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loss of soft tissue volume and laxity of the overlying skin. Volumetric augmentation is a key component of facial rejuvenation
surgery, and should be considered of equal importance to soft tissue lifting. Augmentation can be accomplished
with synthetic fillers, autologous grafts, soft tissue repositioning techniques, and/or alloplastic implants. Only alloplastic
implants, however, provide truly long-term volumetric correction. To date, there have been no large series dealing with
the complications and results of implantation performed concurrently with rhytidectomy, which we have termed “volumetric
rhytidectomy.” We present our experience with 100 patients treated with a combination of malar and chin implants
and rhytidectomy, compared to 200 patients who underwent rhytidectomy alone.
Methods: The authors performed a retrospective review of patients treated with a combination of silicone malar and
chin augmentation with rhytidectomy versus patients treated with rhytidectomy alone. Both groups of patients underwent
close postoperative evaluation at 3 days, 1 week, 2 weeks, and 1 month. All patients were surveyed at 6 months to assess
aesthetic satisfaction. Complication rates were noted and tabulated. Statistical analysis was performed to evaluate for any
differences in the two groups.
Results: Between 2002 and 2006, 100 patients underwent malar and chin implantation along with rhytidectomy; 200 patients
underwent rhytidectomy alone. In the first group, there were a total of 6 cases in which implant removal was necessary,
and 2 cases in which revision was required. There were no statistically significant differences (p < 0.05) observed
between the two groups with respect to major or minor hematoma, seroma, infection, sensory nerve injury, facial nerve
injury, hypertrophic scarring, dehiscence, skin sloughing, or revision.
Conclusions: Volumetric rhytidectomy reliably augments the malar and mental areas, allows for subtle skeletal contouring,
and results in successful rejuvenation. Rhytidectomy is relatively safe to perform concurrently with silicone augmentation,
and does not result in an increased complication rate as compared to rhytidectomy alone. (Ann Otol Rhinol Laryngol 2010;119:174-180.) |