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NESPS 27th Annual Meeting Abstracts

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Presentation of Results after Facial Rejuvenation as Side-by-Side Animated Videos
John W. Little, MD.
Georgetown University Hospital, Washington, DC, USA.

BACKGROUND
Gillies famously observed that photography brought the single most important contribution to the history of plastic surgery.
Before-and-after results following facial rejuvenation have been shown as more-or-less matched side-by-side static images since the advent of this specialty area in the early years of the prior century. Recently, the development of three-dimensional photography has opened a new dimension to this traditional presentation, one that has yet to play out and define itself as to impact, cost, and practicality. More recently still, Lambros has developed a presentation method for recording aging changes in the face over time using the simple “fade” tool within the custom animation panel of the basic Powerpoint presentation software included with most computer purchases. The creation of such
“superimposed faded views” requires especially well-matched young-old images and is labor-intensive in preparation. It is well suited, however, for the presentation of conventional before-and-after results following facial rejuvenation, as well, and allows the viewer to more precisely follow otherwise subtle changes and shifts between the two images.
The potential for another presentation mode has existed for almost as long as photography itself, but has (for unknown reasons) remained ignored. Moving pictures, and more recently videotape formats, allow the side-by-side presentation of animated before-and-after results following facial rejuvenation that bring an increase in the useful information that can be conveyed (the author has presented at least some of his results in this mode during all his presentations since April, 1907).
METHOD
Before-and-after results following facial rejuvenation are shown first as superimposed faded images, then as side-by-side static facial images, and finally as side-by-side animated video images, with the patients first reading the same nursery rhyme, then smiling (if accepted for presentation, frowning images will be included, documenting blockade of this facial action by division of the DAO).
CONCLUSION
The following aspects of the surgical result can be better appreciated in the moving format, taken in ambient light without flash photography:
• enhanced improvements to the volumetric deficiencies of the face, especially the suborbital and cheek zones, as compared to the static views
• lack of interference with the degree or individuality of the smile (although some post-operative smiles appear “prettier”)
• higher position of the mouth (better dental display) during speech
• camouflage of life-long weakness to DLI (right lower lip depressor) by differential fat grafting and muscle section (in final case)


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