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560 59. USA - Vitamin B2 Pharmadass Ltd - - Raw Materials o-Amino-biphenyl Sodium nitrite Tetraacetyl-ribitylxylidine Barbituric acid Hydrogen peroxide CHAPTER 7 Facial Plastic and Reconstructive Surgery 431 Postoperative Nausea: common in forehead lifts; Rx: self limiting, antiemetics Chin and Malar Augmentation Evaluation chinshouldbeatorjustbehindalineperpendiculartoFrankfort horizontal and the vermilion border of lower lip (or nasion) mustconsidereffectsfromadjunctiveprocedures(rhinoplasty, blepharoplasty, liposuction) ideallythemalarregionshouldappearfullandshouldnotfallbelow 5 mm posterior to melolabial groove evaluatemicrogenia(diminishedchineminencerequiring augmentation or sliding genioplasty) versus retrognathia (retrodisplaced mandible requiring sagittal split osteotomies) Surgical Procedures Chin Implants chinimplantstypicallygainupto70projection(aftersettlingand bone resorption) mayinsertchingraftexternallythroughsubmentalcreaseor intraorally, graft is placed subperiosteally or above periosteum Complications: infection, displacement (must be removed and replaced), improper size (wait about 3 months), mental nerve injury, extrusion Sliding Genioplasty movesanteriormostmandibleforward indicatedformoreseverecases(eg,retrognathia,insufficientvertical mandibular height, hemifacial atrophy, failed implant) moredifficult,requiresintraoralincision,mandibularosteotomy, advancement of segment with plates or wires Complications: lip incompetence (if mentalis is not approximated correctly), tooth injury, mental nerve injury Malar Implants maybeapproachedintraorally(caninefossa)orsubcilliary(more accurate) Complications: similar to chin implants 60 Color Atlas of Congenital Heart Surgery ceph R- -L caud common anterior leaflet natural division in leaflet marking stitches in cleft near ventricular septum common posterior leaflet primum ASD rim FIGURE 4-44.
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