Reinnervation is effective in the management of UVFP, although the specific method may be dictated by anatomical limitations. Prospective studies utilizing uniform and consistent outcome parameters are necessary.

These results in conjunction with other presenting circumstances, such as delay in presentation, can assist the surgeon treating patients with maxillofacial injury in recognizing interpersonal violence against women.

Based on our series, the intraoral technique with a midline incision avoiding disruption of the mentalis muscle is recommended for its ease, simplicity, patient satisfaction, low complication rate, and circumvention of an external scar. The external approach should be considered in cases that require a very large implant.

ace-lift or rhytidectomy is a cornerstone procedure in facial rejuvenation and is rising in popularity. 1 While most patients generally report positive overall experiences, elevated pain levels and accompanying opioid consumption can potentially hinder an otherwise excellent surgical effort and outcome. 2,3 Despite the known adverse effects of nausea, vomiting, dizziness, drowsiness, sedation, pruritus, and urinary retention associated with opioid analgesics, they are an established tool in controlling postoperative pain. 4,5 Publications over the last 2 decades outside of the ambulatory cosmetic surgery realm have described the technique of preemptive analgesia for abating postoperative pain. This approach has shown fewer adverse effects, better pain control, faster recovery, and less social burden on the patient than the use of postoperative opioids. 6,7 Nonsteroidal anti-inflammatory drugs (NSAIDs), particularly cyclooxygenase 2 (COX-2) inhibitors may have inhibitory effects in prostaglandin production in both the spinal cord and peripheral nervous system. This is theorized to be responsible for their role in reducing the hyperalgesia state following surgical trauma. 8 Although celecoxib possesses analgesic effects similar to those of classic NSAIDs, it lacks the adverse effects of antiplatelet function, increased risk of gastric ulceration, bleeding, and bronchospasm in patients sensitive to aspirin. 9 Increased risk of myocardial infarction and hypertension has been associated with the COX-2 inhibitors valde-IMPORTANCE Exploring methods of potentially improving patient comfort and pain control in cosmetic facial surgery.OBJECTIVE To examine the effects of celecoxib in reducing pain and possible opioid consumption following face-lift surgery. DESIGN, SETTING, AND PARTICIPANTSWe reviewed the medical records of 100 patients: 50 consecutive patients who underwent a face-lift without receiving perioperative celecoxib and 50 patients who underwent face-lift and received immediate preoperative and standing postoperative celecoxib. MAIN OUTCOMES AND MEASURESIn addition to demographic information, the following outcome measures were recorded for each group: visual analog scale patient-reported pain, acetaminophen and/or opioid consumption rates, and related analgesic adverse effects. RESULTSThe participants in the noncelecoxib vs celecoxib groups had similar demographic characteristics: mean age, 59.6 vs 57.9 years; mean BMI, 23.3 vs 22.3; history of chronic pain or opioid use, 7 (14%) vs 6 (12%); and 94% of both groups were women. Postoperative pain scores were higher in the noncelecoxib vs celecoxib groups; mean (SD) overall pain score was 3.88 (2.20) vs 2.31 (2.36) (P < .001). The noncelecoxib group had a higher number of postoperative opioid doses than did the celecoxib group: 9.40 (4.30) vs 5.18 (4.58) (P < .05). The noncelecoxib group had a higher incidence of postoperative nausea and vomiting: 12 (24%) vs 0 in the celecoxib group. CONCLUSIONS AND RELEVANCEPreemptive treatment with oral celecoxib appears to be...

The MBFI is a reliable and valid tool for measuring fatigue levels in head and neck cancer patients. In the context of initial assessment or posttreatment trending, this brief survey can be rapidly administered, providing valuable objective data on a very common and potentially debilitating symptom.

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While measuring the independent effects of subalar grafting is limited due to contaminant procedures, it can be recognized as a foundation rhinoplasty technique that, in conjunction with septoplasty, provides medialization of the tip in patients with facial asymmetry. Furthermore, aesthetic correction of nostril horizontal dystopia and/or nostril "show" is achieved with the proper application of this technique. This correction represents a unique intervention in rhinoplasty and should be considered a second indication for its use.

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