Facial Volumization: An Anatomic Approach

99 Pages·2017·6.78 MB·English

by  Jerome Paul Lamb

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Facial Volumization
An Anatomic Approach
Jerome Paul Lamb, MD, FACS
Plastic Surgeon Diplomate of the American Board of Plastic Surgery, Inc.
Centerpoint Medical Center, Truman Medical Center
Independence, Missouri, United States
Christopher Chase Surek, DO
Chief Resident
Department of Plastic Surgery
University of Kansas Medical Center
Overland Park, Kansas, United States
58 illustrations
Thieme
New York • Stuttgart • Delhi • Rio de Janeiro
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Library of Congress Cataloging-in-Publication Data
Names: Lamb, Jerome Paul, editor. | Surek, Christopher Chase,
editor.
Title: Facial volumization: an anatomic approach/[edited by]
Jerome Paul Lamb, MD, FACS, Plastic Surgeon Diplomate,
American Board of Plastic Surgery, Inc., Centerpoint Medical
Center, Truman Medical Center, Independence, Missouri,
United States, Christopher Chase Surek, MD, Chief Resident,
Department of Plastic Surgery, University of Kansas Medical
Center, Overland Park, Kansas, United States.
Description: New York: Thieme, [2017]
Identifiers: LCCN 2017021388| ISBN 9781626236943 (print) |
ISBN 9781626238640 (e-book)
Subjects: LCSH: Face--Surgery. | Surgery, Plastic.
Classification: LCC RD119.5.F33 F35 2017 | DDC 617.5/2059-
-dc23 LC record available at https://lccn.loc.gov/2017021388
Copyright © 2018 by Thieme Medical Publishers, Inc.
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Printed in China by Everbest Printing Ltd
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ISBN 978-1-62623-694-3
Also available as an e-book:
eISBN 978-1-62623-864-0
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preparation of microfilms, and electronic data processing and storage.
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This book is dedicated to those colleagues who have encouraged and mentored me along the way.
Most notably, I thank Glenn Jelks, Bryan Mendelson, and Val Lambros, who saw the value of
our preliminary research and encouraged us to publish. During my formative years, it was Don
Kaminski, George Block, and Gus Colon who provided that guidance and support in medical
school, general surgery, and plastic surgery residency that has graced my life. Lastly, this book is
dedicated to my wife Carri, my son Jake, and my daughter Madi, who have given up time with
me that will never be able to be returned in order for me to fulfill a dream.
Jerome Paul Lamb
I dedicate this book to those who have loved, supported, and inspired me. I want to thank my
education mentors who have set great examples for me to follow. My true companion Krystle
Surek, thank you for your patience during this process and for understanding my passion for this
field. To Sharon Surek and Christopher L. Surek who raised me to chase my dreams and
embodied the values of humility and unconditional love. To my grandfather Richard Weber who
showed me that life is what you make of it and that giving up is never an option. Lastly, to our
patients of past, present, and future—they are the instruments by which we are measured, and it
is my sincere hope that this body of work will translate into renewed happiness and joy in their
lives.
Christopher Chase Surek
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Contents
Video Contents
Foreword
Preface
Contributors
1 The Midface
Jerome Paul Lamb and Christopher Chase Surek
2 The Lymphatic Anatomy of the Lower Eyelid and the Malar Region of the Face
Sajna Shoukath and Mark Winter Ashton
3 The Perioral Area, the Chin, and the Jowl
Jerome Paul Lamb, Christopher Chase Surek, and James D. Vargo
4 The Temple and the Brow
Jerome Paul Lamb and Christopher Chase Surek
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Video Contents
1 The Midface
Video 1.1 Pneumatization of the Deep Pyriform Space
Video 1.2 Mid-Face Augmentation
Video 1.3 Vascular Anatomy of the Face
Video 1.4 Deep Pyriform Space Approach to the Tear Trough
Video 1.5 DeMaio V1 and V2
3 The Perioral Area, the Chin, and the Jowl
Video 3.1 The Nasolabial Fold and the Marionette Lines
Video 3.2 Nasolabial Folds with Cannula and Deep Pyriform Space Injection
Video 3.3 Anesthesia
Video 3.4 Building a Fuller Upper Lip: The Retro-Orbicularis Oris Fat Compartment
Video 3.5 Crosshatching
Video 3.6 White Roll and Philtrum
Video 3.7 Sealing Off the Commissure
Video 3.8 Red Lip Enhancement
Video 3.9 Augmentation of the Aging Orbicularis Oris Muscle
Video 3.10 Restoring the Lower Lip White Roll
Video 3.11 Lower Lip Enhancement
Video 3.12 The Pre-Jowl
4 The Temple and the Brow
Video 4.1 Lateral Temporal–Cheek Fat Compartment Volumization
Video 4.2 Upper Brow Volumization
Video 4.3 Swift: One Up and One Over
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Foreword
As a young plastic surgeon, I remember well how the interior of the face looked like a
mysterious and dangerous territory where everything looked like everything else and only
obedience to the empirical ritual of the facelift operation let me feel secure. In time,
increasingly subtle changes of anatomy became old friends while passing them in surgery. I
contemplated the retaining ligaments of the face—thin and weak individually, but very
powerful in aggregate. Further along I began to understand how the anatomy contributed
to both the look of the face and how such an understanding could be a tool to
comprehending the older face and better ways to rehabilitate it. Knowledge is power.
In replacing or adding volume to the aging face subtleties of placement went from being
ignored to being obvious. At first one is happy that an area can be filled at all. In time,
one's powers of observation and discrimination increase to the point that earlier attempts
look crude and artless and one sees and strives for more graceful and less exaggerated
results.
Almost all aesthetic modifications of the face are based on anatomy, the details of which
are usually the last consideration of the aesthetic practitioner. Facelifts were done for
approximately 6 decades before the anatomy of the facial nerve was understood. The first
several years of filler use was for the most part filling wrinkles. Injectors had very little
understanding of the relationship of location and depth of placement to results until about
a decade after their introduction when finally a more balanced and volumetric use of fillers
was established. Cosmetic lasers were accepted very quickly before the occurrence of late
depigmentation was appreciated. One might conclude that early commercial adoption of a
technique precludes thoughtful study of its underlying science.
Things have changed: we have now grown into increased wisdom of many aspects of the
face. The study of facial anatomy has blossomed in the last few years; with more attention
being paid to areas of perceptual interest, the structures that define faces of different ages
can be seen to have altered in knowable ways, not mysterious and arbitrary ones.
Drs. Lamb and Surek have given us a remarkable volume of facial anatomy, compiling
information from other authors but also including extensive clean dissections and
descriptions of their own. The greatest of explanatory tools, the diagrams, are particularly
valuable as they are concise and correct and address the clinician's concerns. Anatomic
phenomena of the face, hollows, ripples, mounds, and others are revealed to have their
origins deep in the face in ways that are not intuitive. Treatments can be made more
rationally with such understandings and many are included in this volume. Knowledge is
power. This book is a major step forward in understanding not only the dry anatomy of the
face, but how it works and how it can be modified for the good. Any student of the face
will be well advised to study the topic and this book in particular.
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