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To evaluate the aesthetic result in the nasal base, when sutured using a personal technique, in patients undergoing bimaxillary surgery.Review of 60 cases in which the alar base suture was used during bimaxillary surgery with an average maxillary advancement of 3.5 mm. The patients were measured on cutaneous points and on side view with cephalometric soft-tissue measurements.The technique of cross-suturing the alar base provided good control on the involuntary movements of the alars that result from maxillary advancement. The frontal view of the patient before and after surgery revealed that good tightening of the nasal base was obtained despite the upper jaw movements. Long-term results appear to be stable.This personal technique of nasal alar suturing during bimaxillary surgery appears to be effective in avoiding unaesthetic deformities of the nasal base as well as providing good facial harmony.

OBJECTIVE To present our experience in the use of fresh-frozen human bone allograft as an interpositional grafting material for sliding genioplasty to correct chin deformities. METHODS Ten patients underwent sliding genioplasty using morcellized and corticospongious fresh-frozen human bone. Four patients underwent orthognathic surgery associated with genioplasty. Six patient underwent genioplasty associated with rhinoplasty. Panorex, lateral, and frontal cephalogram and computed tomographic scans have been performed for each case preoperatively and 12 months after surgery. One patient subsequently asked for plate removal, and with his consent, a bone biopsy specimen was obtained during the operation. RESULTS Stable aesthetic and functional results were observed in all cases. No infections occurred, and no bone resorption has been clinically or radiologically observed. CONCLUSION The use of fresh-frozen bone allograft reduces patient morbidity and operative time, providing a stable and excellent aesthetic result.

To determine if facial autologous fat grafts preserve the morphologic features of adipocytes and guarantee a successful long-term outcome.In a previous study, we performed lipofilling in 99 patients between January 1, 1999, and December 31, 2001. In all patients, we performed 3 fat injections at 28-day intervals. We injected 0.4 mL of adipose tissue in the parafrenal area of the upper lip for each treatment. After 4 months, we obtained a biopsy specimen from the same area. We performed an ultrastructural evaluation on freshly harvested fat at the time of harvesting, on stored fat (-30 degrees C) at 8-week and 12-month intervals, and on the biopsy specimens obtained 4 months after treatment.We observed good preservation of the ultrastructure in the harvested tissue. On histologic examination of the parafrenal area 4 months after grafting, some zones of the biopsy specimens showed putative adipocytes, fat cysts, and collagen fibers adequate for volume increase of the treated area. Ultrastructural images showed lipid droplets intermingled in the connective tissue, phagocytes with internal lipid droplets, and well-preserved adipocytes.This study demonstrates that by using a less traumatic surgical technique, it is possible to increase the cell survival rate of transplanted fat, thereby maintaining a certain number of viable cells and creating a volume increase in the grafted area. The multiple-stage injection technique seems to be a good method, especially when performed with fat stored at -30 degrees C.