Pearls and Pitfalls in Cosmetic

Oculoplastic Surgery

Pearls and Pitfalls in Cosmetic

Oculoplastic Surgery

Edited by

Morris E. Hartstein, MD, FACSClinical Associate Professor, Saint Louis University, Department of Ophthalmology and Division of Plastic and Reconstructive Surgery,

St. Louis, Missouri

John B. Holds, MD, FACSClinical Professor, Saint Louis University, Departments of

Ophthalmology and Otolaryngology-Head and Neck Surgery,St. Louis, Missouri

Guy G. Massry, MDDirector, Ophthalmic Plastic and Reconstructive Surgery. American

Eye Institute, Cedars Sinai Medical Center, Los Angeles, CA, Spalding Dr. Cosmetic Surgery and Dermatology, Beverly Hills,

California, Davidorf Eye Group, West Hills, California

Morris E. Hartstein, MD, FACS John B. Holds, MD, FACSClinical Associate Professor Clinical ProfessorSaint Louis University Saint Louis UniversityDepartment of Ophthalmology Departments of Ophthalmology and Division of Plastic and Otolaryngology-Head and and Reconstructive Surgery Neck SurgerySt. Louis, MO St. Louis, MOUSA USA

Guy G. Massry, MDDirector, Ophthalmic Pastic and Reconstructive SurgeryAmerican Eye InstituteCedars Sinai Medical CenterLos Angeles, CASpalding Dr. Cosmetic Surgery and DermatologyBeverly Hills, CADavidorf Eye GroupWestHills, CAUSA

Library of Congress Control Number: 2007937487

ISBN: 978-0-387-25389-3 e-ISBN: 978-0-387-25389-3

Printed on acid-free paper.

© 2008 Springer Science+Business Media, LLC.All rights reserved. This work may not be translated or copied in whole or in part withoutthe written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection withreviews or scholarly analysis. Use in connection with any form of information storage andretrieval, electronic adaptation, computer software, or by similar or dissimilar methodol-ogy now known or hereafter developed is forbidden.The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as tofiwhether or not they are subject to proprietary rights.While the advice and information in this book are believed to be true and accurate at thedate of going to press, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes nowarranty, express or implied, with respect to the material contained herein.

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v

Foreword

Learning oculofacial surgery is a lot like learning to dance. In the begin-ning, the dance student is consumed with where to put his or her feet. For these new students (or for the rhythmically challenged), dancing ischaracterized by the struggle to step their feet in imaginary numbered shoeprints, 1–2–3–4, and they barely hear the music. In surgery, thebeginning surgeon is preoccupied with steps as well. Their focus is onthe mechanical process. Proscribed steps create the paradigm for per-forming the surgery.

With time, the dance student moves on to the next stage. He does nothave to think as much about where he is putting his feet, and can start to listen to the music and feel the rhythm. The advanced surgeon begins to internalize the steps of surgery so that instead of a preoccupation with the next maneuver, she can start to individualize the surgery to the patient and employ flexibilty in the face of unique problems.fl

The master dancer makes no conscious effort to move his feet; his feetmove him. He does not concentrate on rhythm; the rhythm of the music becomes part of him. Freed from the intellectual exercise of dancing andfrom the technical requirements of keeping time, he is free to break from the restraints of the proscribed steps and invent a new dance as he goesalong.

The master surgeon enjoys a similar freedom. The focus is not on maneuvers and, in fact, the surgeon might be temporarily taken abackif asked to explain the mechanical details of what he is doing. Instead, the thought process is conceptual. The surgeon is visualizing a result, is sensitive to the nuances of the patient’s individual anatomy, and is always making adjustments to address the unique requirements presented bythe case at hand. By approaching the operation conceptually, and having effortless command of anatomy and technique, the master surgeon isfreed from the constraints of proscribed operations, and is able to inventnew surgeries.

In this book, a high octane collection of master surgeons provide awork that refl ects the scope of ophthalmic plastic surgery. There is mate-flrial here for every type of student. The beginner will appreciate step-by-step instructions and clear anatomic diagrams. The advanced surgeon

will be drawn to the delightful tricks and peals that are sprinkled liberally throughout the text. The master surgeon (and the aspiring master) will recognize that they are seeking the same thing that the authors areseeking, and they will be stimulated to continue to search for better treatments and surgeries. The obvious hard work that went into the preparation of this book will pay off handsomely when its readers improve their ability to take care of their patients, and particularly when they are inspired to continue their own journey toward mastery of our discipline.

Robert Alan Goldberg, MDKaren and Frank Daby Professor of Ophthalmology

David Geffen School of Medicine at UCLAChief, Orbital and Ophthalmic Plastic Surgery Division

Jules Stein Eye Institute

vi Foreword

vii

Preface

The goal of this book is to help surgeons perform more effi cient, produc-fitive, and successful surgeries. By sharing our varied experiences, acquired through years of practice, we hope this book will provide insights thatcan enhance surgical outcomes. In compiling this text, we solicited con-tributions from experts in cosmetic oculoplastic surgery, as well as sur-geons from other related fi elds, such as facial plastic surgery, plasticfisurgery, and dermatology. The book is divided into 12 parts, which coverthe spectrum of oculofacial procedures. Each section is divided into concise chapters focusing on just one aspect of a given procedure. Within these short chapters, each contributor offers tips on how to achieveoptimal results. For example, the section on upper lid blepharoplasty issubdivided as follows:

• Preoperative evaluation• Incision planning• Procedure pearls• Adjunctive procedures• Wound closure and postoperative care

There are also multiple presentations on the same aspect of a procedureto provide different points of view and approaches. We greatly appreci-ate the various experts, who have shared their experiences.

Acknowledgments

Roberta D. Sengelmann and Brent R. Moody served as section chiefsfor Part IX, Skin Rejuvenation.

Tamara R. Fountain served as section chief for Part XII, Functional LidMalpositions, Sections 1–2, Ptosis.

We would like to thank Jan Heizer and Chris Kleber, Saint Louis Uni-versity Department of Ophthamology, for their assistance in preparingthis book.

Morris E. Hartstein, MD, FACSJohn B. Holds, MD, FACS

Guy G. Massry, MD

ix

Contents

Foreword by Robert Alan Goldberg . . . . . . . . . . . . . . . . . . . . . . . . vgPreface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . viiContributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xxiii

Part I Preoperative Evaluation

1 Preoperative Evaluation of the Cosmetic Patient . . . . . . . 3Jemshed A. Khan

2 Evaluation of the Cosmetic Patient . . . . . . . . . . . . . . . . . . . 6Rona Z. Silkiss

3 Preoperative Patient Counseling for CosmeticBlepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11William P.D. Chen

Part II Anesthesia

4 Guide to Local Anesthetic Medications . . . . . . . . . . . . . . . 15Vivian Schiedler and Bryan S. Sires

5 Motor Nerve Blocks in Oculofacial Surgery . . . . . . . . . . . . 18Vivian Schiedler and Bryan S. Sires

6 Regional Nerve Blocks in Oculofacial Surgery . . . . . . . . . 22Vivian Schiedler and Bryan S. Sires

7 Procedural Sedation in Oculofacial Surgery . . . . . . . . . . . . 27Vivian Schiedler and Bryan S. Sires

8 Preoperative Preparation and Anesthesia . . . . . . . . . . . . . . 30William P.D. Chen

9 “Digital Diffusion” Technique for the Administrationof Local Anesthetic in Eyelid Surgery . . . . . . . . . . . . . . . . . 32Rona Z. Silkiss

10 Anesthesia for In-Offi ce Oculoplastic Surgery:fiHow We Do It . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33Brent R. Moody and John B. Holds

x Contents

Part III Upper Lid Blepharoplasty

Section One Preoperative Evaluation

11 Upper Eyelid Blepharoplasty: The Evaluation . . . . . . . . . . 41 Evan H. Black, John D. Siddens, Frank A. Nesi,

Shoib Myint, and Geoffrey J. Gladstone

12 Preoperative Examination Checklist for Upper Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

Philip L. Custer

13 Preoperative Evaluation and Documentation in Upper Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

Cat Nguyen Burkat

Section Two Incision Planning

14 Marking Strategies for Upper Blepharoplasty . . . . . . . . . . 51 Guy G. Massry

15 Orbit Size and Lid Marking in Upper Blepharoplasty . . . 53 Philip L. Custer

16 Incisional Guidelines When Marking the Skin inUpper Eyelid Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . 56

Sheri L. DeMartelaere, Todd R. Shepler, Sean M. Blaydon,Russell W. Neuhaus, and John W. Shore

17 Marking the Proposed Upper Eyelid Crease:Determining the Safe Amount of Skin Removal—The Pinch Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58

Jemshed A. Khan

18 Preoperative Measurements in Upper Blepharoplasty:Patient Selection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

Jemshed A. Khan

19 Keys to Success When Marking the Skin in UpperBlepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62

John R. Burroughs and Richard L. Anderson

20 Skin Marking in Upper Blepharoplasty—Avoiding Pitfalls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65

Cat Nguyen Burkat

Section Three Upper Blepharoplasty Procedure Pearls

21 Upper Blepharoplasty: Pearls for the Procedure . . . . . . . . 71 Evan H. Black, John D. Siddens, Frank A. Nesi,

Shoib Myint, and Geoffrey J. Gladstone

22 Fat Excision in Upper Blepharoplasty . . . . . . . . . . . . . . . . . 73 Sheri L. DeMartelaere, Todd R. Shepler, Sean M. Blaydon,

Russell W. Neuhaus, and John W. Shore

Contents xi

23 Mobilizing and Excising the Nasal Fat Pad in UpperBlepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74Jemshed A. Khan

24 Tissue Removal Considerations in Blepharoplasty Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75Rona Z. Silkiss

25 Fewer Hematomas in Upper Blepharoplasty . . . . . . . . . . . 76Martin H. Devoto

26 Blepharoplasty Incisional Modalities: 4.0 RadiowaveSurgery vs. CO2 Laser . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81Joseph Niamtu, III

27 Fat Preservation and Other Tips forUpper Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84Cat Nguyen Burkat

28 Asian Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87Samuel M. Lam

Section Four Adjunctive Procedures in Upper Blepharoplasty

29 Internal Brow Elevation with Corrugator Removal . . . . . 95John R. Burroughs and Richard L. Anderson

30 Excision of ROOF During Upper Blepharoplasty . . . . . . . 99Jemshed A. Khan

31 Addressing the Brow During Upper Blepharoplasty . . . . 100Philip L. Custer

32 Transblepharoplasty Incision Lower Lid Canthopexy . . . . 102John R. Burroughs and Richard L. Anderson

33 Lower Lid Canthopexy Through Upper Lid Incision . . . . 104Guy Ben Simon and John D. McCann

Section Five Wound Closure and Postoperative Care

34 Avoiding Dog Ears During Upper Blepharoplasty Closure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107Peter S. Levin

35 Crease Formation in Upper Blepharoplasty . . . . . . . . . . . . 109Philip L. Custer

36 Use of Tissue Adhesive for Oculoplastic Incision Closure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111Charles B. Slonim

37 Avoiding or Minimizing Postoperative Swelling . . . . . . . . . 112John R. Burroughs and Richard L. Anderson

38 Management of Postblepharoplasty Dry Eye . . . . . . . . . . . 114Morris E. Hartstein

xii Contents

Part IV Lower Lid Blepharoplasty

Section One Preoperative Considerations

39 Lower Eyelid Blepharoplasty: The Evaluation . . . . . . . . . . 121 John D. Siddens

40 Lower Eyelid Blepharoplasty Evaluation: Avoid the Cookie Cutter Approach . . . . . . . . . . . . . . . . . . . . . . . . . 125

Sheri L. DeMartelaere, Todd R. Shepler, Sean M. Blaydon,Russell W. Neuhaus, and John W. Shore

Section Two Lower Blepharoplasty Procedure Pearls

41 Three-Step Technique for Lower Lid Blepharoplasty . . . . 129 Joseph A. Mauriello, Jr.

42 Lower Eyelid Blepharoplasty: ProcedurePearls and Pitfalls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137

John D. Siddens

43 Lower Blepharoplasty: The Bilamelar Approach . . . . . . . . 139 Guy G. Massry

44 The Skin in Lower Lid Blepharoplasty:General Principles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 140

Guy Ben Simon and John D. McCann

45 Incising the Septum over the Nasal, Central, and Lateral Fat Pads in Lower Blepharoplasty . . . . . . . . . 141

Jemshed A. Khan

46 Prolapsing the Inferior Fat Pads and Fornix in LowerBlepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143

Jemshed A. Khan

47 Identifying the Inferior Oblique in TransconjunctivalBlepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145

Jemshed A. Khan

48 Achieving Symmetry in Lower Blepharoplasty Fat Removal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147

Jemshed A. Khan

49 Hemostasis in Lower Blepharoplasty . . . . . . . . . . . . . . . . . . 150 Erin L. Holloman and Sterling S. Baker

50 The Treatment of Festoons in Lower Blepharoplasty . . . . 151 Sheri L. DeMartelaere, Todd R. Shepler, Sean M. Blaydon,

Russell W. Neuhaus, and John W. Shore

Section Three Fat Repositioning in Lower Blepharoplasty

51 Fat Repositioning in Lower Blepharoplasty: Less Is More . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157

Sheri L. DeMartelaere, Todd R. Shepler, Sean M. Blaydon,Russell W. Neuhaus, and John W. Shore

Contents xiii

52 Fat Repositioning in Lower Lid Blepharoplasty: General Principles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158Guy Ben Simon and John D. McCann

53 Transconjunctival Lower Lid Blepharoplasty withand Without Fat Repositioning . . . . . . . . . . . . . . . . . . . . . . . 159Guy G. Massry and Paul S. Nassif

54 Transconjunctival Lower Blepharoplasty withIntra-SOOF Fat Repositioning . . . . . . . . . . . . . . . . . . . . . . . 167Yasaman Mohadjer and John B. Holds

55 Lower Lid Blepharoplasty with Fat Repositioning Using a Foam Bolster . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171Eric A. Steele and Roger A. Dailey

56 Use of Tisseel in Lower Eyelid Blepharoplasty with FatRepositioning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173Asa D. Morton

57 Lower Blepharoplasty with Fat Repositioning Without Sutures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176John R. Burroughs and Richard L. Anderson

Section Four Management of Postblepharoplasty Lid Retraction

58 Managing Postblepharoplasty Lower Eyelid Malposition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183Michael T. Yen

59 Retroauricular Dermal Spacer Graft for LowerLid Retraction Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187Francesco P. Bernardini

60 Mid-Lower Eyelid Tarsoconjunctival Flap-Skin Graft:Treatment of Cicatricial Lower Lid Retraction . . . . . . . . . 190John Pak

61 Treatment of Postblepharoplasty Lower EyelidRetraction with Dermis Fat Spacer Grafting . . . . . . . . . . . 198Bobby S. Korn and Don O. Kikkawa

Part V Forehead Rejuvenation

Section One Preoperative Considerations

62 Which Browlift to Do? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205Andrea N. Hass

63 Browlifting: Patient Evaluation . . . . . . . . . . . . . . . . . . . . . . . 206Andrea N. Hass

64 Preoperative Botox for Endoscopic Browlifting . . . . . . . . 208Andrea N. Hass

xiv Contents

Section Two Endoscopic Forehead Rejuvenation

65 Five Tips for Endoscopic Browlift . . . . . . . . . . . . . . . . . . . . 211 Sheri L. DeMartelaere, Todd R. Shepler, Sean M. Blaydon,

Russell W. Neuhaus, and John W. Shore

66 Anesthesia Options in Endoscopic Forehead Lifting . . . . 212 Andrew S. Eiseman

67 Endoscopic Forehead Rejuvenation: How to Set Up the Operating Room and Trouble Shooting . . . . . . . . . . . . 215

Asa D. Morton

68 Endoscopic Forehead Rejuvenation: Equipmentand Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 217

Asa D. Morton

69 Incision Technique for Endoscopic Forehead Elevation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 220

Andrew S. Eiseman

70 Endoscopic Forehead Elevation: Patient Markingand Preparation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223

Geva Mannor

71 Endoscopic Midforehead Techniques: Improved Outcomes with Decreased Operative Time and Cost . . . . 224

Asa D. Morton

72 Fifteen Principles of Enhanced Success inEndoscopic Browlift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 228

Guy G. Massry

73 Dissection of Central Forehead and Temporal Pocketwith Periosteal Release . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231

Don O. Kikkawa

74 Endoscopic Forehead Lifting: Dealing with the Central Brow Depressors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234

Asa D. Morton

75 Elevation and Fixation of the Lateral Brow andCanthus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 236

Robert G. Fante

76 Fixation Methods in Endoscopic Browlifting . . . . . . . . . . . 237 Andrea N. Hass

77 Endosocopic Browlift with Deep TemporalFixation Only . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 238

Paul S. Nassif

78 Tridimensional Brow, Glabella, and Temple Enhancement with Micro Fat Injection DuringEndoscopic Forehead Rejuvenation . . . . . . . . . . . . . . . . . . . 247

Oscar M. Ramirez and Camilo O. Reyes

Contents xv

79 Scalp Fixation in Endoscopic Browlift . . . . . . . . . . . . . . . . . 254Robert G. Fante

80 Closing and Dressing the Wounds in Endoscopic Browlift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257Robert G. Fante

81 Endoscopic Forehead Rejuvenation: Avoiding and Managing Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . 259Asa D. Morton

Section Three Nonendoscopic Browlifting

82 The Direct Browlift: Focus on the Tail . . . . . . . . . . . . . . . . . 263John B. Holds

83 Soft Tissue Augmentation of the Temporal Brow in Browlifting Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267David E.E. Holck, Jill A. Foster, Manuel A. Lopez,and Kevin A. Kalwerisky

Part VI Mid-Face Lift

84 Mid-Face Lift: General Considerations and How I Do It . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275Guy G. Massry

85 Ten Rules for Mid-Face Lifting for the Repair of Lid Retraction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277Morris E. Hartstein and Guy G. Massry

86 The Subperiosteal Mid-Face Lift Using Bioabsorbable Implants for Fixation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 278David E.E. Holck, Jill A. Foster, Kevin A. Kalwerisky,and Manuel A. Lopez

87 Cheeklifting Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285Clinton D. McCord, Jr.

88 Mid-Face Implants . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287Joseph Niamtu, III

Part VII Botox

89 Introduction to Botox . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 293John R. Burroughs and Richard L. Anderson

90 Evaluating Potential Botox Patients . . . . . . . . . . . . . . . . . . . 294Samuel M. Lam

91 Botox: General Principles of Treatment . . . . . . . . . . . . . . . 296Samuel M. Lam

xvi Contents

92 Botox: Where It Works Best . . . . . . . . . . . . . . . . . . . . . . . . . 298 Jemshed A. Khan

93 Preparation of Botox . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 300 Jemshed A. Khan

94 Documentation of Treatment: Botox . . . . . . . . . . . . . . . . . . 301 Jemshed A. Khan

95 Botox Injection Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . 303 John R. Burroughs and Richard L. Anderson

96 Cosmetic Botox Applications: General Considerations and Dosing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 305

John R. Burroughs and Richard L. Anderson

97 Botox: Avoiding Pitfalls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 307 John R. Burroughs and Richard L. Anderson

98 Botox Injection Techniques: Minimizing Bruising and Discomfort . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 309

Jemshed A. Khan

99 Botulinum Toxin Injections Pearls . . . . . . . . . . . . . . . . . . . . 311 Rona Z. Silkiss

100 Botox Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 312 Jemshed A. Khan

101 Glabella Treatment with Botox . . . . . . . . . . . . . . . . . . . . . . . 314 Samuel M. Lam

102 Corrugator and Procerus Rhytid Treatment withBotox . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 316

Jemshed A. Khan

103 Frontalis Injection with Botox . . . . . . . . . . . . . . . . . . . . . . . . 318 Jemshed A. Khan

104 Frontalis Treatment with Botox . . . . . . . . . . . . . . . . . . . . . . 320 Samuel M. Lam

105 Shaping of the Eyebrows with Botox . . . . . . . . . . . . . . . . . . 322 David F. Horne and Thomas E. Rohrer

106 Botox Injection Techniques: Crow’s Feet . . . . . . . . . . . . . . 326 Jemshed A. Khan

107 Orbicularis Oculi Treatment with Botox . . . . . . . . . . . . . . . 328 Samuel M. Lam

108 Perioral Botox Injections . . . . . . . . . . . . . . . . . . . . . . . . . . . . 330 Jemshed A. Khan

109 Botox Injection to the Lacrimal Gland for the Treatment of Epiphora . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 332

R. Jeffrey Hofmann

Contents xvii

110 Botox Therapy for Hyperhydrosis: How I Do It . . . . . . . . 335Charles B. Slonim

111 Other Uses of Botox . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 336John R. Burroughs and Richard L. Anderson

112 Botox for Axillary Hyperhydrosis . . . . . . . . . . . . . . . . . . . . 338R. Jeffrey Hofmann

Part VIII Fillers

113 Optimizing Outcome from Facial Cosmetic Injectionsand Promoting Realistic Expectations . . . . . . . . . . . . . . . . . 341Leslie Baumann

114 Filler Pearls: General Considerations . . . . . . . . . . . . . . . . . . 344John R. Burroughs and Richard L. Anderson

115 List of Fillers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 345Bradley T. Kovach

116 Dermal Filler Pearls: the Hyaluronic Acids . . . . . . . . . . . . 352John R. Burroughs and Richard L. Anderson

117 Radiesse Pearls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 354John R. Burroughs and Richard L. Anderson

118 Juvederm Pearls: Fine and Superfi cial Lines . . . . . . . . . . . . 356fiJohn R. Burroughs and Richard L. Anderson

119 Achieving Beautiful Lip Augmentation . . . . . . . . . . . . . . . . 357Kimberly J. Butterwick

120 Restylane Injection for the Lower Eyelid TearTrough . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 362R. Jeffrey Hofmann

121 Liquid Injectable Silicone for the Upper Third of the Face . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 364Derek H. Jones

122 Periocular Injectables with Hyaluronic Acid andCalcium Hydroxyapatite . . . . . . . . . . . . . . . . . . . . . . . . . . . . 369Robert A. Glasgold and Samuel M. Lam

123 Pearls and Pitfalls of Botox and Filler Substances in the Upper Third of the Face . . . . . . . . . . . . . . . . . . . . . . . . . 373Seth L. Matarasso

124 Periorbital-Facial Volume Rejuvenation for Focal Defi cits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 379fiJohn R. Burroughs and Richard L. Anderson

125 Pearls for Periorbital Fat Transfer . . . . . . . . . . . . . . . . . . . . 381Lisa M. Donofrio

xviii Contents

126 Complementary Fat Grafting in the Periorbital Region . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 384

Samuel M. Lam, Mark J. Glasgold,and Robert A. Glasgold

127 Autogenous Orbicularis and Fat as a Filler . . . . . . . . . . . . . 386 John R. Burroughs, Michael T. Yen,

and Richard L. Anderson

Part IX Skin Rejuvenation

Section One Skin Care

128 Skin Care 101: The Basics . . . . . . . . . . . . . . . . . . . . . . . . . . . 391 Diane S. Berson

129 Retinoids for the Cosmetic Patient . . . . . . . . . . . . . . . . . . . 393 Kenneth R. Beer

130 Evaluation of Skin Lesions in the Cosmetic PatientMade Simple: Actinic Keratosis . . . . . . . . . . . . . . . . . . . . . . 396

Brent R. Moody

Section Two Nonablative Therapy

131 Chemical Peels for Facial Rejuvenation . . . . . . . . . . . . . . . 401 Andrew J. Kaufman

132 Nonablative Laser and Light Facial Rejuvenation . . . . . . . 404 Jeffrey S. Dover

133 Mesotherapy for Cosmetic Periocular Enhancement . . . . 409 Samuel M. Lam and Gustavo H. Leibaschoff

Section Three Ablative Therapy

134 Skin Rejuvenation Techniques:General Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 413

Erin L. Holloman and Sterling S. Baker

135 CO2 Laser Skin Resurfacing Prophylaxis . . . . . . . . . . . . . . 416 Jemshed A. Khan

136 CO2 Laser Resurfacing Immediate PostoperativeCare Prior to Complete Epithelialization . . . . . . . . . . . . . . 417

Jemshed A. Khan

137 Products Used in CO2 Laser Resurfacing Wound Care:Late Postoperative Care After Complete Epithelialization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 418

Jemshed A. Khan

138 Monopolar Radiofrequency Tissue Tightening . . . . . . . . . . 419 Elizabeth F. Rostan

Contents xix

139 Dual-Mode Erbium-YAG Laser Skin Resurfacing . . . . . . 424John B. Holds

140 Fraxel Treatment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 428Howard Conn

Part X Thread Lift

141 Pros and Cons of Contour Threads for Upper Facial Rejuvenation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 433Michael S. Kaminer

142 Periocular Suture Lifts: Brow andMalar Repositioning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 435Samuel M. Lam

143 Contour Threads Technique Pearls . . . . . . . . . . . . . . . . . . . . 438Michael S. Kaminer

144 Combined Modalities for the Correction of Asymmetric Brow Position . . . . . . . . . . . . . . . . . . . . . . . . . . 440William P. Mack

Part XI Other Cosmetic Procedures

145 Repair of the Torn Earlobe . . . . . . . . . . . . . . . . . . . . . . . . . . 445Yoash R. Enzer

146 Upper Lip Lift as a Complementary Techniquein Facial Rejuvenation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 452Oscar M. Ramirez and Camilo O. Reyes

147 SMAS Malar Fat Pad Lift with Short Scar Face Lift . . . . . 457Paul S. Nassif and Guy G. Massry

148 Ten Tips for a Reliable and Predictable Deep Plane Facial Rhytidectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460David E.E. Holck, Jill A. Foster, Kevin A. Kalwerisky,and O. Bailey Robertson

Part XII Functional Lid Malpositions

Section One Ptosis: Anterior Approach

149 Advantages of Sequential Versus Simultaneous Bilateral Levator Advancement Surgery . . . . . . . . . . . . . . . 475Herbert J. Glatt

150 Considerations in Simultaneous vs. SequentialBilateral Levator Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . 476Robert A. Mazzoli

xx Contents

151 Unilateral Levator Resection for Jaw-Winking Ptosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 478

Stuart R. Seiff

152 Ten Steps to Making Ptosis Surgery More Predictable . . . 479 Russell S. Gonnering

153 Adjustable Suture Technique for Levator Surgery . . . . . . 481 Morris E. Hartstein and John J. Woog

154 Tarsal Switch Levator Resection for the Treatment of Myopathic Blepharoptosis . . . . . . . . . . . . . . . . . . . . . . . . 484

Sheri L. DeMartelaere, Todd R. Shepler, Sean M. Blaydon, Russell W. Neuhaus, and John W. Shore

155 Modifi ed Levator Advancement Ptosis Technique . . . . . . . 490fi Rona Z. Silkiss

156 Minimally Invasive Ptosis Repair . . . . . . . . . . . . . . . . . . . . . 491 Francesco P. Bernardini

157 Small Incision External Levator Repair . . . . . . . . . . . . . . . 494 Mark J. Lucarelli

158 Ptosis Repair by a Single-Stitch Levator Advancement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 497

Don Liu

159 Postoperative Care in Ptosis Surgery . . . . . . . . . . . . . . . . . . 500 Edsel Ing

Section Two Ptosis: Posterior Approach

160 Pearls for Müller’s Muscle–ConjunctivalResection–Ptosis Procedure Combined with Upper Blepharoplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 503

Allen M. Putterman

161 Müller’s Muscle–Conjunctival Resection Pearls: Phenylephrine and Resection Considerations . . . . . . . . . . 506

Melanie H. Erb and Steven C. Dresner

162 Avoiding Lid Contour Abnormalities in Müller’s Muscle–Conjunctival Resection: Recognizingthe Lateral Shift . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 508

Michael E. Migliori

163 Müller’s Muscle–Conjunctival ResectionProcedure Tips . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 509

Melanie H. Erb and Steven C. Dresner

Section Three Entropion

164 Minimally Invasive, Three-Step, Transconjunctival Entropion Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 513

Francesco P. Bernardini

Contents xxi

165 Simple Entropion Repair Using the Orbicularis Strip . . . 515Don Liu

166 Simple “Bedside” Cautery Entropion Repair . . . . . . . . . . . 517David J. Singer

Section Four Ectropion

167 “Simple-Dimple” Lateral Tarsus Fixation . . . . . . . . . . . . . . 521William L. Walter

168 Lower Lid Retractor Dissection . . . . . . . . . . . . . . . . . . . . . . 524Jeffrey P. Edelstein

169 Simple Lower Lid Tightening Without Tarsal Strip . . . . . . 525Don Liu

170 Technique for Medical Canthal Flap to Correct Lid Retraction/Medial Ectropion . . . . . . . . . . . . . . . . . . . . . 526Kathleen M. Duerksen

171 Medial Canthorraphy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 528Francesco P. Bernardini

172 Myocutaneous Flaps and Canthopexy for Repair of Severe Cicatricial Ectropion . . . . . . . . . . . . . . . . . . . . . . . . . 531James Leong and Raf Ghabrial

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 533

xxiii

Contributors

Richard L. Anderson, MD, FACSMedical Director, Center for Facial Appearances, Salt Lake City, UT, USA

Sterling S. Baker, MDAssistant Clinical Professor, Department of Ophthalmology, AdjunctClinical Professor, Department of Dermatology, University of Okla-homa College of Medicine, Oklahoma City, OK, USA

Leslie Baumann, MDProfessor, University of Miami, Miami Heart Institute, Department of Dermatology, Miami Beach, FL, USA

Kenneth R. Beer, MDDirector, The Palm Beach Esthetic Center, Voluntary AssistantProfessor, University of Miami, West Palm Beach, FL, USA

Francesco P. Bernardini, MDOspedale Evangelico Internazionale, Department of Ophthalmology, Genova, Italy

Diane S. Berson, MDAssistant Clinical Professor, Weill Medical College of Cornell Univer-sity, New York Presbyterian Hospital, Department of Ophthalmology, New York, NY, USA

Evan H. Black, MDAssociate Professor, Wayne State University School of Medicine, KresgeEye Institute, Department of Ophthalmology, Detroit, MI, USA

Sean M. Blaydon, MDOphthalmic Plastic and Reconstructive Surgeon, Texas OculoplasticConsultants, Austin, TX, USA

Cat Nguyen Burkat, MDAssistant Professor, Ophthalmic Plastic and Reconstructive Surgery, University of Wisconsin, Madison, WI, USA

John R. Burroughs, MDMedical Director, Eye and Facial Appearances, Colorado Springs, CO, USA

Kimberly J. Butterwick, MDScripps Memorial Hospital, La Jolla, CA, USA

William P.D. Chen, MD, FACSClinical Professor, UCLA School of Medicine, Harbor-UCLA Medical Center, Department of Ophthalmology, Long Beach, CA, USA

Howard Conn, MDPrivate Practice, Irvine, CA, USA

Philip L. Custer, MDProfessor, Washington University School of Medicine, Department of Ophthalmology and Visual Sciences, St. Louis, MO, USA

Roger A. Dailey, MD, FACSLester Jones Chair, Oculofacial Plastic Surgery, Oregon Health and Sci-ences University, Division of Oculofacial Plastic & Reconstructive Surgery, Portland, OR, USA

Sheri L. DeMartelaere, MD, FACSAssistant Professor, Uniformed Services, University of the Health Sci-ences, Director, Ocular and Orbital Trauma Service, Brooke Army Medical Center, Department of Surgery, San Antonio, TX, USA

Martin H. Devoto, MDDirector, Consultores Oftalmologicos, Division of Oculoplastic and Orbital Surgery, Buenos Aires, Argentina

Lisa M. Donofrio, MDAssociate Clinical Professor, Yale University School of Medicine, Department of Dermatology, New Haven, CT, USA

Jeffrey S. Dover, MDSkinCare Physicians, Chestnut Hill, MA, USA

Steven C. Dresner, MDAssociate Clinical Professor, University of Southern California, Depart-ment of Ophthalmology, Los Angeles, CA, Eyesthetica Inc., SantaMonica, CA, USA

Kathleen M. Duerksen, MD, FACSPrivate Practice, Tuscon, AZ, USA

xxiv Contributors

Jeffrey P. Edelstein, MDPrivate Practice, Chandler, AZ, USA

Andrew S. Eiseman, MDAssistant Professor, Uniformed Services University of the Health Sciences, Chief, Oculoplastics and Orbit Disease Center, Department of Surgery, Walter Reed Army Medical Center, Eye Clinic, Washington D.C., USA

Yoash R. Enzer, MDAssistant Clinical Professor, Warren Albert School of Medicine of Brown University, Rhode Island Hospital, Department of Surgery, Divi-sion of Ophthalmology, Providence, RI, USA

Melanie H. Erb, MDAssistant Clinical Professor, University of California at Irvine, Depart-ment of Ophthalmology, Irvine, CA, University of Southern California, Department of Ophthalmology, Los Angeles, CA, Eyesthetica Inc., Santa Monica, CA, USA

Robert G. Fante, MDClinical Associate Professor, University of Colorado, Departments of Ophthalmology and Otolaryngology, Denver, CO, USA

Jill A. Foster, MDAssociate Clinical Professor, The Ohio State University, The Eye Centerof Columbus, Department of Ophthalmology, Columbus, OH, USA

Raf Ghabrial, MBBS, FRANZCOSenior Lecturer, University of Sydney, Sydney Oculoplastic Surgery, Sydney, Australia

Geoffrey J. Gladstone, MDCo-director of Oculofacial Surgery, William Beaumont Hospital, Depart-ment of Ophthalmology, Southfield, MI, USAfi

Mark J. Glasgold, MDClinical Assistant Profesor, Robert Wood Johnson Medical School, Department of Surgery, Highland Park, NJ, USA

Robert A. Glasgold, MDClinical Assistant Professor, Robert Wood Johnson Medical School, Department of Surgery, Highland Park, NJ, USA

Herbert J. Glatt, MDUniversity of Tennessee Medical Center, Department of Surgery, Knox-ville, TN, USA

Russell S. Gonnering, MD, FACSClinical Professor, The Medical College of Wisconsin, Department of Ophthalmology, Brookfield, WI, USAfi

Contributors xxv

Andrea N. Hass, MDHass Plastic Surgery and Medispa, Palm Beach Gardens, FL, USA

Morris E. Hartstein, MD, FACSClinical Associate Professor, Saint Louis University, Department of Ophthalmology and Division of Plastic and Reconstructive Surgery, St. Louis, MO, USA

R. Jeffrey Hofmann, MDAssistant Clinical Professor, Brown University, Rhode Island Eye Insti-tute, Department of Ophthalmology, Providence, RI, USA

David E.E. Holck, MDChairman, Department of Ophthalmology, The University of Texas at San Antonio, Health Sciences Center, Director, Oculofacial Plastics and Orbital Service, Wilford Hall Medical Center, Department of Ophthal-mology, San Antonio, TX, USA

John B. Holds, MD, FACSClinical Professor, Saint Louis University, Departments of Ophthalmol-ogy and Otolaryngology-Head and Neck Surgery, St. Louis, MO, USA

Erin L. Holloman, MDPrivate Practice, Oklahoma City, OK, USA

David F. Horne, MDAssistant Clinical Professor, Cornell University, New York Presbyterian Hospital, Department of Dermatology, New York, NY, USA

Edsel Ing, MD, FRCSCAssistant Professor, University of Toronto, Toronto East General Hos-pital, Toronto, Ontario, Canada

Derek H. Jones, MDClinical Assistant Professor, David Geffen School of Medicine at UCLA, Department of Dermatology, Los Angeles, CA, USA

Kevin A. Kalwerisky, MDFellow, Oculofacial Plastic Surgery, The University of Texas at San Antonio, Health Sciences Center, Wilford Hall Medical Center, Depart-ment of Ophthalmology, San Antonio, TX, USA

Michael S. Kaminer, MDAssistant Professor, Yale Medical School, New Haven, CT, Dartmouth Medical School, Hanover, NH, Department of Dermatology, SkinCare Physicians of Chestnut Hill, Chestnut Hill, MA, USA

Andrew J. Kaufman, MD, FACPAssistant Clinical Professor, David Geffen School of Medicine at UCLA, Center for Dermatology Care, Los Angeles, CA, USA

xxvi Contributors

Jemshed A. Khan, MDClinical Professor, Kansas University School of Medicine, Kansas Uni-versity Medical Center, Department of Ophthalmology, Kansas City, MO, USA

Don O. Kikkawa, MDClinical Professor, Chief, Division of Oculofacial Plastic and Recon-structive Surgery, University of California, San Diego, Department of Ophthalmology, La Jolla, CA, USA

Bobby S. Korn, MD, PhDAssistant Professor, University of California, San Diego School of Medi-cine, Shiley Eye Center, Department of Ophthalmology, Division of Oculofacial Plastic & Reconstructive Surgery, La Jolla, CA, USA

Bradley T. Kovach, MDFlorida Coastal Dermatology Associates, Naples, FL, USA

Samuel M. Lam, MD, FACSFacial Plastic Surgeon, Lam Facial Plastics, Plano, TX, USA

Gustavo H. Leibaschoff, MDPresident, ICAM USA, Inc., Director, International School of Meso-therapy, Dallas, TX, USA

James Leong, MBBS, MMedClinical Associate Lecturer, University of Sydney, Sydney Eye Hospital, Sydney, Australia

Peter S. Levin, MDClinical Adjuvant Professor, Stanford University School of Medicine, Department of Ophthalmology, Mountain View, CA, USA

Don Liu, MDProfessor, University of Missouri, Department of Ophthalmology, Columbia, MO, USA

Manuel A. Lopez, MDDirector, Facial Plastics Service, The University of Texas at San Antonio, Health Sciences Center, Wilford Hall Medical Center, Department of Otolaryngology, San Antonio, TX, USA

Mark J. Lucarelli, MDAssociate Professor, University of Wisconsin, Director, OculoplasticsService, Department of Ophthalmology and Visual Sciences, Madison, WI, USA

William P. Mack, MDClinical Assistant Professor, University of South Florida, Department of Ophthalmology, Tampa, FL, USA

Contributors xxvii

Geva Mannor, MD, MPHHead, Oculoplastic Surgery, SCRIPPS Clinic, Department of Ophthal-mology, La Jolla, CA, USA

Guy G. Massry, MDDirector, Ophthalmic Plastic and Reconstructive Surgery, AmericanEye Institute, Cedars Sinai Medical Center, Los Angeles, CA, Spalding Dr. Cosmetic Surgery and Dermatology, Beverly Hills, CA, Davidorf Eye Group, West Hills, CA, USA

Seth L. Matarasso, MDClinical Profesor, University of California, San Francisco, Department of Dermatology, San Francisco, CA, USA

Joseph A. Mauriello Jr., MDOphthalmic Plastic and Reconstructive Surgeon, University of Medicineand Dentistry of New Jersey, Summit, NJ, USA

Robert A. Mazzoli, MD, FACSConsultant in Ophthalmology to the Surgeon General, Director, Ophthalmic Plastic, Reconstructive and Orbital Surgery, AssociateProfessor, Uniformed Services University of the Health Sciences, Bethesda, MD, Madigan Army Medical Center, Tacoma, WA, USA

John D. McCann, MD, PhDMedical Director, The Center for Facial Appearances, Salt Lake City, UT, USA

Clinton D. McCord, Jr., MDAssociate Clinical Professor, Emory University School of Medicine, Paces Plastic Surgery and Recovery Center, Atlanta, GA, USA

Michael E. Migliori, MD, FACSClinical Associate Professor, The Warren Alpert School of Medicine at Brown University, Rhode Island Hospital, Department of Ophthalmol-ogy, Providence, RI, USA

Yasaman Mohadjer, MDWashington University in St. Louis, Department of Ophthalmology andVisual Sciences, St. Louis, MO, USA

Brent R. Moody, MDAssistant Professor, Vanderbilt University, Department of Dermatol-ogy, Nashville, TN, USA

Asa D. Morton, III, MDDirector, Ophthalmic and Facial Plastic Surgery, Eye Care Center of San Diego, San Diego, CA, USA

xxviii Contributors

Shoib Myint, DO, FAACS, FACOOphthalmic and Facial Plastic Surgeon, Co-director, Beaumont EyeInstitute, William Beaumont Hospital, Department of Ophthalmology, Southfield, MI, USAfi

Paul S. Nassif, MD, FACSSpalding Drive Cosmetic Surgery & Dermatology, Beverly Hills, CA, USA

Frank A. Nesi, MDAssociate Clinical Professor, Kresge Eye Institute, Wayne State University School of Medicine, William Beaumont Hospital, Department of Ophthalmology and Otolaryngology, Royal Oak, MI, USA

Russell W. Neuhaus, MDOphthalmic Plastic and Reconstructive Surgeon, Texas OculoplasticConsultants, Austin, TX, USA

Joseph Niamtu, III, DMDPrivate Practice, Cosmetic Facial Surgery, Richmond, VA, USA

John Pak, MD, PhDOculoplastic Surgeon, Wheaton Eye Clinic, Department of Ophthalmol-ogy, Wheaton, IL, USA

Allen M. Putterman, MDProfessor of Ophthalmology, Co-Director, Oculofacial Plastic Surgery, University of Illinois School of Medicine, Michael Reese Hospital andMedical Center, Chicago, IL, USA

Oscar M. Ramirez, MD, FACSClinical Assistant Professor, The John’s Hopkins University School of Medicine, Baltimore, MD, Esthetique Internationale, Timonium, MD, USA

Camilo O. Reyes, MDClinical Fellow, Esthetique Internationale, Timonium, MD, USA

O. Bailey Robertson, DDSDirector, Facial Plastics Services, Wilford Hall Medical Center, Department of Oral and Maxillofacial Surgery, San Antonio, TX, USA

Thomas E. Rohrer, MDSkinCare Physicians of Chestnut Hill, Chestnut Hill, MA, USA

Elizabeth F. Rostan, MDPrivate Practice, Dermatology and Cosmetic Surgery Center of Char-lotte, Charlotte, NC, USA

Contributors xxix

Vivian Schiedler, MDOculoplastics and Orbital Consultants, Charlottesville, VA, USA

Stuart R. Seiff, MDEmeritus Professor, University of California, San Francisco, Chief, San Francisco General Hospital, Department of Ophthalmology, San Francisco, CA, USA

Todd R. Shepler, MDOphthalmic Plastic and Reconstructive Surgeon, Texas Oculoplastic Consultants, Austin, TX, USA

John W. Shore, MDOphthalmic Plastic and Reconstructive Surgeon, Texas Oculoplastic Consultants, Austin, TX, USA

John D. Siddens, DOOphthalmic Plastic Surgery Clinical Instructor, University of South Car-olina School of Medicine, Department of Ophthalmology, Columbia, SC, USA

Rona Z. Silkiss, MDChief, Division of Ophthalmic Plastic Reconstructive and Orbital Surgery, California Pacifi c Medical Center, Department of Ophthalmol-fiogy, San Francisco, CA, USA

Guy Ben Simon, MDTel Aviv University, Goldschleger Eye Institute, Department of Oph-thalmology, Ramat Gan, Israel

David J. Singer, MD, FACSAssociate Clinical Professor, University of Miami School of Medicine, Anne Bates Leach Eye Hospital of Bascom Palmer Eye Institute, Department of Ophthalmology, Miami, FL, Aspen Valley Hospital, Aspen, CO, USA

Bryan S. Sires, MD, PhDAllure Laser Center and Medispa, Kirkland, WA, USA

Charles B. Slonim, MD, FACSClinical Professor, University of South Florida College of Medicine, Department of Ophthalmology, Tampa, FL, USA

Eric A. Steele, MDAssistant Professor, Oregon Health & Sciences University, Department of Oculofacial Plastic and Reconstructive Surgery, Portland, OR, USA

William L. Walter, MDEmeritus Staff, Washington University Medical Department, BarnesHospital, Private Practice, St. Louis Eye Clinic, St. Louis, MO, USA

xxx Contributors

John J. Woog, MDProfessor, Mayo Clinic, Department of Ophthalmology, Rochester, MN, USA

Michael T. Yen, MDAssociate Professor, Baylor College of Medicine, Department of Oph-thalmology, Houston, TX, USA

Contributors xxxi