb and Smith's Plastic Surgery, Sixth Edition by Charles H Thorne 924 Index Separation of parts procedure, infraumbilical midline hernia and, 672, 672f Septal composite flap, nasal reconstruction and, 394f Septal reconstruction, cartilage graft harvest and, 525 Septic arthritis, 820–821 Septic joints, 820–821 Septocutaneous flaps, 38 Septum constituents of, 516f ULCs and, separation of, 524 Serial excision, Seromas gluteal flap technique, 651 latissimus dorsi flap breast reconstruction, 636 lower truncal contouring and, 547 Serratus anterior flap, soft-tissue reconstruction and, 665 Serum lactic dehydrogenase (LDH), malignant melanoma and, 124 Seventh cranial nerve anatomy of, 415, 417, 417f essential functions of, 415 Severe facial asymmetry, microtia and, 308 Shaft fracture of phalanx, 790, 791f Shave biopsy, malignant melanoma and, 124 Shearing injuries, staging, 720, 721t Sheen graft, nasal tip cartilage, 223 Sheet autograft, face burn and, 143 Sheet skin grafts burn injury and, 143 meshed skin grafts v., Short lower face, correction, 259 Short-scar technique, facelifting and, 504 Shoulder abduction, nerve transfer and, 81 Shunting, hydrocephalus, 241 SIEA See Superficial inferior epigastric artery Sievert (Sv), 162 Silicone (dimethylsiloxane), 60 effects, 578 facial skeletal augmentation, 549 filler materials and, 471 Silicone elastomer implants, capsule formation and, 60 Silicone gel implants, 574, 575–576, 623 prosthetic breast reconstruction, 627 Silikon-1000, filler materials and, 471 Silvadene, donor site, burn injury and, 143 Silver nitrate, post burn period and, 137 Silver sulfadiazine, 30 post burn period and, 136 Simon grade gynecomastia, 618 Simon stage lesions, 615, 616f Simple interrupted suture, 4–5 Single blade method, donor hair follicles and, harvest technique, 562, 562f, 563f Single-digit amputations, replantation in upper extremity, 867 Single follicular units (FU), hair transplantation and, 560, 561f Single vascular pedicle, type I pattern of circulation, vascular anatomy and, 44 Sinonasal tract squamous cell carcinoma, 336 Sirolimus, graft rejection and, 53 Sizers, saline filled, prosthetic breast reconstruction, 627–628, 627f Skeletal class II occlusion, 258 Skeletal class III malocclusion, 258 Skeletal deformity, 3-D CT scan, 250, 250f Skeletal injuries, face and, 313–330 Skeletal molding, history, 96 Skeletal stabilization, tendon transfers and, 846 Skeleton, Number Tessier craniofacial clefts and, 267 Skeleton of chest wall reconstruction, 664–665 Skin adhesives, wound closure and, anatomy, 105 blood supply of, 33–41 closure replantation in upper extremity and, 874 vertical breast reduction, 607 vertical reduction mammaplasty, 603 current transplantation and, 54–55 embryology, 105 envelope dissection, rhinoplasty and, 524 rhinoplasty in infancy and, 223 histology of, 458f layers of, 105, 106f, 457 lesions, laser treatments for, 174 lymphedema and, 717 of nose, 515 plastic surgery and, products, 113–114 radiation therapy and, 165 replacement burn wound and, 147–148 technology, 149 resection patterns vertical breast reduction, 604–605 vertical reduction mammaplasty, 602, 603f resurfacing laser, 175f Rhinophyma, 111, 111f Romberg disease and, 283 of scalp, 356 slough, facelifting and, 505–506 staples, substitutes, wound healing and, 30 territory, musculocutaneous flaps and, 44–45 tumors, categorizations of, 106 type, scar type v., Skin allograft, 54 Skin autograft, 54 Skin bridges, abdominal surgery and, 669 Skin cancer See also Basal cell carcinomas; Malignant melanoma; Squamous cell carcinoma of helical rim, 309 Skin flap necrosis, prosthetic breast reconstruction with, 630 Skin flaps, 9–12 See also Flap(s); Muscle flaps; specific type flap i.e Cervical flaps burn reconstruction surgery and, 157–158 classification of, 9f connective tissue framework and, 36 nerves, vessels hitchhiking with, 39 pivot point and, 10–12, 10f planning, 10 Skin graft, 7–9, 52 adherence, burn injury and, 141 burn reconstruction surgery and, 150, 154, 156 cheek reconstruction and, 374 CM and, 195 donor sites, dorsum of foot defects, 701 face burn and, 143 hands and, 769 hydradenitis suppurativa and, 111, 111f late, burn reconstruction surgery and, 151f for lining flaps, nasal reconstruction and, 393 midfoot defects, 701 nipple-areola reconstruction, 656 oral cavity reconstruction, 445 postoperative care of, 8–9 radiation wounds and, 163 rejection, drugs for, 53 scalp, 359f survival requirements for, technical aspects of, burn injury and, 142–143 tie-over bolster dressing for, 9, 9f types, 7–8, 8f wound reconstruction of foot and ankle, 696 Skin island bleeding response, mandible reconstruction, 433 latissimus dorsi flap breast reconstruction, 634, 635f Skin marker See Markings Skin paradigm bilateral cleft nose repair, 212–213 criticisms of, 213 Skin wounds closure of, 4–7 flexor tendon injuries and, 804, 804f Skin xenograft, 54–55 SKs See Seborrheic keratoses Skull base anatomic subdivisions, 346f reconstruction, 363 Skull base defects reconstruction, 442–444 complications of, 443 goals of, 442–443 tumor resection and, 442 Skull base surgery, 345–347 Sleeping position, Cubital tunnel syndrome, 830 Sliding genioplasty disadvantage of, 553 implant augmentation v., 553 Sliding tarsoconjunctival flap, lower eyelid reconstruction, 401 Sliver, hair transplantation and, 563f Slough, 27 Slow-flow combined malformations, 197–198 Small concha type microtia, 303 Small skull base defects, summary, 444 SMAS See Subcutaneous musculoaponeurotic system SMAS See Superficial musculoponeurotic system SMAS plication, 502–503 SMASectomy, 502, 502f Smiling, facial paralysis and, 422, 423, 423f Smooth implants, smooth-walled capsules, 549 Smooth muscle tumors, 110 SNA See Sella-nasion-subspinale SNAC See Scaphoid nonunion advanced collapse Snap-back test, canthoplasty, 408, 411f SNB See Sella-nasion-supramentale SNB See Sentinel node biopsy Soap, phenol and, 459 Sodium carbonate, soft tissue injuries, 316 Sodium tetradecyl sulfate, VMs and, 196 Soft-tissue arthroplasty, carpometacarpal injuries and, 834, 834f augmentation, 466–472 future of, 472 avulsion, mangled extremity and, 679 coverage tendon transfers and, 846 upper limb surgery and, 739 craniofacial microsomia and, 249 defects, forehead reconstruction, 362–363 defects of thumb, flap selection for, 834, 839t Copyright © 2007 by Lippincott Williams & Wilkins, a Wolters Kluwer business Grabb and Smith's Plastic Surgery, Sixth Edition by Charles H Thorne Index depression, implants for, 553–554 facial injuries and, 313–330 fillers, fat grafting as, 478–483 free flap, mandible reconstruction, 427 infection, cold injury, 147 injuries, 769 treatment of, 315–317 loss, of thumb, 834, 834f management, open tibial fractures and, 681 midline excess, 266 movement, osseous genioplasty and, 556 neurofibroma, 292 number Tessier craniofacial clefts and, 266–267 number Tessier craniofacial clefts and, 267 oral cavity reconstruction, 445 plexiform neurofibromas, of forehead, 294 reconstruction chest wall reconstructions and, 665–667 goals, 165 of hand, 769–778 polymers and, 60–63 sarcomas of extremities, radiation therapy and, 165 SoftForm, wrinkles and, 466 Solar lentigo, 105, 107f bleaching agents, 114 Soleus muscle, 689 Sommerlad’s intravelar veloplasty, primary cleft palate repair, 215 Spasm See also Antispasmodic agents control of, 31 pressure sores and, 723 Spastic disorders, tendon transfers and, 845 Spear technique, reduction mammoplasty, 595–598, 598f, 599f, 600f Speech oral cavity reconstruction, 450 VPI and, 217 Speech bulb appliance, 353, 354f Sphenoid wing tumors, endoscopic approach, 347f Sphincter pharyngoplasty, 218–219 pharyngeal flap v., 219 Spider telangiectasia, 195 Spider veins, laser treatments for, 173, 174 Spinal cord injuries, paralysis and, hand reconstruction for, 851–852 Splinting flexor tendon continuity, 806 hand burn, 144 tenosynovitis, 824 Split-finger graft, eyelid reconstruction, 400f Split-hook active prostheses, hand, 895, 895f Split-thickness skin graft, burn reconstruction surgery and, 150 EMLA for, 92 hands, 769 open tibial fractures and, 681 Spontaneous ulceration, infantile hemangioma, 192 Spreader grafts, 525, 525f Springboard graft, unilateral deformity and, 223 Squamous cell carcinomas (SCCs), 105, 107, 112–113, 112f, 116, 340 histologic grading and, 113 of lip, 332 sebaceus nevus of Jadassohn, 109 Stability in solution, local anesthetics, 91 Stable undisplaced fracture, treatment, scaphoid fractures, 783 Staged subcutaneous excision beneath flaps, lymphedema and, 717, 718f Stahl classification system, lunate fractures and, 786, 787f Stahl ear deformity, 295, 297f, 298, 298f Stainless steel, biomedical implants and, 58 Staphylococci, post burn period and, 136 Staphylococcus animal bites, 820 septic arthritis, 820 Staphylococcus aureus hand infection and, 816 hydradenitis suppurativa and, 111, 111f skin flaps and, Staples, skin grafts and, 143 Static rhytides, 466 Stenstrom technique, antihelical fold manipulation, 296, 298f Steroids graft rejection, 53 inhalation injury, 139 problem wounds and, 31 Stewart-Treves syndrome, 718 Stigmata of facial burns, 161t STN See Supratrochlear nerve Straight line closure lip adhesion, 211 primary unilateral cleft lip, 206, 207f Streptococci, post burn period and, 136 Streptococcus necrotizing fasciitis, 821 septic arthritis, 820 Stress views, wrist and digits, 749–750 Stretch marks, abdominoplasty, 543 Strickland classification, total active motion formula, 806 Strickland method, for flexor tendon continuity, 805 Sturge-Weber syndrome, 195 Sub-mini digital prosthesis, distal phalanx and, 897, 897f Subacute reconstruction, thumb and, 833 Subcondylar fractures, 325–326 Subcranial Le Fort III distraction See Midface Subcutaneous facelift, 500, 501f redraping, 501 undermined skin flap and, 501 Subcutaneous musculoaponeurotic system (SMAS), 356 dissections, 501–502 extended dissections, 502, 502f traditional dissections, 501–502 Subcuticular skin suture, 5–6, 5f traumatic facial wounds, 316 Submandibular gland stones, 342 Submandibular glands, neck rejuvenation and, 503 Submental dissection and platysmaplasty, 503, 503f Submucous cleft plate, 202 Subperiosteal facelift, 504 Subtotal maxillary defect (Type II maxillary defect), 437, 438f Subtotal resection, VMs and, 197 Subungual melanoma, amputation for, level of, 127, 127f Suction-assisted lipoplasty (SAL), 532–533, 538f Sulfur colloid (SC), lymphoscintigraphy and, 128 Sunlight basal cell carcinomas, 111–112, 112f retinoids and, 113 squamous cell carcinomas and, 112 Sunscreen, 114 Superficial burns, 133 Superficial circumflex iliac artery flap (Groin flaps), 774–775, 776f Superficial fascia, 37 Superficial fat layers, 531, 532f Superficial inferior epigastric artery (SIEA), 646 flap, 774, 775f 925 Superficial liposuction, 532 Superficial musculoaponeurotic system-muscle layer, facial nerve and, 499 Superficial musculoaponeurotic system (SMAS), facelift anatomy, 498, 499 Superficial partial-thickness burns, 133, 136f Superficial peeling agents, 458 Superficial rhytides, 466 Superficial temporal arteries, scalp and, 356 Superior oblique medial osteotomy, 529, 529f Support stockings, VMs and, 197 Supporting framework, nasal reconstruction, 392 Supratrochlear nerve (STN), forehead lift, 509, 510f Sural nerve, foot and ankle, 688, 690f Sural nerve grafts, replantation, 879, 980f Surface orbital anatomy, age-related changes and, 488 Surgeon, preoperative preparation for, forehead lift and, 507–510 Surgery, See also Microsurgery; specific type surgery i.e Two-Jaw surgery cleft lip and palate, 199, 200t, 203 complications, botulinum toxins and, 477 complications of, lymphedema and, 718 craniofacial clefting, 278 craniofacial microsomia, 253, 253f craniosynostosis syndromes and, 241–245 CTS and, 829 evaluation and classification, cleft lip and palate, 199, 200t infantile hemangioma, 193 lymphedema and, 716–718 operative preparation for, microsurgery, 67 pressure sores, 723–726 pyogenic flexor tenosynovitis and, 819, 822f results of, lymphedema and, 717–718 syndactyly and, 855–857 thumb basal joint arthritis, 884 upper limb injury, 740–743 Surgical algorithms, CMN and, 122 Surgical clips, MRI and, 765 Surgical decompression, Guyon tunnel syndrome, 830 Surgical excision basal cell carcinomas and, 112 of distant metastases, melanoma and, 130 squamous cell carcinomas and, 113 warts and, 822 Surgical management, burn patient, 141–148 Surgical obturator, maxillary defects and, 352–353 Surgical reconstruction, microtia, 304–308 Surgical resection LMs and, 196 VMs and, 197 Surgically assisted rapid palatal expansion (SARPE), 263–264 Surgisis filler materials and, 471 midline abdominal wall defects and, 671 Survival head and neck cancers and, 344 ILP and, 130 melanoma and, radiation for, 130 Survival rates, head and neck cancer, stage and site specific, 340t Suture(s) antihelical fold manipulation, 296 microsurgery and, 68, 69, 69f otoplasty and, 299 removal, scarring and, scarring and, 3–4 Copyright © 2007 by Lippincott Williams & Wilkins, a Wolters Kluwer business Grabb and Smith's Plastic Surgery, Sixth Edition by Charles H Thorne 926 Index Suture(s) (contd.) technique, flexor tendon continuity, 805, 805f techniques, 4–7, 5f Sv See Sievert Swan neck deformity, 812, 812f Swanson classification of congenital upper limb abnormalities, 855, 855t Sweat duct carcinoma, MMS and, 117 Symes amputation, hindfoot and, 701 Symmetry, determination, 518, 518f Symphalangism, 857 Symphysis fractures, operative technique, 325 Syndactyly, hand reconstruction and, 855–857, 857f Syndactyly of digits, Apert syndrome and, 237f Syndromic craniofacial synostosis, midface distraction, 101 Syndromic craniosynostosis, 188 genetic predisposition, 235 treatment options, 239t Synkinesis, 417 Synovial venous malformations, of knee, 196 Synthetic ruby rod, 169 Synthetic skin substitutes, CMN and, 122 Syringocystadenoma papilliferum, 109 Syringomas, 109 laser treatments for, 174 Systemic conditions, blepharoplasty and, 489–490 Systemic lupus erythematosus, arthritis of, 888 Systemic melanoma, 130 clinical course of, 130 Systemic retinoids, 113 Systemic therapy, breast cancer, 622 T-cells, immunosuppression and, 53, 54 T-skin resection, vertical reduction mammaplasty, 603 T-Type procedures, 548 T1-weighted images, 759 T2-weighted images (FLASH), 759, 760 Tachycardia, fluid resuscitation and, 139 Tacrolimus (FK506) graft rejection and, 53 nerve allograft and, 82 Tagging neurovascular structures, amputated body part and, replantation surgery, 871 Tamoxifen, DCIS and, 621 Tangential excision, burn wounds and, 141–142 Tanzer/Brent technique, auricular reconstruction, 306 Tar burn, Medi-Sol and, 137f Tarsal conjunctival mullerectomy (Fasanella-Servat procedure), ptosis and, 406–408, 407f Tarsal plates, eyelid and, 395 Tarsal tuck canthopexy, 410 Tarsal tunnel exposure, flexor retinaculum release, 704 Tarsofascial layer, eyelid and, 395 Tarsoligamentous sling, 486f Tarsorrhaphy face burn, 143 paralyzed eyelid and, 418 Task analysis, tendon transfers and, 846 Tattoo removal, laser treatments and, 176 Tazarotene gel, 113 TBSA See Total body surface area TCA See Trichloroacetic acid TCOF gene, Treacher Collins syndrome and, 286–287 Tear breakup time, canthoplasty, 408, 411f Tear trough deformity, 487f facelift anatomy and, 500 Tears, eyelid and, 396 Technetium-99m, lymphoscintigraphy and, 128 Technetium-99m bone scintigraphy, phases of, 751–753, 751f Teflon, skeleton of chest wall reconstruction, 665 Telangiectasias, 195 laser treatments for, 173 Telecanthus, soft-tissue injury and, 329 Temperature, skin and, 33 Temperature strip, free TRAM procedure, 649, 649f Templates, mandible reconstruction, 432f Temporal bone, craniofacial microsomia and, 247 Temporal hollowing, 327f, 329 Temporalis transfer, eyelids and, 419, 419f Temporomandibular joint disease See TMJ disease Temporoparietal fascia free flap, hand reconstruction and, 778 Temporoparietal flap, dissection technique, 450 Ten test, nerve injury, 76 Tendon adhesions, replantation in upper extremity, 880, 881t anatomy, zones of hand, 801, 802f avulsion injuries, 804 grafts, 807 healing, 803–803 flexor tendon surgery and, 801–807 repair surgical prerequisites, 846 tendon transfers v., 845 ruptures, 804 transfers basic tenets of, 845 for combined nerve palsies, 851 evaluation and goal establishment, 845 indications for, 845 muscle selection for, 847 muscle-tendon units and, 847, 848f, 849f palsies and, 847–851 postoperative management for, 852–853 Tendon sheath injection technique, tenosynovitis, 824 Tendon sling, lower eyelid, facial paralysis and, 419, 420f Tendon zones, 802, 802f of injury, 808–809, 809f Tendonitis, 824 MRI and, 762, 762f Tennis elbow See Lateral epicondylitis Tennison repair, long upper lip, 220 Tenocytes, 801 Tenolysis, 807 Tenosynovitis, 824–827 edema and inflammation cycle, 824, 825f MRI and, 762, 762f Tenosynovitis of extensor carpi radialis brevis (ECRB), 825 radial nerve compressions and, 831 Tenosynovitis of extensor carpi radialis longus (ECRL), 825 Tensile strain, distraction osteogenesis, 98 Tension, burn reconstruction surgery and, 153 Tensor fascia lata (TFL) flaps infraumbilical midline hernia and, 672, 672f ischial pressure sores, 724, 724f trochanteric ulcers, 726f Tessier classification craniofacial clefts and, 266, 267f facial clefts of, 183 Tessier craniofacial clefts, combination numbers, 274f Testicular autotransplantation, 713–714 Tetanus prophylaxis, 23 Tetracaine, 91 TFCC See Triangular fibrocartilage complex TFL flaps See Tensor fascia lata flaps TGF-ß See Transforming growth factor-beta Thenar flap, 772, 773f, 774f Therapeutic axillary lymphadenectomy, 130 Therapeutic inguinal lymphadenectomy, complications from, 130 Therapeutic lymphadenectomy, 129–130 Thermal injuries, 132–149 Thermal relaxation time, pulsed lasers, 170 Thiopental, hyperventilation and, 94 Thoracic outlet syndrome (TOS), 831–832 Thoracic reconstruction, 663–667 Threshold potential, local anesthetics, 91 Thrombocytopenia, Kasabach-Merritt phenomenon, 191 Thumb amputation, 834–835, 839f, 891f, 896f basal joint arthritis, treatment of, 884–885, 886f basal joint degenerative disease, stages of, 883f, 884 deficiencies, types of, 833–835 dislocations of joints, 800 duplication, Wassel classification, 858f fractures, 795 joint injuries, 798–800, 798f MCP joint, stress view, 798f metacarpal fractures, treatment, 795 phalanges fractures, 795 reconstructions, 737, 833–844 evaluation, 833 indications, 833 procedures, 835–844 technique, choices of, 835, 840t replantation, 868f, 877 Thumb loss classification, 833, 836f Thumb opposition restoration, 737 Thumb ulnar collateral ligament tears, MRI and, 760–761 Thyroglossal duct cyst, head and neck embryology and, 185 Thyroid gland, head and neck embryology and, 185 Tibial fracture chronic osteomyelitis and, 683, 684f hemisoleus flap, 682f Tie-over bolster dressing, skin graft and, 9, 9f TIMP-1 See Tissue inhibitor metalloproteinase Tinea unguium See Onychomycosis Tinel sign, axonotmesis and, 73 Tissue cellular origin of, 186–187 debridement, electrical injuries and, 147 differentiation, vessel size and, 39–40, 40f expander exchange, to permanent implant, 626f, 627–628 expanders, 84, 85f cheek reconstruction and, 379–382 latissimus dorsi flap breast reconstruction, 632 postoperative care, 629–630 prosthetic breast reconstruction, 624, 624f, 625f, 626f types, 84 expansion, 39, 84–90 burn reconstruction surgery, 158, 158f complications, 90 Copyright © 2007 by Lippincott Williams & Wilkins, a Wolters Kluwer business Grabb and Smith's Plastic Surgery, Sixth Edition by Charles H Thorne Index physiology of, 84 postburn alopecia and, 159 reconstructive surgery and, 47 growth, vessel size and, 39–40 heating, surgical effects of, 170 injury, determining, 147 regeneration pathways, 21 scar formation v., 15–16, 16f Tissue inhibitor metalloproteinase (TIMP-1) infantile hemangioma, 190 pressure sores and, 721–722, 722 Titanium, craniofacial plating systems and, 58 TMJ disease (Temporomandibular joint disease), 254 TNM classification (Tumor, node, metastases classification), 331 Toe-to-thumb transfers, 841–842, 841f, 843f Toe ulcers, 697 Toes, preservation of, 697–698 Tolerance, 54 Tongue head and neck embryology and, 184, 185–186, 185f oral cavity reconstruction and, 450 Tongue reconstruction, 446 Tonsillar pillars, tumors and, 445 Topical anesthesia, 92 Topical wound agents burns and, 135–137 eschar and, 136 TOS See Thoracic outlet syndrome Total body surface area (TBSA) burn patient, 133 infection and, 141 fluid resuscitation and, 138 Total contact casting, wound healing and, 25 Total dose, effect of, local anesthetic agents, 92 Total left facial paralysis, 416f Total mastectomy, 621 Total maxillary defect (Type III maxillary defect), 437 eyelid reconstruction and, 438 type IIIA and, 437–438 type IIIB and, 438 Total maxillectomy, 441f Total parotidectomy, 340 Total penile reconstruction, 711 Tourniquets, wrist surgery and, 742 Toxic shock syndrome, lower truncal contouring and, 547 Toxicity, local anesthetics, 91, 93–94 TPF See Traumatic palmar fascitis Tracheostomy, Treacher Collins syndrome and, 287 Tracheotomy, facial injuries and, 313 Traction alopecia, hair transplantation and, 568f Traction fixation, fractures and, 680 Traction sutures, face burn and, 143 TRAM flap (Transverse rectus abdominus musculocutaneous flap), 43 See also Expanded TRAM flaps; Perforator TRAM contraindications for, 647 contrast of techniques, 651, 653 future, 653–654 indications for, 639, 647 irradiated breast and, 165–166 latissimus dorsi flap breast reconstruction, 636 risk factors, 647t techniques, 647–651 tissue expansion and, 90 Trans-sutural distraction Transblepharoplasty, approach to glabellar muscles, 513f Transcaphoid perilunate dislocation, 747f, 748, 748f Transconjunctival lower blepharoplasty, 492 Transcription factor Runx2/Cbfa1, embryology and, 187–188 Transcutaneous incisions (Intraoral incisions) chin augmentation and, 553 mandible distraction, 99 orbitozygomatic fractures, 320, 320f TransCyte, burn wound and, 148 Transdomal sutures, nasal tip projection alteration, 526, 526f Transfer of regional flaps, wound complications, 675 Transfer of single functional units, hand and, 737 Transferred muscles, re-education of, 853 Transforming growth factor-α, palate development and, 187 Transforming growth factor-beta1 , distraction osteogenesis, 97–98 Transforming growth factor-beta (TGF-ß) clotting cascade, 17 signaling, embryologic development and, 187 Transition zone, 97 Transmetacarpal replantation, 877, 878f, 879 Transmetatarsal amputation, 701 Transnasal medial canthoplasty, 322 Transosteotomy distraction, 96 Transplant biology history, 52 plastic surgery applications and, 52–57 Transplant immunology, 52–54 Transplantation See also Donor site antigens, 52–53 current plastic surgery and, 54–57 future, 57 nomenclature, 52 Transport segment, 96 Transposition skin flap cheek reconstruction and, 375–376 planning, 10, 10f, 11f Transverse amputations, 892 Transverse rectus abdominis musculocutaneous flap See TRAM flap Trapezial resection arthroplasty, with ligament reconstruction, 885, 885f Trapezium fracture, 787 Trapezius flap cheek reconstruction and, 378–379 soft-tissue reconstruction and, 665 Trapezius muscle, latissimus dorsi flap breast reconstruction, 634 Traumatic arthritis, 882 Traumatic palmar fascitis (TPF), 863, 863f Traumatic wounds, 316 Treacher Collins syndrome (Mandibulofacial dysostosis), 285–288, 286f Kaban-Mulliken classification, 288f pathogenesis of, 286–288 Tretinoin See Retin-A Triangular fibrocartilage complex (TFCC), 779 acute traumatic tear, 759f, 760 arthrography, 750 lunotriquetral instability, 782 tears, MRI and, 759f, 760 Tricalcium phosphate-osteogenic composite, bone grafts substitutes and, 59 Trichloroacetic acid (TCA) peel, 457, 458–459, 460, 460f destruction depth of, 459f pretreatment, 459 Trichofolliculoma, 109 Tricholemmoma, 109 Trichophyton rubrum, onychomycosis, 822 927 Trigeminal nerve, temporal region of scalp, 357, 357f Trigger finger See Digital flexor tenosynovitis Triphasic Doppler, foot and ankle wound care, 691 Tripier flap canthal reconstruction, 402f lower eyelid reconstruction, 400, 401 Tripod-type reconstruction, hand and, 852 Trisulfide, lymphoscintigraphy and, 128 Trochanteric ulcers, 725–726 Trott method, bilateral cleft, 214 Truncal deformity, weight-loss patients, circumferential lipectomy and, 545, 546f Trunk, tissue expansion and, 86 Tubed radial forearm flap, 453, 453f Tuberous sclerosis, laser treatments for, 174 Tubiana, R., hand surgery and, 737, 738f Tubigrip, lower extremity burns and, 145 Tubular carcinoma, 619 Tuft fractures, 795 Tumescent technique, liposuction and, 94 Tumor, node, metastases classification See TNM classification Tumor map, MMS and, 117, 118, 118f Tumor suppressor genes p16, head and neck cancer and, 338 Tumor(s) See also specific type tumors i.e Parotid gland tumors of bone, MRI and, 763f, 764–765, 764f, 765f CT and, 756, 757f extirpation, nerve reconstruction after, 76 face and body, MMS and, 115–116, 116t mandible reconstruction, 434 margin assessment, MMS and, 117 MMS and, 116–117 MOHS technique, 115 MRI and, 756 resection, skull base defects and, 442 of sella turcica, endoscopic approach, 346f spill, 341 tonsillar pillars, 445 treatment of, MMS and, 116, 116t ulceration, 663 malignant melanoma and, 124 Turban tumor See Cylindroma Turribrachycephaly, 230, 230f Twist transcription factor, Saethre-Chotzen craniosynostosis and, 188 Two-flap palatoplasty, 216 Two-Jaw surgery, 260, 264 Two-layer plication, mini-abdominoplasty, 541, 543 Two-stage nasolabial flap, nasal reconstruction, 389, 391f Type maxillary defect See Limited maxillary defect Type I deformities, facial burn reconstruction, 161 Type I muscles, segmental flaps and, 45 Type II deformities, facial burn reconstruction, 161 Type II maxillary defect See Subtotal maxillary defect Type II muscles, segmental flaps and, 45 Type III mandibles, Treacher Collins syndrome and, 287 Type III maxillary defect See Total maxillary defect Type III muscles, segmental flaps and, 45 Type IV maxillary defect See Orbitomaxillary defects Type IV muscles, segmental flaps and, 45 Copyright © 2007 by Lippincott Williams & Wilkins, a Wolters Kluwer business Grabb and Smith's Plastic Surgery, Sixth Edition by Charles H Thorne 928 Index Typical mycobacterial infections, 823 Tzanck smear, Herpetic whitlow and, 818, 820f Ulceration See also specific type ulcer i.e Marjolin ulcer infantile hemangioma and, 192 metatarsal head, 698 midfoot defects, 701 pressure distribution, 721 ULCs See Upper lateral cartilages Ulnar collateral ligament (UCL) injury, 798, 799, 799f tear treatment, 799, 799f Ulnar nerve, 830 compressions neuropathies, 830 fascicular topography, 76, 77f harvesting, 80 palsies, tendon transfers for, 848–850 wrist and, 741, 742f Ulnar nerve block, wrist and, 741, 742f Ulnar polydactyly, 859 Ulnar styloid, standard radiographs, 746f, 747 Ultrasonography, vascular malformations, 194 Ultrasound-assisted liposuction (UAL), 533, 536f, 537f Ultrasound (US) burn depth, 134 hand and wrist, 753 Ultraviolet light, basal cell carcinomas, 111–112, 112f Umbilical incision, 574, 574f Undercorrection, eyelid ptosis correction, 408 Undermined skin flap redraping of, subcutaneous facelift, 501 subcutaneous facelift, 501 Underresection of tissue gynecomastia, 618 vertical breast reduction, 612 Unilateral cleft lip repair, 220–221 nasal lining release, 209f operative technique, 207–210 primary tip rhinoplasty, 209f Unilateral complete cleft lip, 201, 201f correcting, 204–205 Unilateral coronal synostosis, 224, 229–230, 230f skull deformities, 229f Unilateral incomplete cleft lip, 200–201, 201f operative technique, 210 Unilateral mandibular distraction, 100 Unna boot burn injury and, 143 lower extremity burns and, 145 venous stasis ulcers, 32 Unna paste, 457, 458 Upper arm, replantation, 879 Upper auricular pole, position alteration, 298 Upper eyelid, 395 facial paralysis and, 418–419, 419f reconstruction, zone defects, 397, 398f, 399 structural elements of, cross-section, 396f Upper eyelid paralysis, gold weight, 418, 418f Upper eyelid retractors, 484–485 Upper lateral cartilages (ULCs), septum and, separation of, 524 Upper lid blepharoplasty, 491 Asian, 491 Upper lid markings, blepharoplasty, 490, 490f Upper limb(s) amputations aesthetic considerations, 890 patient response to, 890 prostheses and, 890–897 arthritis, 882–897 compression, overview of, 828–829 infections of, 815–823 injury, categories of, 740 prostheses, 892–897 reconstruction algorithm for, 88 operative principles, 741–743 surgery physical examination in, 739–740 principles of, 739–743 Upper lip defects, 368–369 Upper orbit, preoperative evaluation of, 488–489 Upper-third auricle defects, 300, 301f Upper-third auricular defects, 300, 301f Urine output, fluid resuscitation and, 139 UV radiation, malignant melanoma and, 124 UVB rays, sunscreens and, 114 V-Y advancement flap bilateral, hands, 769, 770f closure, LeFort I osteotomy and, 263 technique applications for, 12, 13f cheek reconstruction and, 375, 375f wound reconstruction of foot and ankle, 696, 699f VAC device See Vacuum-assisted wound closure device Vacuum-assisted wound closure device (VAC device), 27 burn injury and, 143 wound reconstruction, foot and ankle, 693 wound reconstruction of foot and ankle, 695–696 Vagina, acquired defects of, 709 Vaginal reconstruction, rectus abdominus flap and, 709–710 Valacyclovir herpes virus, TCA peel and, 459 laser abrasion, 464 Valium, spasm, 723 Van Nuys Prognostic Index, DCIS and, 621 Vancomycin-resistant Enterococcus (VRE), antimicrobials and, 30 Varicose veins, laser treatments for, 172, 173–174 Vascular anatomy foot and ankle, 687, 689f patterns of, 43, 43f Vascular anomalies, 189–198 nomenclature of, 189 nosology of, 189 Vascular Anomalies Centers, 198 Vascular channels, MRA and, 765, 766f Vascular compromise, lower truncal contouring and, 548 Vascular delay, axial-pattern flaps and, 43 Vascular endothelial growth factor (VEGF) distraction osteogenesis, 97–98 infantile hemangioma, 190 tissue expansion and, 84 Vascular injury, mangled extremity and, 679–680 Vascular insufficiency, nonhealing wounds and, 49, 50f Vascular lesion(s) laser treatments for, 171–174 lasers, 170–171 Vascular malformations categories of, 193 molecular genetics in, 193, 194t subcategories for, 193, 194t Vascular neoplasms, 189, 190t ISSVA and, 189, 190t Vascular repair technique, history of, 66 Vascular supply, foot and ankle wound care, 691 Vascular system, development, embryo and, 36–37 Vascular territories, three dimensional, 37f Vascularized bone, reconstructive surgery and, 47, 47f Vascularized graft, 52 Vasodilatory activity, local anesthetic agent and, 91 Vasospasm, papaverine for, microsurgery and, 70 Vector of distraction, 96 Vectors, mandible distraction and, 99, 99f VEGF See Vascular endothelial growth factor Vein graft anastomoses, replantation in upper extremity and, 873–874 Vein grafts, 81–82 head and neck irradiation, 166 Velopharyngeal insufficiency (VPI) operative treatment of, 217–219 pharyngeal surgery for, 218–219 preoperative evaluation, 218 submucous cleft palate and, 202 Venolymphatic malformations, laser treatments for, 173 Venous anastomoses, replantation in upper extremity and, 873 Venous hum, mandible reconstruction, 433 Venous malformations (VMs), 193, 196–197 laser treatments for, 172, 173f Venous stasis ulcers, wound care of, 32 Venous system, development, 34, 35f Ventral hernia repair, 670–672 Vermilion, 367–368 advancement flap, 367f deficiency, unilateral cleft lip repair and, 220 lip defect and, 366 switch flaps, 367, 368f Verruca vulgaris, 106–107 laser treatments for, 174 Verrucous carcinoma, MMS and, 117 VersaJet water dissector, burn-wound excision, 142, 142f Vertical breast reduction breast meridian, 604 complications, 610, 612 medially based pedicle and, 604–612 operative technique, 605–607, 606f, 610 postoperative course, 608f, 609f, 610, 610f–611f summary, 612–613 Vertical deficiency of ramus, vertical vector, 99, 99f Vertical-incision mastopexy, 584–586, 586f Vertical limb, vertical-incision mastopexy and, 584–586, 586f Vertical mastopexy, 583, 584f Vertical mattress suture, 5, 5f Vertical maxillary excess, 259 Vertical pedicle technique, reduction mammoplasty, 592–593, 592f preoperative markings, 592, 592f–593f Vertical reduction mammaplasty, 602–613 procedure design, 602–604 Vertical resection pattern, skin resection patterns, 604–605, 605f Vertical scar augmentation mastopexy, 589, 590f Vertical skin resection pattern, vertical breast reduction, 604 Vertical vector, mandible distraction, 99 Vessel segment, microsurgery and, 68, 68f Vessels areas fixed to mobile, 39 origin, 40 Copyright © 2007 by Lippincott Williams & Wilkins, a Wolters Kluwer business Grabb and Smith's Plastic Surgery, Sixth Edition by Charles H Thorne Index size and tissue growth, 39–40, 41f tissue planes and, 39 Vicryl, skeleton of chest wall reconstruction, 665 Videofluoroscopy, hand and wrist motion, 750 Villonodular synovitis, 887 Vinca alkaloid, infantile hemangioma, 192 Vincristine, infantile hemangioma, 192 Vincula, 803f Vincular mesentery system, 803f Viral infection, of hand, 822–823 Virus, CO2 laser and, 176 VISI See Volar intercalated segment instability Vision craniosynostosis and, 226 craniosynostosis syndromes and, 239–240 Visual acuity, 411f craniosynostosis and, 226 Vitallium, corrosion and, 58 Vitamin A connective tissue disorders, 703 skin and, 113 Vitamin C, topical, skin and, 113–114 Vitamin E, scars and, 114 Volar cross-finger flap, 772, 773f thumb amputation, 891f, 892 Volar intercalated segment instability (VISI) deformity, lunotriquetral instability, 782 Volar neurovascular advancement flap (Moberg flap), hands, 769–770 Volar V-Y advancement flaps, hands, 769, 770f von Langenbeck two-flap technique, primary cleft palate repair, 216 VPI See Velopharyngeal insufficiency VRAM See Rectus abdominus myocutaneous flap VRE See Vancomycin-resistant Enterococcus Vulva, surface defects of, 708–709 W-plasty, scar and, 13, 14, 14f Wallerian degeneration, 73, 828 Wartenberg syndrome, 831 Warthin tumor, 341 Warts, 106–107 hands and, 822 Wassel classification, thumb duplication, 858f Watson knife, tangential excision, 142 Weber-Ferguson approach, plexiform neurofibromas of face, 294 Webster-Bernard operation, lower-lip defects and, 371, 371f Webster technique, otoplasty and, 298 Webster’s triangle, preservation, 528, 528f Wedge excision, 6, 7f, 301f Weight-loss, massive, circumferential lipectomy and, 545 Wetting solution, liposuction and, 534, 534t Whistle deformity, bilateral cleft lip, 221 Whitnall tubercle, eyelid and, 395 WHO See World Health Organization Wood lamp examination, face burn, 143 Workhorse flap, anterior skull base defects and, 441f, 443 World Health Organization (WHO), malignant melanoma and, 125 World War II hand specialization and, 736–737 post-war era, hand surgery and, 737–738, 738f Worsening organ dysfunction, fluid resuscitation and, 139 Wound care, 23–32 See also Dressings; specific type wound i.e Radiation wound adjuncts to, 25, 27–28, 30–32 advances in, 23, 24t agents, burns and, 135–137 foot and ankle, 690–696 diagnostic studies, 690–691, 693 fundamentals, 23–25 problem wounds, timing and, 30–32 products, pressure sores and, 727 of uncomplicated wounds, 30 Wound-edge eversion, scar and, Wound reconstruction See also Flap(s); Grafts foot and ankle biomechanics, 696 postsurgical care, 697 preparing for, 693–696 treatment options, 695–696 Wound remodeling See Remodeling phase Wound(s) See also Delayed healing wounds; Skin wounds; Ulceration closure abdominal surgery and, 669 abdominal wall reconstruction, 668–670 hand surgery and, 743 mandible reconstruction, 433 radiation wounds and, 164 reconstructive ladder in, 14, 14f comorbidities and, 702–704 complications, 675 dehiscence eyelid ptosis correction, 408 head and neck irradiation, 166 extensions, hand surgery and, 742–743 facial burns and, 151 healing, abnormal response to, 20–21 bacteria and, 25 future modalities in, 32 hypoxia and, 24 immobilization, 743 impairments in, conditions contributing to, 23, 25t inflammatory cascade of, 26f inflammatory phase, 16–19, 17f injury response and, 15 ischemia-reperfusion injury, 24–25 lower truncal contouring and, 547 normal, phases of, 16–20, 17f normal and abnormal, 15–22 pressure relief and, 723 proliferative phase of, 19–20, 19f reconstruction of absent vagina, 707 remodeling phase, 20, 20f semantics of, 16 vertical breast reduction, 612 vitamin C, 114 wound reconstruction to, foot and ankle, 694 infection, chemical peel, 461 measurement, foot and ankle wound care, 691 moist v dry, healing of, from nasal reconstruction, 387–388 929 negative pressure dressings, 675, 683 open burn reconstruction surgery, 150 tendon transfers and, 846 reconstruction, preparing for, foot and ankle, 693–696 scar therapy, 30 shape and position, abdominal surgery and, 670 Wraparound toe transfer, 842, 844 technique, 841f, 844 Wrinkle lines dermabrasion, 461 incisions and, Wrinkles (Rhytides) laser treatments for, 175, 175f types of, 466 Wrist anatomy, 779 arthrodesis, 887 arthroscopy, lunotriquetral instability, 782 disarticulation, 896f extension, radial nerve palsies and, 847–848 fractures of, 779–787 ligamentous injuries of, 779–787 normal axial MRI of, 758f coronal MRI of, 758f sagittal MRI of, 759f radiographic imaging, 744–768 reconstruction, median nerve and, 741, 742f replantation, 879 synovitis, 887 views, standard radiographs, 747–749, 747f Xenogeneic transplantation, 53 Xenograft, 52 Xenon flashlamps, 171 Xeroderma pigmentosum, 110 basal cell carcinomas, 111 Y-shaped vein grafts, replantation in upper extremity and, 873, 874f Yellow dye laser, 169 Z-plasty, 12–14 burn reconstruction surgery and, 153, 154–155, 154f, 155f, 156 burns and, 151 geometric principle of, 12–13, 13t classic 60 degree angle, 13, 13f hypertrophic scarring and, 158, 159f lower eyelid reconstruction, 401 multiple, 157f phalangization, 838 planning and uses of, 13–14 rotation advancement flap, 377 short upper lip, 220 type I deformities, 161 vermilion deficiency, 220 Zyderm collagen implants, filler materials and, 471–472 Zygomatic arch fractures, 320–321 complications, 321 reduction of, 320, 320f Zygomatic complex, craniofacial microsomia and, 247 Zyplast collagen implants, filler materials and, 471, 472 Copyright © 2007 by Lippincott Williams & Wilkins, a Wolters Kluwer business Grabb and Smith's Plastic Surgery, Sixth Edition by Charles H Thorne Copyright © 2007 by Lippincott Williams & Wilkins, a Wolters Kluwer business Grabb and Smith's Plastic Surgery, Sixth Edition by Charles H Thorne ... Professor of Otolaryngology and Surgery (Plastic Surgery) New York University Medical Center New York, New York Joseph J Disa, MD, FACS Associate Attending Surgeon Plastic and Reconstructive Surgery... Professor Department of Plastic and Reconstructive Surgery Washington University School of Medicine St Louis, Missouri Randall Nacamuli, MD Resident Division of Plastic and Reconstructive Surgery... at Brooklyn Director, Division of Plastic Surgery and Hand Surgery Services Department of Surgery, Division of Plastic Surgery The Brookdale University Hospital and Medical Center Brooklyn, New