Rectus Abdominis Myocutaneous Flap Harvest

This video highlights the surgical nuances of rectus abdominis myocutaneous free flap harvest.

Thermal Punctal Cautery for Chronic Ocular Surface Disease

In this video, permanent punctal occlusion is performed with high-temperature thermal cautery for the treatment of refractory ocular surface dryness, in this case due to graft-versus-host disease.

Scalp Reconstruction with a Free Anterolateral Thigh Flap: Microvascular Anastomosis

This procedure depicts the microvascular anastomosis between the free anterolateral thigh (ALT) flap and the superficial temporal artery (STA) and superficial temporal vein (STV).

Scalp Reconstruction with a Free Anterolateral Thigh Flap: Flap Inset

This procedure demonstrates the inset of the anterolateral thigh (ALT) flap into a large composite wound after oncologic resection.

Glabellar Flap Reconstruction After Mohs Surgery

The procedure in this video demonstrates a bi-lobed glabellar flap reconstruction after Mohs micrographic excision of a basal cell carcinoma in the medial canthus of the eyelids.

Full-thickness skin grafting for coverage of dorsal hand defect

Title: Full-thickness skin grafting for coverage of dorsal hand defect Authors: Vincent Riccelli, Brian Drolet MD, Elizabeth Lee MD Affiliations: Vanderbilt University Medical Center Corresponding Author: Vincent Riccelli (vincent.riccelli@vanderbilt.edu)

Excision of Nailbed Remnant following Finger Amputation

Excision of Nailbed Remnant following Finger Amputation Authors: Vincent Riccelli M.D. Candidate, Brian Drolet M.D., F. Bennett Pearce M.D. Affiliations: Vanderbilt University Medical Center Corresponding Author: Vincent Riccelli

Dermis Fat Graft Implantation into Anophthalmic Socket

Dermis fat graft implantation has been used for decades to augment orbital volume and surface area in patients with congenital anophthalmia as well as those suffering complications of secondary anophthalmia following enucleation. It is most commonly performed as a means of socket reconstruction in patients with an exposed or extruded orbital implant and to prevent socket contracture. In this video, a dermis fat graft is harvested from the buttock and implanted into an anophthalmic socket for treatment of exposure of orbital implant in the right socket of a patient who was status post enucleation in both eyes for painful blind eyes. Suzanne K. Freitag, MD Victoria Starks, MD Zujaja Tauqeer Ophthalmic Plastic Surgery Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School

Deep Inferior Epigastric Perforator Flap: Microvascular Anastomosis and Neurotization

Deep Inferior Epigastric Perforator Flap: Microvascular Anastomosis and Neurotization This video depicts the microvascular anastomosis of the deep inferior epigastric artery and vein to the internal mammary artery and vein in an anterograde fashion for a delayed bilateral deep inferior epigastric perforator (DIEP) flap reconstruction in a 53-year-old female patient status post bilateral mastectomy for breast cancer. Authors: Vincent Riccelli M.D., Eva Niklinska B.S., Ashkan Afshari M.D., Stephane Braun M.D., Kent K. Higdon M.D., Galen Perdikis M.D., Julian Winocour M.D. Affiliations: Vanderbilt University Medical Center Corresponding Author: Eva Niklinska

Scalp Reconstruction with a Free Anterolateral Thigh Flap: Flap Dissection

This procedure depicts the harvest of the anterolateral thigh flap to be utilized in the reconstruction of a post-extirpative scalp defect.

Deep Inferior Epigastric Perforator Flap: Abdominal Flap Dissection

Deep Inferior Epigastric Perforator Flap: Abdominal Flap Dissection This video depicts the abdominal flap dissection for a delayed bilateral deep inferior epigastric perforator (DIEP) flap reconstruction in a 53-year-old female patient status post bilateral mastectomy for breast cancer. Authors: Eva Niklinska B.S., Vincent Riccelli M.D., Ashkan Afshari M.D., Stephane Braun M.D., Kent K. Higdon M.D., Galen Perdikis M.D., Julian Winocour M.D. Affiliations: Vanderbilt University Medical Center Corresponding Author: Eva Niklinska

Deep Inferior Epigastric Perforator Flap: Abdominal Closure and Flap Inset

Deep Inferior Epigastric Perforator Flap: Abdominal Closure and Flap Inset This video depicts the abdominal closure and DIEP flap inset for a delayed bilateral deep inferior epigastric perforator (DIEP) flap reconstruction in a 53-year-old patient status post bilateral mastectomy for breast cancer. Authors: Eva Niklinska B.S., Vincent Riccelli M.D., Ashkan Afshari M.D., Stephane Braun M.D., Kent K. Higdon M.D., Galen Perdikis M.D., Julian Winocour M.D. Affiliations: Vanderbilt University Medical Center Corresponding Author: Eva Niklinska

Collagenase Injection of the Dupuytren Hand

Contributor: John Zhao Collagenase clostridium histolyticum (CCH) injections were FDA approved in 2010 for use in Dupuytren’s contracture.  Interest among surgeons in this office-based treatment has rapidly increased in the past 5 years due to its shorter recovery time and limited complication rates compared to open fasciectomy. DOI: http://dx.doi.org/10.17797/qps5cwzfgu Editor Recruited By: David Bozentka, MD

Sliding Osseous Genioplasty and Coronoidectomy in a Patient with Treacher-Collins Syndrome

Contributors: Andrew Weaver and Kumar Patel, PA-C 18 y.o. female with Treacher-Collins syndrome (patients have micrognathia, underdeveloped facial bones, particularly the cheek bones, and a very small jaw and chin. She is only able to open her mouth to 20mm due to the interference of her coronoid process with her zygoma/ DOI: http://dx.doi.org/10.17797/959yiezvoo

Plastic Surgery Pearls for basic suturing: instruments & technique

Contributors: Kumar Patel, PA-C Basic plastic surgery suturing techniques geared towards medical students and residents, including starting position, basic simple suture, deep dermal suture, vertical mattress, horizontal mattress and running subcuticular. DOI: http://dx.doi.org/10.17797/udwdtpze6v

Ear Reconstruction with Postauricular Flap

The post-auricular flap is utilized for larger ear reconstructions.  More commonly, it is reserved for defects that are not amenable to primary closure or helical rim advancement flaps. DOi#: http://dx.doi.org/10.17797/4k9jzjrexh

Cranioplasty for Sagittal Craniosynostosis

Cranioplasty with barrel stave osteotomies to treat sagittal suture craniosynostosis.

ND:YAG Laser Therapy of Tongue Venous Malformation

This is a visual representation of the treatment of a venous malformation within the substance of the tongue. The laser directly treats the venous malformation via selective photothermolysis while preventing injury to the tongue itself. Venous malformations infiltrate normal tissue as a birthmark but continue to grow with time and show no evidence of regression. Instead of excising the venous malformation with some of the tongue itself this is a way of controlling the lesion. As seen, the ND:YAG laser set at 25 Watts and 1.0 sec duration is used to shrink the venous malformation. The laser is fired in a polkadot fashion in order to prevent mucosal sloughing. The surface is relatively protected as the laser selective penetrates the VM. DOI: http://dx.doi.org/10.17797/938qzyj3uh

Hemangioma Excision

Infantile hemangiomas are vascular tumors composed of proliferating endothelial cells. They uniquely undergo rapid expansion from birth to 6-8 months of age and subsequent slow dissolution over several years thereafter. Some hemangiomas are at risk of causing functional problems during their growth phase as seen in this upper eyebrow lesion obstructing the visual axis. Laser, surgical and medical treatment options are available for problematic hemangiomas. This patient was elected to undergo excision to completely remove the lesion and forego a long course of medical therapy (propranolol). Because of the their vascular nature, excision of hemangiomas requires careful planning and hemostasis. The hemangioma is marked in elliptical fashion along natural aesthetic facial lines along the brow. The inferior mark in incised first. Careful subdermal dissection is critical to completely excise to the hemangioma near the surface and find the appropriate plane. Control of bleeding is maintained by monopolar and bipolar electrocautery as well as dissecting the lesion from one side and alternating to the other. The plane of deep dissection is rarely below the subcutaneous layer thus protecting important nerves and vessels. Complete removal is possible. Closure is performed with dissolvable monocryl or PDS suture with dermabond superficially. A plastic eyeshield (blue) is placed at the beginning of case to protect the patient's cornea during the procedure. DOI: http://dx.doi.org/10.17797/zlvhux8afu

Keloid Excision

Bilateral ear keloid excision with steroid injection. DOI# 10.17797/rfealpdd24

Cranioplasty and Scar Revision

Contributors: Michael Golinko (MD) and Kumar Patel (PA) A six-year-old male with history of skull trauma acquired in an ATV accident underwent emergency craniotomy three years ago. He now presents with bone resorption, frontal bossing, scalloped bone, and a widened scar in the middle of his forehead from the previous surgery. DOI#:https://doi.org/10.17797/bysho32ez5

Fronto-Orbital Advancement and Cranial Vault Remodeling for Metopic Craniosynostosis

Contributors:Michael Golinko, MD, MA, Eylem Ocal, MD and Kumar Patel, PA Premature metopic suture fusion is corrected using fronto-orbital advancement and cranial vault remodeling to open the fused suture and allow for adequate brain growth. DOI#: https://doi.org/10.17797/hg9xbuxoms

Endoscopic Carpal Tunnel Release

Contributors: T. Shane Johnson This video will outline the approach to a single port endoscopic carpal tunnel release, reviewing relevant anatomic landmarks, surgical views specific to the technique and unique operative tools. DOI#: https://doi.org/10.17797/iwzq8qis7k Editor Recruited By: David Bozentka

Dorsal bridge plating for distal radius factures

Contributors:Katherine Faust and Jacob Brubacher Internal distraction, or bridge plating, of distal radius fractures is a valuable tool for highly comminuted and unstable fracture patterns. Additionally, this technique is valuable for those fractures that extend into the metadiaphysis or for multiply injured patients requiring stable fixation for mobilization. Bridge plating allows for stable fixation in poor bone quality and early use of the injured extremity.

Posterior Cranial Vault Remodeling for Shunt-Induced Crainiocerebral Disporpotion (CCD)

Contributors: Kumar Patel, PA-C and Gregory W. Albert Posterior cranial vault remodeling post shunt induced Crainiocerebral Disporpotion (CCD) Patient is a 5 y/o boy having frequent headaches which may be indicative of increased intra-cranial pressure in addition to a step-off deformity of his posterior calvarium. DOI#: http://dx.doi.org/10.17797/d03zxkvg2h

Median Nerve Autogenous Vein Wrapping For Revision Carpal Tunnel Release

Contributors: Jonathan Isaacs and Amy Kite Median nerve autogenous vein wrapping for revision carpal tunnel release due to traction neuritis. DOI: http://dx.doi.org/10.17797/lr0euenlv3 Editor Recruited By: David Bozentka, MD

Alopecia Excision and Repair

Contributors: Michael Golinko  and Kumar Patel Removal of an approximately 5 cm congenital alopecia using an O to Z or yin-yang flap method. DOI: http://dx.doi.org/10.17797/rbbu00mhp0

Microtia Reconstruction: Stage 1

Stage 1 Microtia Repair using rib cartilage and modifications to the Nagata method of auricular formation. DOI#: http://dx.doi.org/10.17797/cquv22l7p3

Bilateral Cryptotia Repair

Contributors: Shira Koss 6 year old boy suffering from bullying at school as a result of bilateral cryptotia, a very unusual congenital ear anomaly in which the superior helix is buried under temporal skin. DOI#: http://dx.doi.org/10.17797/le4g6c5rk5

Bilateral Sagittal Spilt Osteotomy and Genioplasty in Patient with Lymphatic Malformation

Contributors: Michael Golinko, MD,  John Jones, MD, DMD,  Kumar Patel, PA Bilateral sagittal split osteotomy and genioplasty in 5y/o girl with lymphatic malformation. DOI#: https://doi.org/10.17797/hlo056ep2r

LeFort I Osteotomy and Advancement in Patient with Maxillary Hypoplasia

Contributors: Michael Golinko, Kumar Patel and Bridget O'Leary LeFort I osteotomy and advancement in 18y/o female patient with maxillary hypoplasia DOI: https://doi.org/10.17797/1cu3tz50yf

Expansion Sphincter Pharyngoplasty

Contributors: Raj Dedhia, M.D Obstructive sleep apnea is a common disorder with many possible etiologies. Surgical therapy is aimed at reducing or eliminating an area of airway stenosis that predisposes patients to obstructive sleep apnea. Expansion sphincter pharyngoplasty consists of transecting the palatopharyngeus and reinserting it into the lateral soft palate and periosteum of the pterygoid hamulus to widen the pharyngeal airway. DOI #: https://doi.org/10.17797/i9jgkva8m4

Bilateral Cleft Lip Repair

Contributors: Larry Hartzell Repair of the bilateral cleft lip deformity can be challenging to the cleft and craniofacial surgeon.  The goals of an acceptable repair must include precise continuity of the cupid's bow, maximizing philtral length, and establishing a mucosa lined sulcus.  We present an example of a repair of the bilateral incomplete lip as described by Millard. DOI: http://dx.doi.org/10.17797/qefi9lqbam

Endoscopic assisted sagittal strip craniectomy with barrel stave osteotomies in sphinx position

Contributors: Rongsheng Cai and Roop Gill. Endoscopic assisted sagittal strip craniectomy with barrel stave osteotomies to treat sagittal suture craniosynostosis.

Rhomboid Flap Reconstruction of Necrotic Cheek Lesion

The patient had an unidentified dermal filler placed outside of the United States over a decade ago. She developed a subsequent severe reaction which left her with extensive subdermal fibrosis and epidermal necrosis. Pathologic analysis revealed almost entire replacement of the dermal-epidermal layer with a foreign body and granulomatous reaction. The location at the cheek lower lid junction and the available lateral skin laxity deemed the rhomboid flap as the best option for reconstruction. Editor Recruited By: Michael Golinko, MD

Immediate post natal myelomeningocele defect closure using rhomboid fasciocutaneous flaps

Myelomeningocele is the most common form of neural tube defect, developing after the 4th week of gestation. Although diagnosed prenatally, many patients did not have a chance to be treated before birth. The best approach in these situation is to perform surgical treatment at time zero. A multidisciplinary team must be prepared to perform dural repair and soft tissue coverage. This video illustrates our approach for soft tissue reconstruction using rhomboid fasciocutaneous flaps with maximal preservation of perforator vessels. Contributors Dov Charles Goldenberg, MD Phd, Division of Plastic Surgery, Hospital das Clinicas, University of Sao Paulo Medical School Vania Kharmandayan, MD, Division of Plastic Surgery, Hospital das Clinicas, University of Sao Paulo Medical School Tatiana Moura, MD, MSc, Division of Plastic Surgery, Hospital das Clinicas, University of Sao Paulo Medical School

Surgical Treatment of Nasal Tip Hemangioma Using Open Rhinoplasty Approach

Hemangiomas are the most common benign tumors of the infancy and its location on the nasal tip poses particularly as a challenge. A recent study published by out group defined an algorithm for surgical approach to hemangiomas. Nasal tip hemangiomas carry a high risk for growth related deformities and is a usual indication for surgery. The best approach must warrant a result at least similar or even better to spontaneous involution. In this video we present a case where an open rhinoplasty approach was designed to remove the tumor, reposition the anatomic structures and reduce visible scars. Contributors Dov Charles Goldenberg, MD Phd, Division of Plastic Surgery, Hospital das Clinicas, University of Sao Paulo Medical School Vania Kharmandayan, MD, Division of Plastic Surgery, Hospital das Clinicas, University of Sao Paulo Medical School

Resection and modified purse-string closure of frontal hemangioma

Infantile hemangiomas occurring in the face may represent a real problem to a child. Clinical significance is ultimately determined by the degree of tissue deformation. Large dimensions; specific locations; and the presence of complications such as ulceration, bleeding, or infection indicate active treatment to minimize morbidity. The combination of clinical features and response to pharmacologic treatment are the main standpoints indicating surgery during the active phases of infantile hemangiomas. The concept of minimal possible scar is relevant, and the use of purse-string sutures, initially proposed by Mulliken et al., promotes a real reduction in the final scar dimensions. In this video surgical resection of a frontal hemangioma illustrates a modified purse string suture, to reduce the dimensions of a linear scar. Contributors Dov Charles Goldenberg, MD Phd, Division of Plastic Surgery, Hospital das Clinicas, University of Sao Paulo Medical School Vania Kharmandayan, MD, Division of Plastic Surgery, Hospital das Clinicas, University of Sao Paulo Medical School

Le Fort I Osteotomy with placement of Distractor

Our patient is a 20 year old boy with severe maxillary hypoplasia with a history of bilateral cleft lip and palate. We performed a maxillary advancement with distraction osteogenesis. Nikhil Kamath, BS Aaron Smith, MD Michael S. Golinko, MD Kumar Patel, PA-C

Revision Facial Bipartition Osteotomy

Revision Facial Bipartition Osteotomy in 14y/o Female. Contributors: Aaron Smith, MD; Kumar Patel, PA; Ashley Bartels, BS; Rongsheng Cai, MD; Roop Gill, MD

Split Thickness Skin Graft

Skin grafting involves closure of an open wound using skin from another location which is transferred without its own vascular blood supply, relying on the vascular supply of the wound bed for survival. Skin grafts can be split thickness grafts that may involve meshing the donor skin in order to cover a proportionally larger area than the donor skin may have allowed. Besides the ability to cover a large area, a split thickness skin graft (STSG) allows for egress of fluids thereby maximizing close contact between the wound and the graft, which is necessary for vascularization and survival of the graft. A STSG can be taken at a variety of thicknesses but at any level taken, part of the donor dermis is left intact. Other options for skin grafts include full thickness grafts and biomedical grafts such as Integra. Full thickness skin grafts (FTSG) take the dermis as well as epidermis, usually covering smaller areas. FTSG has reduced contracture and often a better color match compared to STSG, but can have reduced survival due to increased thickness of tissue. The decision of the type of graft used in the procedure is made in accordance with the needs of the recipient site, the likelihood of graft take, and the availability of donor skin. The patient may either go home after the procedure with small areas of skin grafting with instructions for immobilization and elevation of the grafted area. The patient may be admitted depending on the patient’s general health status and the wound. Shear forces are avoided to the grafted area, and the donor site dressings may require prn changes due to fluid leakage until the skin epithelium regenerates from residual dermal structures. In the case presented in this video, a 12 year old girl was victim to a degloving injury of the left dorsal foot secondary to a motor vehicle accident. A STSG was determined appropriate for wound coverage as her wound bed had granulated in very well, covering all critical structures and providing a healthy bed for graft take. Linda Murphy MA Roop Gill, MD

Lower eyelid ectropion repair with lateral tarsal strip and medial spindle procedure

One of the most common causes of lower lid ectropion is horizontal lid laxity, the incidence of which increases with age. This condition induces poor ocular surface tear film coverage which leads to irritation, tearing, and keratopathy. Lateral tarsal strip fixation is the technique which is widely used to repair involutional ectropion due to horizontal lid laxity. Medial spindle procedure is the well-known technique for puntal ectropion correction. Both surgeries are minimally invasive, simple and effective. Contributors Suzanne K. Freitag, MD, Ophthalmic Plastic Surgery Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School Thidarat Tanking, MD, Ophthalmic Plastic Surgery Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School

Superiorly Based Pharyngeal Flap for Velopharyngeal Dysfunction

Velopharyngeal dysfunction (VPD) refers to the improper control of airflow through the nasopharynx. The term VPD denotes the clinical finding of incomplete velopharyngeal closure. Other terms used to describe VPD include velopharyngeal insufficiency, inadequacy and incompetence. However, the use of VPD has gained popularity over these terms as they may be used to infer a specific etiology of impaired velopharyngeal closure.1 Control of airflow through the nasopharynx is dependent on the simultaneous elevation of the soft palate and constriction of the lateral and posterior pharyngeal walls. Disruptions of this mechanism caused by structural, muscular or neurologic pathology of the palate or pharyngeal walls can result in VPD. VPD can result in a hypernasal voice with compensatory misarticulations, nasal emissions and aberrant facial movements during speech.2 The assessment of velopharyngeal function is best preformed by a multispecialty team evaluation including speech-language pathologists, prosthodontists, otolaryngologists and plastic surgeons. The initial diagnosis of VPD is typically made with voice and resonance evaluation conducted by a speech-language pathologist. To better characterize the patient’s VPD, video nasopharyngeal endoscopy or speech videofluoroscopy can be used to visualize the velopharyngeal mechanism during speech. VPD may first be managed with speech-language therapy and removable prostheses. For those who are good surgical candidates and do not fully respond to speech-language therapy, surgical intervention may be pursued. Surgical management of VPD is most commonly accomplished by pharyngeal flap procedures or sphincter pharyngoplasty. In this video, a superiorly based pharyngeal flap with a uvular mucosal lining flap was preformed for VPD in a five-year-old patient with 22q11 Deletion Syndrome and aberrantly medial internal carotid arteries.

Temporal (Gillies) Approach to a Zygomatic Arch Fracture

This video documents the steps typically followed during open reduction of isolated, depressed zygomatic arch fractures.  The patient's hair was shaven for clarity and for proper marking of key anatomic landmarks. Such landmarks are shown and discussed in sequence with the key surgical steps.

Marcus Couey, DDS, MD; Eric Reimer, DDS; Andrew Bhagyam, DDS; Phillip Freeman, DDS, MD; Jose M Marchena, DMD, MD

The University of Texas Health Science Center at Houston, School of Dentistry, Department of Oral & Maxillofacial Surgery

Custom PMMA implant and DBX Cranioplasty for large cranial calavarial defects

Following a post-traumatic head injury from a gun shot wound in a seven year old African American female, a 3D CT was performed to assess for correction of a large cranial calavarial defect using a custom PMMA implant. A trilaminar Cranioplasty was planned using an absorbable plate underlay, demineralized bone graft in between and an onlay of absorbable plate. A post-operative CT was obtained showing the implant in a good position.

Breast Reduction Mammoplasty: Inferior Pedicle Technique

Patient X is a 20-year-old Caucasian woman who suffers from symptomatic macromastia. A Wise pattern skin resection was drawn, beginning by marking a point 20.5cm from the suprasternal notch on each breast along the breast meridian, indicating the apex of the skin resection and position of the future nipple placement. A triangle was then drawn with sides of 8cm each and a base of 7cm, with the apex again at the point noted above. The base of the inferior pedicle was drawn by marks 5.5cm to either side of this intersection, giving a pedicle with a 11cm base. Additional anatomic landmarks were also marked, including the suprasternal notch, and the sternal midline.

Neonatal Mandibular Distraction Osteogenesis with Multivector External Devices

Pierre Robin sequence (PRS) is a craniofacial malformation characterized by micrognathia and glossoptosis, with or without cleft palate. A subset of infants with PRS will suffer from airway obstruction severe enough to merit surgical intervention. Surgeries for PRS include tongue lip adhesion, tracheotomy, gastrostomy, and bilateral mandibular distraction osteogenesis. Distraction osteogenesis refers to a process in which a bone is lengthened after an initial osteotomy by means of separating the two resulting segments slowly over time. In the neonatal mandible, hardware used for distraction may be implanted beneath the skin or affixed externally. Each device has its advantages and disadvantages, however external devices are less expensive, do not typically require preoperative computed tomography scanning, may be adjusted easily throughout the distraction process, and are easily removed following consolidation, avoiding a second invasive procedure and lengthy anesthetic. This video presents the technique of neonatal mandibular distraction osteogenesis using multivector external distractors.

Grade 1 Microtia Repair Using Autologous Auricular Cartilage Transfer

The goal of auricular reconstruction is to achieve a natural appearance of the reconstructed side with a form that resembles the normal ear and endures over a lifetime. For severe deformities in which major cartilaginous elements are missing, established reconstructive techniques using alloplastic constructs wrapped in temporoparietal fascia or carved costal cartilage grafts may be employed. For cases of minor deformity in which all named cartilaginous components are present, albeit deficient compared to the normal side, transfer of autologous auricular skin and cartilage may be used to achieve symmetry between normal and abnormal ears. This video presents the surgical technique and results of a grade 1 microtia reconstruction using autologous auricular cartilage transfer. This two-stage method of reconstruction avoids the use of autologous rib or alloplastic materials and often avoids the use of skin grafting altogether.

Implantation of Tissue Expander in Poland Syndrome Patient

This patient is a seventeen-year-old female with Poland syndrome, resulting in a hypotrophic left pectoralis major muscle and rib anomalies. A tissue expander is implanted on the left side to increase the capacity of the left breast tissue in order to make room for a future, permanent implant.

Orbital Decompression through Conjuctival and Lynch Incisions

Surgical orbital decompression for proptosis secondary to Graves' Disease.

Upper Eyelid Blepharoplasty

Introduction: Cosmetic Upper Blepharoplasty involves removing excess skin from the upper eyelid to enhance the appearance of the upper eyelids. Methods: Markings were made for the inferior incision on the upper eyelid between 8-10 mm above the upper lash line. Forceps are used to pinch the excess upper eyelid skin in the middle, nasal, and temporal, aspects of the upper eyelid. Markings are then made superiorly at the middle, nasal, and temporal points and are connected. Toothed forceps are used to pinch the excess upper eyelid skin, using the markings as a guide. Iris scissor is used to excise the pinched excess skin and the underlying orbicularis muscle. The skin between the two eyelids was closed. Conclusions: In our experience, cosmetic upper blepharoplasty is an efficient way to enhance the appearance of the eyes. By: Peyton Yee, Addison Yee Surgeon: Suzanne Yee, MD, FACS Dr. Suzanne Yee Cosmetic and Laser Surgery Center, Little Rock, AR, USA Recruited by: Gresham T Richter, MD

Retroseptal Transconjunctival Approach to Orbital Floor Blowout Fracture

The transconjunctival approach was first described by Bourquet in 1924 and then modified by Tessier in 1973 for exposure of the orbital floor and maxilla for the treatment of facial trauma. This approach can be carried out either in a preseptal plane by separating the orbital septum from within the eyelid (preseptal approach) or posterior to the septum and eyelid (retroseptal approach) by making an incision through the bulbar conjunctiva directly above the orbital rim. The main advantage of the retroseptal approach is that it does not involve dissection and disruption of the eyelid itself, therefore, reducing the incidence of post-operative lid laxity and position abnormalities. This video will show a retroseptal approach to an orbital floor blowout fracture. A lateral inferior cantholysis is performed to facilitate eversion and retraction of the lower eyelid.

Bilateral Wise Pattern Inferior Pedicle Reduction Mammoplasty

We present a 16-year-old female with hypertrophic breasts of bra size 38H, bra strap grooving, and worsening back and posterior shoulder pain limiting activity and affecting posture, who underwent bilateral reduction mammoplasty using the Wise pattern inferior pedicle technique. 998 g of tissue was removed from the patient’s right breast, and 852 g of tissue was removed from the patient’s left breast. The procedure was uncomplicated; however, the postoperative period was complicated by minor skin breakdown at the most inferior portion of the incision along the inframammary fold, as well as some serous drainage that shortly resolved with treatment. Overall, the patient is satisfied with the results of the reduction. She reports comfortably wearing size 38C bras and has noticed significant improvement in back pain, shoulder pain, and bra strap grooving six months after the procedure.

Bilateral Subcranial Le Fort III Osteotomies with Midface Distraction – A Surgical Review

In this video, we showcase the bilateral subcranial Le Fort III osteotomies with midface distraction using Kawamoto distractors. The surgery was performed in a 4-year-old boy with Crouzon Syndrome to correct his severe proptosis, increase the nasopharyngeal airway space and improve his severe negative overjet. Internal distractors were chosen to achieve maximum correction at this age. The patient undergoing surgery had no intraoperative or postoperative complications. A full separation of his facial bones was achieved. The patient had an uneventful recovery period, and there was a significant improvement in his proptosis and malocclusion. Santiago Gonzalez, BS, BA (1); Michael Golinko, MD, MS (2) 1. University of Arkansas for Medical Sciences – College of Medicine 4301 W. Markham, #550 Little Rock, AR 72205 2. Vanderbilt University Medical Center, Department of Plastic Surgery 2900 Children’s Way, 9th Floor Doctor’s Office Tower Nashville TN 37232

Primary Repair of Unilateral Complete Cleft Lip and Nose Deformities

The following video demonstrates the author's method for repairing wide unilateral complete cleft lip and cleft nasal deformities. Details of surgical markings as well as nuances of technique are demonstrated. Video documentation of immediate results as well as progress of healing over the following year are included.

Lip Pit Excision

This video shows a pediatric patient with Van der Woude syndrome. He has lip pits that are classic for this syndrome and his family desired surgical correction. This video outlines and shows the steps of the modified simple excision technique as well as discussing tips for a successful surgery.

Cranioplasty for Metopic Craniosynostosis

This video demonstrates an open anterior cranial vault reconstruction for metopic craniosynostosis on a 5-month-old female.

Tongue Reduction (Partial Glossectomy) for Pediatric Macroglossia

This video demonstrates how to perform a tongue reduction using a Y-V advancement technique for pediatric macroglossia.

Pre-operative marking for the Fisher technique in unilateral cleft lip repair

This video outlines the steps taken for pre-operative markings that need to be made prior to performing unilateral cleft lip repair using the Fisher anatomic subunit approximation technique. The technique has been written about in detail by Dr. David Fisher in his article "Unilateral Cleft Lip Repair: An Anatomical Subunit Approximation Technique". This video simply outlines the markings that are made prior to performing this technique, which are crucial for correctly carrying out the repair.

Treatment of mild eyelid ptosis with conjunctivo-mullerectomy

Mild eyelid ptosis with good elevator function can be treated with minimally invasive procedures. When Muller's muscle contraction corrects the deficiency (evaluated by phenilefrine test) conjunctivo-mullerectomy is the procedure of choice. This video presents the surgical steps to perform conjunctivo-mullerectomy. Contributors Dov Charles Goldenberg, MD Phd, Division of Plastic Surgery, Hospital das Clinicas, University of Sao Paulo Medical School Vania Kharmandayan, MD, Division of Plastic Surgery, Hospital das Clinicas, University of Sao Paulo Medical School

Closed Nasal Reduction

Closed nasal reductions are the standard of care for displaced nasal bone fractures. Reduction should occur within 3 weeks of the initial injury, but after swelling has subsided. The success rate is 60-90% in uncomplicated cases, however 6-17% of patients will require a future septorhinoplasty. This procedure was performed under general anesthesia.

Internal Mammary Vessel Harvest

This video demonstrates the cadaveric harvest of the internal mammary artery and vein for use in head and neck microvascular reconstruction.

Incomplete Cleft Palate Repair: Von Langenbeck Converted to Two-flap Palatoplasty with Furlow Double Opposing Z-Plasty

Title: Incomplete Cleft Palate Repair: Von Langenbeck Converted to Two-flap Palatoplasty with Furlow Double Opposing Z-Plasty Authors: Nima Vahidi, MD1; Nilan Vaghjiani, BS1; Rajanya Petersson, MS, MD1,2 1Virginia Commonwealth University School of Medicine, Richmond, VA 2Children Hospital of Richmond at VCU, Richmond, VA Overview: 10-month-old male with 18q deletion syndrome, Pierre Robin sequence (cleft palate, glossoptosis, and micrognathia), eustachian tube dysfunction, cardiac disease including ASD, VSD and WPW, pulmonary hypertension, as well as tracheostomy and G-tube dependence. In preoperative evaluation he was noted to have an incomplete cleft palate involving the hard and soft palate. He was noted to have bilateral eustachian tube dysfunction with effusions present. After discussion with family decision was made to proceed with surgical intervention.

Fibula Free Flap Harvest

We present the harvest of a osteocutaneous fibula free flap for head and neck reconstruction performed at the University of Cincinnati. This reconstructive technique has a wide variety of implications but has found greatest utility in the reconstruction of mandibular defects.

Microtia Reconstruction- Auricular Framework Creation from Rib Cartilage

This video demonstrates the carving and creation of the auricular framework as performed by Dr. Rousso after harvesting cartilaginous ribs 6-9. This is a modification of the techniques described by Dr. Nagata and Dr. Firmin. 

Lower Lip Sling Suspension with Bidirectional Fascia Grafts For Isolated Marginal Mandibular Nerve Palsy

The procedure in this video demonstrates a lower lip sling suspension technique for isolated marginal mandibular nerve palsy using bidirectional fascia grafts.

Surgical Management of Axillary Tissue Hypertrophy

Prior to surgical incision, antibiotic prophylaxis is administered with appropriate intravenous antibiotics. The skin is incised and the posterior incision dissection is done perpendicular, straight down, through the subcutaneous fat. After the skin is incised, the dissection is beveled outward anteriorly. This creates a subcutaneous flap anteriorly. At all locations, the dissection is done down to, but not violating, the clavipectoral fascia. Anteriorly, any axillary creases or folds are obliterated by scoring of the subcutaneous tissue. The axillary breast tissue is then excised, marked for appropriate laterality, and submitted for permanent pathology. The resulting void is copiously irrigated and hemostasis is ensured. Long acting anesthetic is used to infiltrate the regional sites for postoperative analgesia. A 15-French Blake drain is placed posteriorly through a separate stab incision. The skin edges are meticulously aligned at the anterior and posterior edges with redundancy kept in the middle (Figure 6). The incisions are closed in two layers. An absorbable suture is used in interrupted buried fashion followed by an absorbable subcuticular stitch. 2-octyl cyanoacrylate liquid adhesive and self-adhering mesh (Dermabond Prineo) is placed superficially. Video 1 summarizes the technique.

A Pediatric Case of Levator Palpebrae Resection

In this video, we present a case of levator palpebrae resection in an 8-year-old patient with right eye ptosis. In the pre-op photo, significant ptosis of the right eye can be appreciated. An incision was planned along the lid crease. 0.1 ml of 1: 100,000 epinephrine was injected. An incision was made by electro-cautery along the lid through the skin and orbicularis. Westcott scissors were used to further dissect horizontally. The septum was identified and opened. The preaponeurotic fat was identified and lifted, and the levator aponeurosis was identified. The levator was then tagged with two 6.0 Vicryle sutures, and isolated from surrounding tissues. Next, three6-0 Mersilene sutures were run from the upper tarsus to the levator. They are tightened with releasable notes. The lid elevation and contour were evaluated and adjustments were made until contour and height were equal and appropriate. The temporary surgical knots were transitioned into permanent surgical knots. Approximately 14 mm of excess levator was then excised. Next, three lid crease formation sutures were placed using 6-0 Vicryl. These were attached to the subcu-skin and levator to recreate the upper eyelid crease. Skin closure was performed with 6-0 fast-absorbing gut sutures. In this one-week post-op photo, the ptosis of his right eye was improved. Thank you for watching!

Rectovaginal Fistula Repair with a Vascularized Gracilis Muscle Interposition Flap

The surgical management of rectovaginal fistulas remains difficult, as they tend to be recurrent and vary widely in location and complexity. We present a case of a 63-year-old woman with a low-lying rectovaginal fistula who initially underwent chemoradiation and a Low Anterior Resection for a low-lying rectal cancer. Her course was uneventful until two years post-operatively, at which time her anastomotic staple line became stenotic with associated bleeding. This was initially addressed by Gastroenterology who executed a dilation and achieved hemostasis with Argon Plasma Coagulation. This remedied the stenosis, however, it was complicated by the formation of a rectovaginal fistula. Due to the low-lying location and its presence in an irradiated field, a transvaginal approach with an interposed gracilis flap was elected for repair.

Lacrimal Probing and Irrigation

This video demonstrates lacrimal probing and irrigation to investigate the anatomy, patency, and functional status of the lacrimal drainage system.

Punctal Dilation and Mini-Monoka Stent Insertion

This video demonstrates punctal dilation and insertion of a Mini-Monoka stent for treatment of epiphora due to punctal/canalicular stenosis.

Repair of Tessier 7 Cleft Lip Deformity

The most common of the rare craniofacial clefts, Tessier's No. 7 cleft is represented by a deficiency of tissue that may span from the oral commissure to the ear. (1) The repair of the cleft of the lip must include especial attention to restoring continuity of the orbicularis oris muscle as well the vermillion. This case is presented as an example of the repair of the Tessier 7 cleft lip deformity. DOI #: http://dx.doi.org/10.17797/4h2edlts5zz

Anand R. Kumar, MD, FACS, FAAP

Johns Hopkins University School of Medicine

• Associate Professor, Departments of Plastic Surgery and Pediatrics

Anand R. Kumar, MD, FACS, FAAP is an Associate Professor in the Departments of Plastic Surgery and Pediatrics at the Johns Hopkins University School of Medicine. A pediatric plastic/craniofacial surgeon and basic science researcher, he conducts investigation into the cellular biology of muscle derived progenitor cells as a source of pathologic heterotopic ossification and for novel regenerative medicine applications. His clinical practice focuses on craniofacial surgery including craniosynostosis, correction of hypertelorism(wide eyes), pediatric and adolescent facial skeletal deformities (Pierre Robin Sequence) with airway obstruction using traditional orthognathic (jaw) surgery and distraction osteogenesis.

Dr. Kumar established the center for facial skeletal surgery and the center for pediatric craniofacial surgery at the University of Pittsburgh Medical Center and now at Johns Hopkins respectively with an emphasis on multidisciplinary care for dentofacial anomalies. He has led efforts to improve outcomes in pediatric sleep apnea using skeletal surgery and distraction osteogenesis for multilevel airway obstruction. In addition, he has participated in multi-institutional trials for improvement of clinical outcomes in neonatal tongue base collapse (Pierre-Robin Sequence).

Dr. Kumar as authored over 30 original scientific publications in peer-reviewed journals and contributed to multiple plastic and orthopedic surgery textbooks over the last 10 years. He serves as a reviewer for many plastic surgery and basic science journals and has been invited as a speaker or panelist to many institutions and at organizational meetings across the United States. He currently serves as Vice President of Communications on the board of the American Society of Maxillofacial Surgeons (ASMS). In addition, he serves on multiple committees in the American Society of Plastic Surgeons and the ASMS.

As an honor student in the biological sciences at the University of California, Irvine, Dr. Kumar received his medical degree from the Albert Einstein College of Medicine. He completed his general surgery residency at the Mayo Clinic Rochester and later completed a second residency in plastic and reconstructive surgery at the University of California, Los Angeles (UCLA). He subsequently completed a pediatric plastic/craniofacial surgery fellowship after his residency at UCLA. In 2004, prior to his academic appointment, Dr. Kumar volunteered for military service and joined the United States Navy until 2010. In Bethesda, MD, he served as director and staff pediatric plastic surgeon of the Military Craniofacial Unit at Walter Reed National Military Medical Center. He served as division chief in plastic and reconstructive surgery at the National Naval Medical Center in Bethesda and on board the United States Naval Support Hospital Ship Comfort. In 2010, Dr. Kumar was recruited to the University of Pittsburgh as the director of facial skeletal surgery until 2013 when he was recruited to Johns Hopkins.

Michael Golinko, MD

University of Arkansas for Medical Sciences

• Medical Director of Craniofacial Program, Arkansas Children’s Hospital
• Assistant Professor of Plastic Surgery, UAMS

Dr. Michael Golinko, M.D., is a Board Certified General Surgeon with clinical interests in Craniofacial, Cleft & Paediatric Plastic Surgery. Dr. Golinko is also Board Eligible with the American Board of Plastic Surgery, and is licensed in the states of Arkansas, and Georgia. Currently, Dr. Golinko serves as one of the Medical Directors of Arkansas Children’s Hospital Craniofacial Program, and is Assistant Professor of Plastic Surgery at the University of Arkansas Medical Sciences.

Dr. Golinko received his M.D. degree from University of South Florida (USF) in 2004, preceded by a M.A. in Medical Anthropology from Universiteit van Amsterdam (UVA) in 2002, and a B.Sc. in Physics from Massachusetts Institute of Technology (MIT) in 1998.

Dr. Golinko’s professional training includes General Surgery residencies at State University of New York (SUNY) and New York University (NYU), as well as a residency in Plastic & Reconstructive Surgery at Emory University School of Medicine, and he most recently served as a Fellow in Craniofacial Surgery/Pediatric Plastic Surgery at New York University (NYU).

From 1998 to 2008, Dr. Golinko held medical research positions at MIT, Massachusetts General Hospital, and completed Post-Doctoral Research Fellowships in the Department of Surgery, Division of Wound Healing at both Columbia University and New York University.

Dr. Golinko has contributed extensively to numerous peer-reviewed publications, book chapters, and abstracts. Moreover, Dr. Golinko has travelled the world to deliver numerous presentations, co-chair lectures and conferences, and media appearances.

Dr. Golinko has been awarded and recognized for the following: Operation Smile Regan Fellowship Recipient (2012), National Institute of Health (NIH) Loan Repayment Program Recipient (2007 – 2009), and Columbia University College of Physicians & Surgeons, Department of Surgery, Startup Grant (2006).

In the spirit of a true leader, Dr. Golinko served as past-President and Mission Leader of Project World Health, Managing Trustee of the Barry Golinko Trust of the Jewish Communal Fund, past-Surgery Department Representative of the Committee on Interns and Residents (CIR) and currently was selected to participate in the Arkansas Children’s Hospital Physician Leadership Development course.

Dr. Golinko currently belongs to several professional societies as follows: American Cleft Palate-Craniofacial Association, American Association of Wound Care, American College of Surgeons, and the Southeastern Society Of Reconstructive Plastic Surgeons.
In 2016, Dr. Golinko served on the American Society of Maxillofacial Surgeons/Plastic Surgery Foundation Combined Pilot Research Grant Committee. In addition to his professional work, Dr. Golinko has generously donated his time and many talents to numerous volunteer and humanitarian efforts all over the world.

Dov Goldenberg, MD

University of Sao Paulo Medical School

• Coordinator of Pediatric Plastic Surgery
• Supervisor (Residency Program in Plastic Surgery at the Division of Plastic Surgery), Hospital das Clinicas – University of Sao Paulo Medical School
• Attending Cranio-facial Surgeon – Division of Head and Neck Surgery and Otorhiolaryngology, Hospital A.C. Camargo
• Senior Surgeon and head of Cranio-maxillo-facial Surgery Team, Hospital Albert Einstein
• Chief of Pediatric Plastic Surgery Group, Hospital Municipal Infantil Menino Jesus

Residing in São Paulo, Brazil, Dr. Goldenberg graduated from the University of São Paulo Medical School. He then continued his studies with Postdoctoral Training and completed the Residency Program in General Surgery, followed by the Residency Program in Plastic Surgery at the Hospital of the Faculty of Medicine, University of São Paulo, Brazil.

Soon thereafter, Dr. Goldenberg earned his PhD in Plastic Surgery at the University of São Paulo Medical School, where he also gained his title as Full Professor of the Department of Surgery.

Dr. Goldenberg is the Editor-In-Chief for the Brazilian Journal of Plastic, International Associate Editor of Plastic and Reconstructive Surgery Journal (PRS), and past President of the Brazilian Association of Craniomaxillofacial Surgery.

His areas of interest in plastic surgery include Pediatric Plastic Surgery, Cranio-facial Surgery and Vascular Anomalies.

Nahyoung Grace Lee, MD

Harvard Medical School

• Massachusetts Eye and Ear Infirmary

Grace Lee, M.D. is an ophthalmologist at Massachusetts Eye and Ear (MEE) with a rigorous clinical practice in ophthalmic plastic surgery.  Approximately 80% of her time is devoted to patient care, which is integrated with teaching residents and fellows in the clinic and surgical setting.  This component also includes direct instruction in the wet lab and weekly supervision in the MEE emergency room.  Twenty percent of Dr. Lee‘s time is spent doing clinical and basic science research.Dr. Lee completed her BA of Neuroscience at Johns Hopkins University followed by a doctorate in Medicine. Upon completing her ophthalmology residency at the University of Southern California, she pursued a fellowship in ocular oncology and pathology at the Casey Eye Institute, at the Oregon Health & Science University. She directly taught residents in the pathology lab as well as through over 15 hours of didactic lectures. Her additional training involved three years of fellowship in oculoplastic surgery at MEE, where she was the recipient of the Fellow of the Year teaching award.  During this fellowship, Dr. Lee collaborated with Dr. Leo Kim to produce an animal model of orbital inflammation and investigated angiogenesis in thyroid eye disease, which was published in Ophthalmology. At the culmination of her training, she was inducted into the American Society of Ophthalmic Plastic and Reconstructive Surgeons (ASOPRS) and is now Assistant Professor of Ophthalmology at Harvard Medical School (HMS).Dr. Lee‘s clinical expertise and innovations have focused on thyroid eye disease and common conditions in ophthalmic plastic surgery.  She has expanded her clinical practice to involve anterior segment tumors, building on her fellowship in ocular oncology.  In the process, she has trained 4 fellows, 3 of whom have accepted or will be accepting positions at academic institutions.  Additionally, she serves as an oral board examiner for the American Board of Ophthalmology.

Neil Tanna, MD, MBA, FACS

Hofstra Northwell School of Medicine

• Associate Program Director of Plastic Surgery
• Northwell Health
• Associate Professor of Plastic Surgery
• Hofstra Northwell School of Medicine

Dr. Neil Tanna is a Double Board Certified Plastic Surgeon with clinical interest in cosmetic and reconstructive surgery. He is among a very small group of Plastic Surgeons in the world to have completed formal training in Otolaryngology, Plastic & Reconstructive Surgery, and Microvascular Surgery.

After receiving his medical degree from Albany Medical College, Dr. Tanna completed a full Otolaryngology – Head & Neck Surgery residency at The George Washington University. He pursued further training and completed a second full residency in Plastic & Reconstructive Surgery at the University of California, Los Angeles (UCLA). He then completed a fellowship in advanced reconstructive and microvascular surgery at the Institute of Reconstructive Plastic Surgery at New York University (NYU).

Beyond his plastic surgery clinical practice, Dr. Neil Tanna is a mentor, respected educator, and prolific author. Currently, he serves in many leadership roles. He is Chief of Plastic Surgery at one of the one of the Northwell Health hospitals. He is an Associate Professor with the Hofstra University School of Medicine, where he is engaged in the education of students. He also serves as Associate Program Director for the Plastic Surgery Residency with Northwell Health System. He trains resident physicians in becoming Plastic Surgeons.

The medical work and clinical research of Dr. Neil Tanna have been widely published in national and international medical journals. He has authored over 75 publications in major peer-reviewed medical journals and written over 10 textbook chapters. Given his interest in aesthetic and reconstructive surgery of the head and neck, breast, and body, Dr. Tanna has been invited to present at over 75 national and international meetings. He presents the latest advances in plastic surgery to his colleagues and other surgeons from all around the world.

Dr. Neil Tanna has been recognized in the 2015 and 2016 New York Times Super Doctors List for his noteworthy and outstanding achievements.

Cleft Lip Revision: Tips and Tricks

Attendees will learn various tips and tricks to a successful cleft lip revision procedure. There will be a Q&A session to address common challenges and how to address them.

Course Directors

Panelists

Alveolar Bone Graft Surgery: Tips and Tricks

This webinar will focus on the surgical management of alveolar clefts with bone grafting and fistula closure. Our panel of experts will share various techniques and graft source materials including tips and tricks learned along the way. Our guest moderator will lead a panel discussion at the end of the session to discuss some of the controversies and key points in alveolar grafting.

Covid-19 Impact on Anesthesia and Aero-Digestive Surgeries

Please join us for an interactive webinar on a variety of topics related to COVID 19. Organized by the Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India and moderated by Dr. Jayanthy Pavithran, Dr. Deepak Mehta, and Dr. Kishore Sandu, this panel will discuss the following topics:

1. Practical tips for endoscopy and use of powered instruments. | Presented by Dr. Deepak Mehta, Director, Pediatric Aerodigestive center and Dr. Shasidhar Tatavarthy, Senior consultant, Head, Ent Head Neck surgery Artemis Hospitals, Delhi

2. Psychiatry and C19. | Presented by Dr. Kusum Kathpalia (NY State)

3. Covid 19: An anesthetist’s view point from its pathogenesis to future airway interventions. | Presented by Dr. Patrick Schoettker, Medecin Chef- Anesthesia department. Lausanne University Hospital. Switzerland

4. Airway surgeries during Covid times. | Presented by Dr. Kishore Sandu, Medecin Chef, ORL department, Lausanne University Hospital. Switzerland.

5. Albatross Cases In Airway. | Presented by Dr. EV Raman , Consultant ENT Surgeon, Convenor, Children’s Airway and Swallowing Center ( CASC),Manipal Hospital, Bangalore and Dr.Rakesh Srivastava, Senior Consultant (Laryngologist, Sushrut Institute of Plastic Surgery & Super speciality Hospital, Lucknow, India.

This webinar is geared towards: airway surgeons (adult & pediatric), laryngologists, ENT, anesthesiologists and phoniatricians (SLP).

For more info on the CSurgeries webinar series, please go to www.csurgeries.com

Cleft Primary and Revision Rhinoplasty: Tips and Tricks

Tune in for the latest in our series on Cleft Surgery featuring Dr. Raj Vyas from UC Irvine and Dr. Usama Hamdan with the Global Smile Foundation. The discussion will focus on making sure that attendees know proper procedures as well as common complications and how to avoid them.

Larry Hartzell, MD FAAP is an Associate Professor of Otolaryngology Head and Neck Surgery at Arkansas Children’s Hospital. He is the Director of the Pediatric Otolaryngology fellowship. Dr Hartzell also has been the Cleft Team Director in Arkansas since 2012. He is passionate about international humanitarian mission work and dedicates much of his research efforts to cleft surgical and clinical care as well as velopharyngeal insufficiency. Dr Hartzell is actively involved in multiple academic societies and organizations including the AAO-HNS and ACPA.

Dr. Goudy is a professor at Emory University School of Medicine and the director of the division of otolaryngology at Children’s Healthcare in Atlanta. Dr. Goudy’s clinical job involves repair of craniofacial malformations including cleft lip, cleft palate, and Pierre Robin sequence, and he also participates in head and neck tumor resection and reconstruction.

Dr. Hamdan is President and Co-Founder of Global Smile Foundation, a 501C3 Boston-based non-profit foundation that provides comprehensive and integrated pro bono cleft care for underserved patients throughout the world. He has been involved with outreach cleft programs for over three decades. Dr. Hamdan is an Otolaryngologist/Facial Plastic Surgeon with former university appointments at Harvard Medical School, Tufts University School of Medicine and Boston University School of Medicine. For his philanthropic service to the people of Ecuador, he was awarded the Knighthood, “Al Merito Atahualpa” En El Grado De Caballero, by the President of Ecuador in March 2005. He received Honorary Professorship at Universidad de Especialidades Espíritu Santo, School of Medicine, in Ecuador on March 5, 2015 for his contributions in the field of Cleft Lip and Palate.

Dr. Vyas obtained his BS from Stanford and his MD from UCLA before completing integrated plastic surgery residency at Harvard and a fellowship in Craniofacial Surgery at NYU. He is an active clinician, scientist and educator with over 200 peer-reviewed publications and presentations, 20 book chapters, dozens of invited lectures, and multiple NIH and foundational grants. Dr. Vyas is passionate about advancing knowledge and skill for cleft care worldwide, partnering with Global Smile Foundation as both a clinician and Director of Research.

After completing a pediatric craniofacial fellowship at Boston Children’s Hospital, he joined the Division of Plastic and Reconstructive Surgery at Washington University in St. Louis 2011. He is Director of Craniofacial and Medical Director of the Operating Rooms at Saint Louis Children’s Hospital (SLCH). He treats patients with craniosynostosis or other craniofacial abnormalities (congenital or traumatic). He obtained a Master of Science in Clinical Investigation in May 2017 at Washington University to advance his ability to perform high quality clinical research and this program allows him to take advantage of the tremendous resources available for faculty and residents. His research focus is in craniofacial with particular interest in craniosynostosis and cleft lip and palate.

Dr. David Yates MD, DMD, FACS is passionate about serving children with Cranial and Facial deformities and Cleft Lip and Palate. He is a Board Certified Oral and Maxillofacial Surgeon and was recently awarded the inaugural “Physician of the Year” award by El Paso Children’s Hospital. He is the Division Chief of Cranial and Facial Surgery at El Paso Children’s Hospital and has been critical in bringing complex craniofacial surgery to the region. In addition to being a partner with High Desert Oral and Facial Surgery, he directs the craniofacial clinic at El Paso Children’s Hospital and the craniofacial clinic at Providence Memorial Hospital. He has also been integral in starting a clinic for children with Cleft Lip and Palate in Juarez, Mexico at the Hospital De La Familia (FEMAP). He is now happily settled with his wife and four kids serving the greater El Paso/Las Cruces/Juarez region.

How to Rotate and Advance a Lip

This seminar will review the history and surgical technique of the Millard rotation-advancement unilateral cleft lip repair.  Nuances of the technique designed to optimize outcomes will be discussed and will be illustrated in photographic and video format.

Richard E. Kirschner, M.D., F.A.C.S, F.A.A.P.

Chief, Department of Plastic and Reconstructive Surgery / Director, Cleft Lip and Palate Center
Nationwide Children’s Hospital in Columbus, OH

Richard E. Kirschner, M.D., F.A.C.S, F.A.A.P. is Robert and Edgar T. Wolfe Foundation Endowed Chair, Chief of the Section of Plastic and Reconstructive Surgery, Director of the Cleft Lip and Palate Center, and Co-Director of the 22q Center at Nationwide Children’s Hospital.  He serves as Professor of Surgery and Senior Vice Chair of the Department of Plastic Surgery at The Ohio State University College of Medicine.  Dr. Kirschner served as President of the American Cleft Palate-Craniofacial Association in 2016.  He is co-editor of Comprehensive Cleft Care, now in its second edition, and of the upcoming publication Cleft Palate and Velopharyngeal Dysfunction.  He is co-founder of Casa Azul America, Inc., a non-profit organization devoted to providing education to professionals and care to underprivileged children with cleft lip and palate in Latin America and of Magical Moments Foundation, a wish granting charitable organization dedicated to serving children with facial differences.

Management of VPD in 22q Deletion Syndrome

This seminar will review the pathophysiology, assessment, and surgical management of velopharyngeal dysfunction in children with 22q deletion syndrome.

Richard E. Kirschner, M.D., F.A.C.S, F.A.A.P.

Chief, Department of Plastic and Reconstructive Surgery / Director, Cleft Lip and Palate Center
Nationwide Children’s Hospital in Columbus, OH

Richard E. Kirschner, M.D., F.A.C.S, F.A.A.P. is Robert and Edgar T. Wolfe Foundation Endowed Chair, Chief of the Section of Plastic and Reconstructive Surgery, Director of the Cleft Lip and Palate Center, and Co-Director of the 22q Center at Nationwide Children’s Hospital.  He serves as Professor of Surgery and Senior Vice Chair of the Department of Plastic Surgery at The Ohio State University College of Medicine.  Dr. Kirschner served as President of the American Cleft Palate-Craniofacial Association in 2016.  He is co-editor of Comprehensive Cleft Care, now in its second edition, and of the upcoming publication Cleft Palate and Velopharyngeal Dysfunction.  He is co-founder of Casa Azul America, Inc., a non-profit organization devoted to providing education to professionals and care to underprivileged children with cleft lip and palate in Latin America and of Magical Moments Foundation, a wish granting charitable organization dedicated to serving children with facial differences.

Michael Golinko Was Live! Craniosynostosis: A Surgeon's Perspective

On February 14th, 2018 we were honored to have Michael S. Golinko MD, MA, FAAP, host our first Facebook Live. Dr. Golinko is one of our valued CSurgeries Section Editors for Plastic Surgery, Medical Director of the Craniofacial Anomalies Program at the Arkansas Children’s Hospital, and an Assistant Professor of Plastic Surgery for the University of Arkansas for Medical Sciences.
Dr. Golinko was a great presenter during the live event and shared his views on best practices for approaching craniosynostosis. His discussion on the subject provides information that both surgeons, medical students, and patients will find interesting and informative.

Topics Dr. Golinko covers include:

• What is craniosynostosis
• How common is craniosynostosis
• Types of craniosynostosis – sagittal, coronal, metopic, lambdoid
• Craniosynostosis vs. plagiocephaly
• Brain growth in the first year of life
• Facts about the development of the brain and development issues that might occur with craniosynostosis
• The importance of operating on the skull when an infant has craniosynostosis to allow for normal brain growth
• Common consults including flat head, closed soft spot, suture closure, and premature fusion
• Signs, symptoms, and risks of craniosynostosis
• Downstream effects of untreated craniosynostosis
• Treatment options for addressing craniosynostosis – cranial vault remodeling, spring assisted
• Survivor rates and complications

Watch the recorded Facebook Live here!

Dr. Golinko also walks us through his team’s published CSurgeries video Fronto-Orbital Advancement and Cranial Vault Remodeling for Metopic Craniosynostosis.  He discusses why he recommends CSurgeries as an educational tool for both surgeons and medical students and wraps up by answering questions on the topic.
Dr. Golinko shared his presentation here.
A special thanks to Dr. Michael Golinko for hosting such an informative Facebook Live.

Introducing our presenters for the upcoming Cleft Lip Revision webinar!

This webinar comes as the latest in a long line of installments dealing with the Cleft Palate. In this session, attendees will learn various tips and tricks to a successful cleft lip revision procedure. There will be a Q&A session to discuss common challenges and how to address them.

Meet the Course Directors

Meet the Presenters

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