239

AAbscess

as bacteremia risk factor, 64soft tissue fi llers-related, 199–200, 202stitch, 143wound infection-related, 53–54

Acneas hypertrophic scarring and keloid

cause, 87, 89skin resurfacing-related, 169, 170, 190treatment of, 72, 175, 176, 177

Acquired immunodefi ciency syndrome (AIDS), 47–48

Ala, free margin distortion on, 102–104, 105, 107–108

Alcohol, as antimicrobial agent, 141Alcohol use

effect on surgical outcomes, 6as facelift-related complications risk

factor, 224perioperative discontinuation of, 6, 38as wound infection risk factor, 47

Allergic reactionsto alcohol, 141anaphylaxis, 12–13to collagen injections, 199–200, 201to latex, 13, 14to lidocaine, 14to soft tissue fi llers, 203to sutures, 144

Allergy history, 4Alopecia, facelift-related, 232, 233Alzheimer’s disease, 4American Heart Association, 9, 11, 15,

68–73American Red Cross, 9American Stroke Association, 155-Aminolevulinic acid, 176–177Amoxicillin, 67Anaphylactoid reactions, 12Anaphylaxis, 10, 12–13, 139, 221

Anesthesia, 10nerve injury-related, 30, 33tumescent, 225–226, 227, 230

Angiogenesis, 78Antibiotic prophylaxis, 62–76

in ablative laser skin resurfacing patients, 171

for bacterial endocarditis, 62, 68–73, 74

intraincisional, 65for wound infections, 47, 54, 55, 62–68,

74Antibiotics

allergic reactions to, 12, 14as hemorrhage cause, 5topical

adverse effects of, 65, 141, 142, 170for surgical site infection

prophylaxis, 64–65Anticoagulants, 36–37, 38–39

effect on wound healing, 79as facelift-related complications risk

factor, 224as hemorrhage risk factor, 79, 193–194

Antiplatelet agents, 36–37, 38–39discontinuation prior to face-lifting

procedures, 224effect on wound healing, 79as hemorrhage risk factor, 79, 193–194

Antithrombotic agents, 36–37Antiviral prophylaxis

for herpes simplex virus infections, 170, 171

in laser skin resurfacing patients, 64Anxiety/anxiety disorders, in patients,

13, 14, 162in cosmetic surgery patients, 158–159as hypertension cause, 40

Anxiolytics, drug interactions of, 6Aquamid, 204Artefi ll/Artecoll, 202–203

Asepsis, in surgical site preparation, 52–53

Aspirin, 11discontinuation prior to facelifting

procedures, 224effect on wound healing, 79as hemorrhage risk factor, 36–38, 79

Autologen, 201Axonotmesis, 21

BBacitracin, 64, 65, 141, 142Bacteremia, 64, 68–69

antibiotic prophylaxis for, 69–70, 71–73

occult, 53Bacterial infections, laser skin

resurfacing-related, 170, 171Basal cell carcinoma, 104, 108, 112, 147Basal cell nevus syndrome, 113–114Benzalkonium chloride, 139Beta-adrenergic agents, as anaphylaxis

treatment, 13Bleaching agents, 172, 176Bleeding disorders

as perioperative hemorrhage cause, 36, 38

preoperative evaluation of, 7, 224–225Bleomycin, intralesional, 92Blepharoplasty, 109, 187Blood thinners, as purpura risk factor,

218Body dysmorphic disorder, 159–162,

163–164Botulinum toxin injections, 207–212

action mechanisms of, 207complications of, 23, 207–211

prevention of, 208–209treatment of, 209–211

contraindications to, 209as nerve injury treatment, 35

Index

240 Index

Broken line techniques, for scar revision, 121, 123–126

Buccal nerveinjuries to, 24–26, 33–35, 228, 229location of, 24–25

Burns/burn scars, 87, 88, 92electrocoagulation-related, 227treatment of, 64, 65, 92, 119

CCalcium hydroxylapatite microspheres,

205Cancer, as wound infection risk factor,

47Candidiasis, 57–58, 171Cardiovascular system, preoperative

evaluation of, 6–7Cautery, excessive use of, 79Celecoxib, 37Cellulitis, 58, 59, 197Centers for Disease Control and

Prevention (CDC), 62, 64, 66, 82–83

Central nervous system disorders, preoperative evaluation of, 6

Cervical nerveanatomy of, 22–23, 31, 32injuries to, 31–33

Chemical peels, 64, 184–185Chlorhexidine, 52–53, 62, 63

as anaphylaxis cause, 12–13as dermatitis cause, 139–140

Chlorohexylenol, 52Clindamycin, 67, 71

intraincisional, 65Clopidogrel, 36, 37–38Clostridial infections, 49, 58Coagulopathy. See also Bleeding

disordersdrug-induced, 36–39

Collagen, role in wound healing, 77, 78Collagen-based soft tissue fi llers, 199–201Corticosteroids, effects on wound

healing, 47, 79Cosmetic surgery patients

preoperative cosmetic consultations with, 156

preoperative psychiatric consultations with, 156–158

psychological complications and comorbidities in, 4, 155–166

Cosmoderm, 200–201Cosmoplast, 200–201“Crash carts,” 11Cryotherapy, 90–91, 118, 120, 149–150Cultures, bacterial, 52, 54Curettage, as pigmentary change cause,

149Cyclooxygenase-2 inhibitors, 37Cymetra, 201

DDebulking, surgical, for scar revision,

121, 133, 134, 135–136, 219Defi brillation, as ventricular fi brillation

treatment, 9, 10, 11Defi brillators

automatic external, 11–12implanted, 15–17

Dehiscence, of wounds, 53, 77–81management of, 81prevention of, 82–83risk factors for, 6, 78–79

Dementia, 4Depression

in cosmetic surgery patients, 159, 162–163

evaluation of, 157Dermabrasion, 121, 122, 184, 185–190Dermadeep, 204Dermatitis

allergic contact, 139, 144differentiated from wound

infections, 48–49facelift-related, 232–233skin resurfacing procedures-related,

169, 170, 189topical antibiotics-related, 65

atopic, as endocarditis risk factor, 72

contact, 139–142topical antibiotics-related, 83

eczematous, 131erosive pustular, 145immediate contact, 139irritant contact, 139, 140

differentiated from wound infections, 48–49

facelift-related, 232–233laser skin resurfacing-related, 169,

170Dermative, 204Dermatographism, 218Dermologen, 201Dextrose 50% solution, 11Diabetes mellitus

as wound dehiscence risk factor, 78–79

as wound infection risk factor, 8, 47Diabetic patients

preoperative evaluation of, 8wound healing in, 78–79, 82

Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), 159, 161

Diastasis recti, 194, 195Diazepam, 11, 15Dietary supplements. See also Herbal

supplementsas hemorrhage risk factor, 5

Diphenylhydramine, 11, 14

Diplopia, botulinum toxin injection-related, 209, 210

Dipyridamole, 36, 37–38“Doctor shopping,” 162“Dog ears,” 102Down’s syndrome, 40–41Drainage, of infected wounds, 53–54,

64Drains, for hemorrhage/hematoma

management, 40, 197Drugs. See also names of specifi c drugs

effects on wound healing, 79Dysesthesia, radiofrequency-related,

177, 178

EEar piercing, 87, 89Ear shape, facelift-related alteration of,

234Ear wound infections, 50–51, 65, 68Ecchymoses, 41, 42, 197, 209, 210Eclabium, 100, 111, 113Ecnasion, 104, 108Ectropion, of the eyelids, 33–34, 110,

173defi nition of, 104differentiated from eyelid retraction,

104Edema, 145–146

chemical peel-related, 185effect on wound healing, 78, 79laser therapy-related, 168, 169,

175–176liposuction-related, 197sclerotherapy-related, 218

Ehlers-Danlos syndrome, 40–41Elastosis, dermal, ablative laser repair

of, 167–168Electrocoagulation, 16

as burn cause, 227for intraoperative hemorrhage

control, 40, 226Electrodessication, 16

for intraoperative hemorrhage control, 40

as nerve injury treatment, 35as pigmentary change cause, 149

Electrofulguration, 16, 40Electrosurgery, in patients with

pacemakers/defi brillators, 15–17Emergencies, in the dermatology offi ce,

9–20emergency plan for, 9–12equipment for, 11–12types of, 12–17

Emergency medical services (EMS), 9, 13, 15

Endocarditiscausal agents of, 60prophylaxis for, 62, 68–73, 74

Index 241

Endocrine disorders, preoperative evaluation of, 8

Enterococcus infections, 66, 67, 68–69

vancomycin-resistant, 51Ephedra, as perioperative hemorrhage

cause, 36, 37Epidermolysis bullosa, as milia cause,

145Epinephrine, 8, 11, 13Erythema

ablative laser skin resurfacing-related, 168, 169, 170, 172, 173

chemical peel-related, 185, 187dermabrasion-related, 184, 187–188keloid-related, 87nonablative laser skin remodeling-

related, 174, 175–176radiofrequency-related, 177, 178scarring-related, 87, 115, 173sclerotherapy-related, 218soft tissue fi llers-related, 199, 200, 201,

202Erythema ab igne, 196Erythromycin, 67Erythromycin sterate, as contact allergy

cause, 141Erythromycin sulfate, as contact allergy

cause, 141Escherichia coli infections, 66, 67Estrogen, 217Ethyl alcohol, 63Exercise, as anaphylaxis cause, 12Extravasation, of sclerosing agents,

219–221Eyebrows

cocked, 210, 211ptosis of, 209, 211

Eyelidsectropion of. See Ectropionfree margin distortion of, 104,

109–111, 112lymphedema of, 145–146ptosis of, 209, 210retraction of

differentiated from eyelid ectropion, 104

postoperative transient, 95–96Eye surgery, as edema cause, 145–146

FFace

asymmetry ofbotulinum toxin injection-related,

210facelift-related, 234–235

free margin distortion on, 95–114Facelifting procedures, 224–237

complications of, 225–235contour irregularities, 226–227

facial asymmetry and premature sagging, 234–235

intraoperative, 225–229postoperative, 229–234

operative phase of, 225preoperative phase of, 224–225

Facial artery, palpation of, 27Facial nerves. See also specifi c facial

nervesmotor nerve anatomy and injuries,

22–28sensory nerve anatomy and injuries,

28–31Facial surgery, as edema cause, 146Fascian, 201Fasciitis, necrotizing, 54–55, 58, 59,

197–198Fat grafting, autologous, 196, 197Fibrinolytic disorders, as perioperative

hemorrhage cause, 36, 38Flaps. See Skin fl apsFluids

extracellular, complications of, 145–147intravascular, administration during

liposuction, 1925-Fluorouracil, 92, 118, 119, 120Freckles, removal of, 187Free margins

distortion of, 95–114regional considerations in, 102–113revision techniques for, 100–102self-correction of, 96

perioperative considerations regarding, 95–96

second intention healing of, 96–99, 100

Fungal infections, ablative laser skin resurfacing-related, 170, 171

Fusiform ellipse, 100

GGangrene

gas, 58, 59hemolytic streptococcal. See Fasciitis,

necrotizingGeneral anesthesia, liposuction under,

192–193Genodermatodoses, 36, 37–38Geometric broken lines (GBL), 121,

123, 124, 125–126Glabella, collagen injection-related

necrosis in, 200Glycerin, chromated, 216, 218, 220Grafts. See Skin graftsGranulation tissue, excessive, 144–145Granulomas, soft tissue fi ller-related,

199, 202, 203, 204Great auricular nerve

anatomy of, 28, 32injuries to, 31–33, 228

HHair removal, from surgical sites, 47, 48,

62Head. See also Face

anatomic “danger zones” of, 22, 23–33

Hematomas, 36, 40, 42–44, 193–194differentiated from wound infections,

48, 49effect on wound healing, 78, 79expanding, 43–44, 197

facelift-related, 230as necrosis cause, 80

facelift-related, 225–226, 229–230, 231

small, indolent, 43soft tissue fi llers-related, 202symptoms of, 48as wound dehiscence cause, 79, 81

Hemodialysis patients, 7Hemorrhagic complications, 36–45. See

also Hematomas; Hemostasiscauses of, 5, 6, 36–41, 225–226types of, 41–44

Hemosiderin, 215, 216–217Hemostasis

inadequate intraoperative, 36, 39–40in wound healing, 77

Hepatic function, preoperative evaluation of, 7

Herbal supplementsas contact dermatitis cause, 170as hemorrhage cause, 5, 36, 37, 39, 41,

193–194Hernias, in liposuction patients, 194Herpes simplex virus infections, 58, 101,

169, 170–171Herpes virus infections, 174, 183–184,

188–189Hexachlorophene, 139Human immunodefi ciency virus (HIV)

infections, 47–48, 204–205Hyaluronic acid fi llers, 201–202Hyperemia, skin resurfacing-related,

187–188Hyperpigmentation

liposuction-related, 197postoperative, 149, 150sclerotherapy-related, 213–217skin remodeling-related, 174, 175, 176skin resurfacing-related, 168, 169,

171–172, 185–187soft tissue fi llers-related, 202

Hypersensitivity reactions. See also Allergic reactions

to bovine collagen injections, 199–200, 201

delayed-type, 202Hypertension, 7, 36, 37, 78–79Hypochondriasis, 159

242 Index

Hypopigmentationcryotherapy-related, 91dermabrasion-related, 121, 122postoperative, 149–150skin resurfacing-related, 169, 172–173,

187, 189Hypoxia, smoking-related, 6

IImiquimod, 92Immunosuppression, as wound infection

risk factor, 46–47Immunosuppressive drugs, effect on

wound healing, 6Impetigo, 183, 184Implanted cardiac devices (ICD), 7,

16–17Incisions, surgical

as hypertrophic scaring and keloid cause, 87, 89

as pigmentary change cause, 149Infections. See also Wound infections

botulinum toxin injection-related, 211

facelift-related, 230–231liposuction-related, 197–198skin resurfacing-related, 169, 170–171,

188–189as wound dehiscence risk factor, 79

Informed consent, 183Infraorbital defects, 96, 109, 111Infraorbital nerve

anatomy of, 28injuries to, 30

Insect bites, 87Insight, lack of, 4Interferon therapy, for scars, 91, 117,

119International normalized ratio (INR),

39Iodophors, 52, 62, 63

adverse reactions to, 140–141Ischemic heart disease, as mortality

cause, 9Isopropyl alcohol, 52, 53Isotretinoin, 184, 187

JJudgment

evaluation of, 157lack of, 4

KKeloids, 115, 116, 118

burn-related, 92comparison with hypertrophic scars,

87, 88facelift-related, 232–234as facelift-related complications risk

factor, 224

isotretinoin-related, 184prevention of, 87, 89, 90, 116, 232–234as pruritus cause, 148recurrence of, 119treatment of, 87–94, 116, 120, 232–234

Keloid surgery, as hematoma cause, 43Kenalog, 120, 184, 226Klebsiella infections, 67

LLacerations, as scar and keloid cause, 87,

88Laser therapy, 167–182

ablativefor scar revision, 121, 123, 124for skin resurfacing, 167–173,

178–179for hyperpigmentation, 216–217for hypopigmentation, 187for keloids, 91nonablative

for scar revision, 120–121for skin remodeling, 174–176, 178

as pigmentary change cause, 150preoperative patient evaluation for,

167for scars, 91, 118, 120–121, 173side effects of, 91technical basis for, 167

Latex allergy, 13, 14Lentigines, 167–168, 187Lidocaine

allergic reactions to, 12, 14hepatic dysfunction and, 7intraincisional, 65toxicity of, 193use in liposuction patients, 193, 194

Linezolid, 56Lip

free margin distortion on, 95, 111–113soft tissue fi ller injections into,

201–202, 203Lipoatrophy, 204–205Liposuction, 192–198

in combination with facelifting procedures, 224, 226, 227, 229

under general anesthesia, 192–193under local anesthesia, 192, 193tumescent

as infection cause, 197–198local complications of, 195–197preoperative assessment for,

193–195ultrasonic, 193

Liver disease, 7Local anesthesia, use in liposuction

patients, 192, 193Local anesthetic injections, patients’

tolerance to, 147Lorazepam, 11, 15

MMalnutrition, as wound infection risk

factor, 47Mandibular nerve, marginal

injuries to, 26–28, 33–34, 228–229location of, 228

Mania, evaluation of, 157Manic-depressive disorders, 162Marfan’s syndrome, 40–41Massage therapy, for scars, 117, 118–119Medical and surgical histories, 4–8Melanocytes, cold sensitivity of, 149Mental nerve

anatomy of, 28, 30–31injuries to, 31

Mental status examinations, 157Microscopic epidermal necrotic debris

(MEND), 178–179Milia, 145, 169, 170, 189–190Minnesota Multiphasic Personality

Inventory, 155Mitral valve prolapse, 69Mohs’ micrographic surgery

as alar crease defect cause, 108as ear wound infection cause, 50–51,

68endocarditis prophylaxis in, 71, 72free margin distortion associated with,

99as herpes simplex virus infection risk

factor, 58infection rate in, 64intraincisional antibiotic prophylaxis

for, 65as nerve injury cause, 24, 26, 229in patients with implantable cardiac

devices, 17preoperative questionnaire for, 5

Molecular mimicry, 201Mood, evaluation of, 157Mupirocin, 64

as contact allergy cause, 141intranasal application of, 66

Muscle twitching, botulinum toxin injection-related, 211

Mycobacterial infections, 57, 197, 198, 230

Myonecrosis, clostridial, 58, 59

NNares, Staphylococcus aureus

colonization of, 66Nasal tip, ptosis of, 96Nasal valve, compromise of, 148–149Neck

anatomic “danger zones” of, 22, 23–33excessive liposuction of, 196, 197

Necrosis, cutaneous tissuecollagen injection-related, 200defi nition of, 81

Index 243

differentiated from dehiscence, 80prevention of, 82–83sclerotherapy-related, 219–221smoking-related, 6of surgical wounds, 53, 80, 81–82treatment of, 81–82

Neomycin, as contact allergy cause, 141, 142

Neomycin sulfate, 64–65Nerve injuries, 21–35. See also specifi c

nervesin anatomic “danger zones,” 22, 23–33facelift-related, 227–229management of, 33–35

Neurofi bromatosis, 15Neuromas, 147, 234Neuropraxia, 21Neurosurgery, complications of, 147–148Neurotmesis, 21Nitroglycerin tablets, 11Nonsteroidal anti-infl ammatory drugs,

38discontinuation prior to facelifting

procedures, 224effect on wound healing, 79as hemorrhage risk factor, 5, 36, 37,

38, 39, 79as purpura risk factor, 218

Nose, free margin distortion on, 95, 96, 97, 98, 99, 102–104, 105–108

OObsessive-compulsive disorder, 159, 161,

162Organ transplant patients, 7Orientation, to person, time, and place,

3–4, 156–157Osteoporosis, 148

PPain

botulinum toxin injections-related, 208postoperative, 82, 147–148

facelift-related, 234scarring-related, 115, 118

sclerotherapy-related, 218Para-aminobenzoic acid (PABA), 14Paraesthesia, liposuction-related, 197Paranoia, in cosmetic surgery patients,

159Patent foramen ovale, 221Penicillin, allergic reactions to, 54, 65, 71Personality, types of, 159Petrolatum

as alternative to antibiotic ointment, 142

effect on wound healing, 83as postoperative wound dressing, 64,

81, 169use in scar massage therapy, 118

Phenol, as chemical peel agent, 187, 190Phlebology, 213Photodamage, ablative laser repair of,

167–168Photodynamic therapy, short-contact,

176–177Photographs, as preoperative

documentation, 183Photorejuvenation

with laser therapy, 175with short-contact photodynamic

therapy, 177Photothermolysis, fractional, 178–179Phototoxic reactions, 177Physical examination, preoperative, 8Pigmentation. See also

Hyperpigmentation; Hypopigmentation

postoperative changes in, 149–150“Pixie ear” deformity, 234Polidocanol, 214, 216, 218, 220Polyacrylamide gels, 204Poly-L-lactic acid, 204–205Poly(methy methacrylate) microspheres,

202–203Polymyxin B, 64, 141Pores, enlarged, 189, 190Porphyria, as milia cause, 145Posttraumatic stress disorder, 162Povidone-iodine, 140Preoperative evaluation, 3–8Pressure, for intraoperative hemorrhage

control, 226Pressure dressings, for hemorrhage/

hematoma control, 40, 197Pressure therapy, for keloids and

hypertrophic scars, 90, 117, 118–119

Prodigiosin, 51Propionibacterium infections, 50Prosthetic joint infections, prophylaxis

for, 68, 73Prosthetic valves, endocarditis of, 68, 69Proteus, 67Protoporphyrin IX, 176–177“Proud fl esh,” 144–145Pruritus

keloid-related, 87postoperative, 115scar-related, 118, 148skin resurfacing-related, 169, 170, 171,

189Pseudomonas infections, 51, 64–65,

67–68, 171, 188Psychological profi les, of patients, 3–4Psychotherapy, 163–164Ptosis, 96, 209, 210Pulmonary system, preoperative

evaluation of, 7Purpura, sclerotherapy-related, 218, 219

RRadiation therapy, for keloids and

hypertophic scars, 91, 118, 120Radiofrequency treatment, nonablative,

177–178Refl ex sympathetic dystrophy, 147–148Renal function, preoperative evaluation

of, 7Resurfacing procedures. See also

Chemical peels; Dermabrasionas herpes simplex virus infection risk

factor, 58laser-based, 167–173

ablative, 167–173, 178antibiotic prophylaxis for, 64as fractional photothermolysis,

178–179nonablative, 178

as pigmentary change cause, 150preoperative consultations for,

183–184Retinoids, effect on wound healing, 6Rhytidectomy

complications of, 225, 228, 230, 232as nerve injury treatment, 35

Rhytideslaser therapy for, 167–168, 175lateral orbital, 209

Rosacea, 148

SSaline, hypertonic, as sclerosing agent,

214, 218, 220“Saturday night palsy,” 21Scalp, erosive pustular dermatitis of, 145Scalpel sculpting, of scars, 133, 136–137Scars

ablative laser skin resurfacing-related, 169

atrophic, 175, 176evaluation of, 115, 116–117excision of, 121, 133hematoma-related, 42hypertrophic, 115, 116, 118

comparison with keloids, 87, 88facelift-related, 232–234isotretinoin-related, 184liposuction-related, 197prevention of, 116, 119, 232–234revision of, 119skin fl ap sloughing-related, 231skin resurfacing-related, 169, 173,

187–188treatment of, 87–94, 116, 119, 121,

134, 232–234pigmentary changes in, 149–150preoperative evaluation of, 8revision and camoufl age of, 115–138

of hypertrophic scars, 87–94, 116, 119, 121, 134, 232–324

244 Index

Scars (cont.)nonsurgical options for, 115,

117–121surgical options for, 121–137

suture-related, 143–144Scar tissue, postoperative pain in, 147Schizophrenia, 157, 158Sclerosing agents, 214

extravasation of, 219–221inadvertent arterial injections of,

221–222Sclerosis, 213

tuberous, 15Sclerotherapy

complications of, 150, 213–223contraindications to, 213defi nition of, 213

Scrubbing solutions, aseptic, 52–53Sculptra, 204–205Sedation, conscious, 6Sedation agents, drug interactions of, 6Seizures, 6, 10, 15Seromas

differentiated from wound infections, 48, 49

effect on wound healing, 78, 79facelift-related, 226, 230, 231liposuction-related, 197–198as necrosis cause, 80symptoms of, 48treatment of, 48as wound dehiscence cause, 79of wounds, 146–147

Serosanguinous discharge, 53Serous discharge, 168, 169Serratia marcescens infections, 51Shaving, of surgical sites, 47, 48, 62Silicone, as soft tissue fi ller, 203–204Silicone dressings, for scar revision, 117,

119Silicone gel sheets, 90, 119Silver nitrate, as excessive granulation

tissue treatment, 144–145Skin, preoperative evaluation of, 8Skin fl aps

antibiotic prophylaxis for, 64hinged turnover, 104, 107meliolabial interpolation, 104, 105nasolabial transposition, 104, 106necrosis and sloughing of, 80, 82,

231–232perforation of, 227rhombic transposition, 96, 97two-staged, for alar rim defect repair,

104use in facelifting, 225

Skin graftsfor alar distortion free margin

revision, 102–103antibiotic prophylaxis for, 64

for eyelid defects, 110, 111necrosis of, 80, 81as pigmentary change cause, 150for wound contraction prevention, 98

Skin picking, 161–162Skin remodeling, nonablative laser,

174–176Smoking

effect on surgical outcomes, 6effect on wound healing, 82as facelift-related complications risk

factor, 224, 225as wound dehiscence risk factor, 79as wound infection risk factor, 47

Smoking cessation, perioperative, 6, 82Snap test, 110Sociopaths, 159Sodium tetradecyl sulfate, 214, 218, 220,

222Soft tissue fi llers, 199–206

permanent, 199, 202–204semipermanent, 199, 204–205temporary, 199–202

Sotradecol, 214, 218“Spider veins,” 213Spinal accessory nerve

anatomy of, 22–23, 31injuries to, 31–32, 229

Squamous cell carcinoma, perineural, 147

Staphylococcus aureus infections, 48as endocarditis cause, 68, 69methicillin-resistant, 55–57, 65, 66, 67,

71, 143of prosthetic valves, 73of surgical sites, 50, 51, 53, 64, 66–67,

68, 69, 171as toxic shock syndrome cause, 197

Staphylococcus epidermidis infections, 50, 73

Status epilepticus, 10, 15Steroids

as contraindication to collagen injections, 199

effect on wound healing, 6as hemorrhage cause, 36, 38intralesional

as keloid and hypertrophic scar cause, 89–90, 91, 92

as scar treatment, 119, 120as postoperative infection risk factor,

6Stomatitis, alcohol-related, 141Streptococcus infections, 50, 67, 68Strias, 194, 195Stroke, 14–15, 221Sturge-Weber syndrome, 15Subcision®, of depressed scars, 133, 137Sudden cardiac death, 9Sudeck’s atrophy, 148

Suicide, 162, 163Sunscreens, 171–172Superfi cial musculoaponeurotic system

(SMAS), 21–22, 23, 25, 27, 28, 35in facelifting procedures, 224, 225, 227,

228–229, 234Supraorbital nerve

anatomy of, 28–29injuries to, 29–30

Surgical history, 4, 5, 8Surgical prepatory agents, as dermatitis

cause, 139–141Surgical sites

aseptic preparation of, 52–53infections of. See Wound infections

Suturesburied, 49, 79, 82, 87, 89, 142–143complications of, 49, 87, 89, 142–144excessively tight, 79in facelifting procedures, 225plication, 226removal of

in contact dermatitis, 141–142from infected wounds, 53, 54

spitting, differentiated from wound infections, 49

stainless steel, 144for wound dehiscence prevention, 79,

82for wound necrosis prevention, 82

Syncope, vasovagal, 10, 13–14Systemic lupus erythematosus, 15

TTacrolimus, as keloid treatment, 92“Talkesthesia,” 13Tape, surgical, cutaneous reactions to,

141, 142, 197Telangiectactic matting, 217–218Telangiectasia, 148, 213

effect of skin resurfacing on, 189hereditary hemorrhagic, 40–41sclerotherapy-related, 217–218steroids-related, 188

Temporal nerve, injuries to, 23–24, 229Thought processes

disordered, 4evaluation of, 157

Thromboembolitic complications, 39Thrombolytic (fi brinolysis) therapy, 37Thrombophlebitis, sclerotherapy-related,

221Thrombosis, deep venous, 221Thyroid disease, preoperative evaluation

of, 8Ticlopidine, 36, 37–38Toxic shock syndrome, 189, 197Trauma, as hypertrophic scars and

keloid cause, 87, 88Trendelenberg position, 9, 13

Index 245

Triamcinolone acetonide, intralesional, 90, 91, 92

Trichloracetic acid (TCA), 185, 187, 190Trigeminal nerve

anatomy of, 28injuries to, 28–31

Trimethoprim-sulfamethoxazole, 67–68

Tumors, recurrence of, as pain cause, 147

UUlcers, 82, 220–221Urticaria, 139, 141, 218

VVaccinations, as hypertrophic scarring

and keloid cause, 87, 89Vancomycin resistance, 51Varicose veins, 213Verapamil, 92Visual disturbances, sclerotherapy-

related, 221Vitamin E, as perioperative hemorrhage

cause, 36, 37, 39, 41, 193–194V to Y repair, of eclabium, 113

WWarfarin, 5, 38Wound care, 52–53, 82–83Wound contraction, 96–99, 101Wound dehiscence. See Dehiscence, of

woundsWound healing

delayed, 81, 188in diabetic patients, 8normal, 77–78phases of, 77, 184pruritus during, 148by secondary intention, 96–99, 100,

110, 113Wound infections, 46–61

classifi cation of, 46, 47in diabetic patients, 8, 47diagnostic criteria for, 47differential diagnosis of, 48–49as keloid cause, 87life-threatening, 58–59management of, 53–55methicillin-resistant Staphylococcus

aureus-related, 55–57microbiology of, 50–51prevention of, 52–53

prophylaxis for, 62–68, 74risk factors for, 46–48, 65–66risk of, 62, 63unusual causes of, 57–58

Wound margins. See also Free marginscontact dermatitis at, 141–142

Wounds, surgical. See also Wound care; Wound healing; Wound infections

classifi cation of, 63–64seroma of, 146–147tensile strength of, 79

W-plasty, 121, 123, 124, 125–126Wrinkles. See Rhytides

ZZ-plasty

for eclabium revision, 112–113for ecnasion revision, 104, 108for free margin distortion revision,

100–102, 110–111for scar revision, 121, 124, 126–129,

130–133Zyderm collagen implants, 199–200Zygomatic nerve, injuries to, 24–26,

33–35Zyplast collagen implants, 199, 200