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Three-dimensional imaging technology has only recently been described in the literature as a means to plan and better understand tissue expansion. This application is a logical use of the technology as the volume changes achieved with tissue expansion are controlled and often dramatic. This article reviews some of the phenomena associated with tissue expansion that… Read More

PHILOSOPHICAL CONSIDERATIONS Traditional practice in rhinoplasty has tended to rely on resection of the nasal osseocartilaginous framework to achieve aesthetic or functional objectives. Most successes using this approach have proved short lived because the weakened nasal scaffold remaining after reductive surgery often has inadequate strength to withstand the contractile forces of healing. The classic stigmata… Read More

A Stable, Predictable Technique for Major Dorsal Reconstruction J. Jared Christophel, MD; Peter A. Hilger, MD Objective: To assess the long-term stability of osseocartilaginous dorsal onlay rib grafts used for augmentation rhinoplasty. Methods: Patients who had rib grafts used for augmentation rhinoplasty from 2000 through 2009 were assessed for graft viability, graft mobility, graft warping,… Read More

Steven S. Orten, MD; Peter A. Hilger, MD; Minneapolis, Minn A 49-YEAR-OLD PATIENT was seen in consultation for evaluation of chronic nasal air- way obstruction. In 1967, he underwent a septorhinoplasty with significant skeletal reduction to improve the form and function of his nose. His airway was worse postoperatively. The patient noted improvement in his… Read More

Surgical Implications Burke Robinson, MD, Peter Hilger, MD In the evaluation of a patient for cosmetic surgery, an underlying congenital origin for the deformities noted, with possible expression in multiple organ systems, should always be considered. In this case, a 19 year old woman requesting rhinoplasty exhibited facial anomalies: lack of quadrangular and lower lateral… Read More

Peter A. Hilger, MD, George L. Adams, MD At the University of Minnesota and affiliated hospitals several methods of mandibular reconstruction have been used. From October 1978 through March 1984, 11 patients have undergone reconstruction with the A-0 plate technique. These patients had both traumatic and oncologic defects. All patients treated with this technique have… Read More

ROBERT H. MAISEL, M.D., PETER A..HILGER, M.D., GEORGE L. ADAMS, M.D., Minneapolis, MN, ANTHONY M. GIORDANO, M.D., Richmond, VA. ABSTRACT Forty-five patients were evaluated for reconstruction of the mandible. Thirty-four patients has a particulate cancellous bone and marrow (PCM) crib graft placed. Thirty of 34 were successful at the primary operation producing a success rate… Read More