Facial plastic and reconstructive surgery publications and research papers authored or co-authored by Dr. Peter Hilger and Dr. Lyford-Pike.

COVID-19 is an emerging viral illness that has rapidly transmitted throughout the world. Its impact on society and the health care system has compelled hospitals to quickly adapt and innovate as new information about the disease is uncovered. During this pandemic, essential medical and surgical services must be carried out while minimizing the risk of disease transmission to health care workers. There is an elevated risk of COVID-19 viral transmission to health care workers during surgical procedures of the head and neck due to potential aerosolization of viral particles from the oral cavity/naso-oropharynx mucosa. Read more.

Facial expression of emotion is a foundational aspect of social interaction and nonverbal communication. In this study, we use a computer-animated 3D facial tool to investigate how dynamic properties of a smile are perceived. We created smile animations where we systematically manipulated the smile’s angle, extent, dental show, and dynamic symmetry. Then we asked a diverse sample of 802 participants to rate the smiles in terms of their effectiveness, genuineness, pleasantness, and perceived emotional intent. We define a “successful smile” as one that is rated effective, genuine, and pleasant in the colloquial sense of these words. We found that a successful smile can be expressed via a variety of different spatiotemporal trajectories, involving an intricate balance of mouth angle, smile extent, and dental show combined with dynamic symmetry. These findings have broad applications in a variety of areas, such as facial reanimation surgery, rehabilitation, computer graphics, and psychology. Read More. 

The debate continues around transconjunctival versus transcutaneous approaches. Despite the perceived safety of the former, many experienced surgeons continue to advocate the latter. This review aims to present a balanced view of each approach. It will first address the anatomic basis of lower lid aging and then organize recent literature and associated discussion into the transconjunctival and transcutaneous approaches. The integrated algorithm employed by the senior author will be presented. Finally this review will describe less mainstream suture techniques for lower lid rejuvenation and lower lid blepharoplasty complications with a focus upon lower lid malposition. Read More.

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. Read More!

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. Read More.

The Mustarde technique is one of the most commonly used methods for creation of the antihelical fold in the prominent ear deformity. One part of this procedure that can be difficult to perform is precise tightening of the cartilage conforming sutures. 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. Read More.

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. Read more.

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. Read more.

Forty-five patients were evaluated for reconstruction of the mandible. Thirty-four patients has a particulate cancellous bone and marrow (PCM) crib graft placed. Read more.

To live longer and look better, men and women maintain their health and wellness by modifying their diet, exercising, and avoiding deleterious activities such as smoking or alcohol consumption. Although these lifestyle adjustments can help to maintain or improve health, there is often a disconnection between how people may feel on the inside and their outward appearance. With the advent of nonsurgical interventions such as Botox and injectable fillers, as well as newer less invasive surgical techniques, cosmetic procedures and facial rejuvenation are increasing in popularity. The most common motivator for men and women interested in cosmetic surgery is to look younger and improve their appearance; however, men are twice as likely as women are to undergo cosmetic procedures for anticipated work-related benefits. Read more.

Objective: To evaluate the anatomic effects of the transnasal nasal “inside-out” lateral osteotomy in comparison to a continuous lateral osteotomy to widen the excessively narrow bony nasal pyramid. Read more.

Preservation of the middle nasal vault has increasingly become a topic of interest and concern in rhinoplasty. Modification of the nasal dorsum with traditional techniques may create unfavorable cosmetic results and adverse functional sequelae due to collapse of the middle nasal vault. Read more.

Congenital nasal anomalies are rare Choanal atresia occurs in approximately one in 8000 live births. The cleft lip deformity, with its associated nasal deformity, occurs in roughly one in every 1000 live births. Read more.

Let’s face it. Nose development is usually hereditary and, whether you like it or not, the nose your father or mother has is likely to be your own.  As you mature, a handed-down overdeveloped nose, enlarged bridge and wide tip may very well come to create your profile. Read more!