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Arch Facial Plast Surg. 2001;3:226.

Beauty
General John Burgoyne by Sir Joshua Reynolds.

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The Future of Facial Plastic Surgery
In a final series of articles on facial plastic surgery in the new millennium, 2 noted experts discuss developments in their areas of expertise. Michael D. Seidman, MD, writes on "Genetics, the Facial Plastic and Reconstructive Surgeon, and the Future" in conjunction with many of the other ARCHIVES journals discussing human genomics. Kristen M. Kelly, MD, and colleagues from the Beckman Laser Institute present "Nonablative Laser and Light Rejuvenation: The Newest Approach to Photodamaged Skin." They discuss the present and future advances in their rapidly evolving field.

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Vertical Lobule Division in Rhinoplasty: Maintaining an Intact Strip
Minas Constantinides, MD, and associates present a prospective study of 24 patients, including 4 revision cases, who underwent variations of vertical lobule division (VLD). With their technique, VLD occurs anywhere along the lobule. The medial and lateral crura are approximated and VLD can be combined with other tip reconstruction techniques. In this series, the VLD was able to decrease projection, increase rotation, decrease rotation, correct the tip asymmetries, and shorten the infratip lobule with good consistency.

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Effect of Blended Carbon Dioxide and Erbium:YAG Laser Energy on Preauricular and Ear Lobule Keloid Fibroblast Secretion of Growth Factors: A Serum-Free Study
Elbert T. Cheng, MD, and colleagues describe a serum-free in vitro model to determine the effect of combined carbon dioxide and erbium:YAG laser irradiation on keloids producing fibroblasts from 2 distinct facial sites. Fibroblasts from both the preauricular area and ear lobule demonstrated decreased transforming growth factor 1 production compared with non–laser-treated fibroblasts. Laser-treated preauricular fibroblasts showed increased production of basic fibroblast growth factor. These results suggest clinical promise in the treatment of keloids and demonstrate different growth factor profiles in keloids from 2 facial regions.

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Frontotemporal Reconstruction With Hydroxyapatite Cement and the Radial Forearm Free Flap
Uttam K. Sinha, MD, and associates discuss a practical alternative to the widely used myocutaneous free flaps for extensive frontotemporal defects. They describe 8 consecutive patients with extensive soft tissue and bony defects in the frontal and temporal regions who underwent primary reconstruction with hydroxyapatite replacement for bone and the radial forearm free flap for soft tissue coverage. Outcomes were good and there was low morbidity from the radial forearm free flap harvest. In addition, operative time was reduced because no intraoperative changes in patient position were required.

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