Authors:
Marc Cohen, MD, Thomas Jefferson Medical School, Ophthalmology, Philadelphia, PA, and Nancy Swartz, MS, MD, Thomas Jefferson Medical School, Ophthalmology, Philadelphia, PA and Wills Eye Institute, Ophthalmology, Philadelphia, PA

Introduction

The 38^th Annual Fall Scientific Symposium of the American Society of Ophthalmic Plastic and Reconstructive Surgery — Rebuild, Restore, Rejuvenate was held November 9 – 10, 2007, at the Marriot in New Orleans, Louisiana. This year's scientific program was outstanding with many distinguished and diverse speakers, who provided new data and techniques in the area of oculofacial plastic surgery. The first day of the meeting was devoted to aesthetics and there were presentations and discussions focusing upon techniques for optimizing aesthetic results in the facial cosmetic patients. The highlights of this day are reviewed below.,

Analysis of the Anatomic Changes of the Aging Face using Computer-Assisted Tomography

It is now well understood that there are characteristic soft tissue changes in the face that occur with aging. Dr. Carrie Morris, MD, and colleagues described a retrospective study that evaluated the type of changes that occur in the facial skeleton as people age. This retrospective study analyzed 100 computed tomography (CT) scans performed at the Duke University Medical Center. Patients were divided into four groups, young females (age 18-30), young males (age 18-30), old females (age 55-65) and old males age (55-65). Scans were evaluated with the Vitrea^® software package (Vital Images, Inc., Minnetonka, MN). It was demonstrated that the skeleton remodels with age. The general pattern observed was that the frontal bone moved anteriorly and inferiorly while the maxilla moved posteriorly and superiorly. In other words, there was a general rotation of the face with the general angle of the face becoming more acute over time. This study also revealed that the degree of change was greater in woman than in men.,

Plasmakinetic Resurfacing of the Eyelids: Initial Clinical Investigation

Dr. Brian Biesman, MD, reviewed a new method of eyelid skin resurfacing that is in early clinical investigation. Plasma skin resurfacing (PSR) involves using radiofrequency generated nitrogen plasma to ablate the superficial layers of the skin. This is a new technology that is in an early phase of evaluation in its use on the eyelids. It is believed that this technology may offer shorter healing times than CO₂ laser resurfacing.,

A New Technique Using Radiesse Through an Intra-oral Approach for Facial Recontouring

Dr. Sheila Barbarino, MD, and Dr. Joseph Eviatar, MD, reported a retrospective chart review of 23 patients treated for midface fat atrophy with Radiesse^®. These patients were treated via the intraoral route with injections given through the gingival at the superior sulcus. Radiesse^® was injected just above the periostium with care given to avoid the infraorbital nerve. The authors felt that this approach offered less bruising and less discomfort than the traditional percutaneous route of injection. No significant complications were encountered and there were no post-treatment infections.