The authors present their experience with the use of Zyplast (glutaraldehyde crosslinked collagen) for the treatment of skin creases in the aging face, lip augmentation, scars, and facial atrophy. One hundred female patients were studied over a nine-month period. The results were found to be superior in some aspects compared with Zyderm II collagen, but there is loss of correction after six months and repeated "top-up" injections are needed every four to six months to maintain a satisfactory cosmetic correction. Zyplast collagen has not reduced the number of patient visits nor the cost of treatment.

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Morbidity of the conchal cartilage donor site is evaluated in this article. Forty-two patients (from 1984-1994) with 44 donor sites were reviewed retrospectively. In 27 cases an anterior approach was used and in 17 cases a posterior approach was used. Four complications were observed: two cases of delayed healing in the post auricular approach, one case of flattening of the ear after an anterior approach, and one case with an anterior hypertrophic scar was seen. Only one case needed further surgical intervention. The anterior approach is technically easy, safe, and quick to perform but should be avoided in patients with a history or genetic predisposition to keloid or hypertrophic scars.

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Results are presented of dermis grafts used in conjunction with surgery for aging changes in the face. During a two-year period grafts were used to correct crease lines in the glabella and nasolabial creases, as well as angles of the mouth and vermilion. Volume of the grafts was well maintained and very few complications occurred. This technique offers better long-term results than can be obtained by collagen or fat injections. The results and techniques are presented in detail.

Patients seeking secondary rhinoplasty present with various concerns. Preoperative identification of the underlying problems and determination of the techniques required to correct them are important to successful secondary procedures. LEVEL OF EVIDENCE 4: Therapeutic.