Facial Surgery: Plastic and Reconstructive PDF

Preface

A movement to create a subspecialty within otolaryngology/head and neck surgery began four decades ago, driven by the recognized need to focus aesthetic and reconstructive procedures in the head and neck toward a select group of individuals with specialized training. This concept has now fully matured in the United States as facial plastic and reconstructive surgery. The emergence of the distinct field of facial plastic and reconstructive surgery has likewise found solid footing in Europe, Central and South America, and Australasia and continues to resonate with surgeons across the globe; the field has entered an exciting new phase of global connectivity. The lines between and among specialties have blurred in positive and productive ways, and our modern understanding of the relationship between form and function has continued to evolve.

We have crafted this textbook to reflect these important trends. Authors from disparate specialties, including facial plastic and reconstructive surgery, oculoplastic surgery, plastic surgery, oral and maxillofacial surgery, dermatology, and others, have been brought together to produce a body of work that is intended to represent the best of cross-specialty collaboration and cross-continent communication.

This book arose from a precursor text of the same name, published in 1997. Like many works of that era, the original book represented an institutional approach to the field of facial plastic and reconstructive surgery. The contributing authors were practicing at or had received training at the Massachusetts Eye and Ear Infirmary and thus had been heavily influenced by the historic figures from this institution: Dr. Varaztad Kazanjian, Dr. Edgar Holmes, Dr. Aram Roopenian, Dr. Richard Webster, and Dr. William Montgomery. The current text is intended to capture a broader scope of intellectual energy and surgical creativity that globalization of our field and cross-specialty collaborations have fostered, while simultaneously preserving important elements of the historic work at The Infirmary and Harvard Medical School.

Throughout the chapters, historical perspective is deliberately emphasized to highlight the importance of thought leaders that have come before us. The current generation of surgeons owes much to past leaders, who forged the concept that form and function lie along an important continuum. Surgeons concentrating on aesthetic issues of the nose, ear, periocular region, and face must now have a thorough understanding of the ways in which aesthetic surgical manipulation can either enhance or impair function. Likewise, head and neck reconstructive surgeons must give intensive consideration to aesthetic outcomes when planning and executing complex reconstructive procedures.

Driven by the coupling of aesthetics and function mandated by modern surgical standards, this book is organized by facial zone, rather than separated into “aesthetic” and “reconstructive” segments. The first six chapters highlight the basic principles of facial plastic and reconstructive surgery, including anatomy, proportions and beauty, visual documentation, and the principles of wound healing, aging, and flap design. Thereafter, sections are organized by facial zone or structure: the scalp and forehead, the eyelids and orbit, the nose, the ear, the bony facial skeleton, and the facial skin and soft tissue. Each section covers the range of aesthetic and reconstructive subjects relevant to the zone or structure in question. A separate section addresses conditions which affect multiple facial zones or tissues. The final section targets emerging trends and new directions in facial plastic and reconstructive surgery, designed to keep the reader both abreast of emerging technology and intrigued and excited about the future possibilities for our specialty.

The book is accompanied by an e-book version, allowing access wherever the surgeon may be, and a wealth of operative videos. In addition, we include a pilot educational feature, modeled after modern Internetbased open access global teaching programs, which emphasizes learning through a coupling of both visual and oral teaching. This unique experiment, which we term “Medflix,” is presented in the form of videoteaching supplements that accompany chapters on Anatomy, Facial Aging, Acute Auricular Injuries, Local Flaps for Auricular Reconstruction, Microtia, Mandibular Fractures, Facial Paralysis, Evaluating Patient Outcomes, and Tissue Engineering. These educational supplements are intended to appeal to both visual and auditory learners and those who prefer to watch, rather than read, a chapter.

Our hope is that residents, fellows, and mature surgeons across disciplines will gain valuable knowledge from the content presented herein.

Any project undertaken by two people is by necessity a complex melding of styles and strengths, involving fluid and occasionally lively interchange, whose aim is to produce a final product that integrates the ideas of both participants into a common vision. It is our sincere hope that this unified vision is reflected in the pages of this book.