Scar revision remains a time-tested method for improving otherwise untoward surgical outcomes.  The surgeon must think about patients seeking scar revision in a sequence of two steps.  The first is assessing the patient candidacy, evaluating time since last surgery, medical factors that contribute to poor healing, and the overall readiness of the patient.  Regarding the last factor, surgeons must trust their instinct when patients are seeking scar revision.  There can be a higher prevalence of splitting or body dysmorphic disorder in patients seeking scar revision.  If, in your judgement, t

Rhytidectomy is a popular surgical treatment option for the aging face.  Preoperative evaluation and preparation ensure appropriate patient selection who are considered good surgical candidates which results in higher patient satisfaction and a reduction in complications.  As the field evolves, there continues to be advances in surgical techniques that the surgeon must be abreast of.  Furthermore, as with any surgical procedure, rhytidectomy has its own set of unique complications that a surgeon must be familiar with as well as treatment options for each.  With the appropriate patient selec

Wound healing proceeds through a stepwise fashion from hemostasis to inflammation to proliferation to remodeling. Surgeons can promote tissue healing by handling tissue carefully, preventing infection, and creating a tension-free and moist wound environment. Patients should be encouraged to refrain from smoking, moderate-heavy drinking, and controlling glycemic levels in the perioperative time period. Vitamin, mineral, and protein deficiencies are correlated with impaired wound healing and supplementation should be offered if malnutrition is suspected. 

Optimal reconstruction of a given defect relies on understanding and defining the involved location and surface area, tissues layers lost, proximity to neurovascular structures, and the defect’s relationship to the facial subunits. The goals of reconstruction are to establish functional support, provide soft tissue coverage, minimize distortion, while maintaining aesthetic appearance. This module will focus on reviewing facial unit anatomy and understanding reconstruction based on aesthetic facial subunits. 

Tissue expansion is a reconstructive option that may be suitable for repair of cutaneous defects. Its use can provide increased availability of local tissue of similar characteristics for rearrangement. Successful implementation requires careful planning, vigilance during inflation, and appropriate patient counselling. This module will review basic science of tissue expansion, strategies for choosing the appropriate implant, and managing/avoiding complications.

The skin undergoes many changes with aging and sun damage. Many options are available for skin rejuvenation, including the use of laser, light therapy, radiofrequency, ultrasound, dermabrasion, chemical peels, and dermaceuticals. This outline describes the anatomy, pathophysiology, basic science, clinical applications, and clinical pearls of various skin re-surfacing techniques. Pre-treatment considerations and recognition and management of complications are also reviewed. 

Rhinoplasty surgery is a technically difficult and physically demanding surgery.  

In western society, ratings of physical attractiveness decline with advanced age for both men and women. This decline is greater for women. No study has definitively revealed an increase in psychological pathology in patients seeking facial plastic surgery compared to the general population. Use of preoperative screening assessments may identify patients who may have poor postoperative psychological / psychosocial outcomes however to date none of these screening instruments have proven practical in implementing in actual clinical settings.

The skin varies in terms of thickness and composition across the body. The skin is divided into an epidermis and dermis. They are connected by a complex basement membrane zone. The main cell of the epidermis is the keratinocyte. The mitotically active basal layer generates keratinocytes that migrate and differentiate superiorly. They are shed as anucleate keratinocytes of the stratum corneum in about 28 days.