Minas S Constantinides, M.D.

Osteotomies in the crooked nose
Bloom, Jason D; Immerman, Sara B; Constantinides, Minas
2011 Oct;27(5):456-466, Facial plastic surgery
The crooked nasal pyramid and upper third of the nose can be straightened with various osteotomes. Appropriate solutions to maximize successful nasal straightening require a thorough knowledge of the anatomy, a comprehensive preoperative plan, and the appropriate osteotomy choice
— id: 145754, year: 2011, vol: 27, page: 456, stat: Journal Article,

Cartilage grafting in nasal reconstruction
Immerman, Sara; White, W Matthew; Constantinides, Minas
2011 Feb;19(1):175-182, Facial plastic surgery clinics of North America
Nasal reconstruction after resection for cutaneous malignancies poses a unique challenge to facial plastic surgeons. The nose, a unique 3-D structure, not only must remain functional but also be aesthetically pleasing to patients. A complete understanding of all the layers of the nose and knowledge of available cartilage grafting material is necessary. Autogenous material, namely septal, auricular, and costal cartilage, is the most favored material in a free cartilage graft or a composite cartilage graft. All types of material have advantages and disadvantages that should guide the most appropriate selection to maximize the functional and cosmetic outcomes for patients
— id: 114853, year: 2011, vol: 19, page: 175, stat: Journal Article,

Franchise medicine: how I avoid being a commodity in a global market
Constantinides, Minas
2010 Feb;26(1):34-38, Facial plastic surgery
As facial plastic surgery becomes more global, pressures for practices to become commoditized will increase. Commoditized practices are those in which price drives the quality of the product. Franchised surgical practices have also recently increased within the United States and abroad. These are always commoditized by their corporate philosophies. There are better ways to create value than to lower price to compete with a neighboring practice. By establishing a Transcendent Relationship of growth, both the surgeon and the patient are more satisfied with their facial plastic surgical experiences. Key tools helpful in predicting future directions for a practice, the Four Compass Points and the Average Best Patient, will be introduced
— id: 107270, year: 2010, vol: 26, page: 34, stat: Journal Article,

Nasal soft tissue trauma and management
Immerman, Sara; Constantinides, Minas; Pribitkin, Edmund A; White, W Matthew
2010 Dec;26(6):522-532, Facial plastic surgery
The nose is the most prominent of all facial structures and is susceptible to many types of trauma. All soft tissue injuries of the nose have the potential to distort its appearance and adversely affect the patient's self-image and self-esteem. Once life-threatening injuries are stabilized, a careful history and physical exam should be completed and treatment individualized. The ultimate objective of treatment is to achieve both functional and cosmetic restoration with timely diagnosis and repair. Immediate nasal reconstruction is ideal when medically possible because this decreases long-term sequelae
— id: 114596, year: 2010, vol: 26, page: 522, stat: Journal Article,

Management of acute soft tissue injury to the auricle
Lavasani, Leela; Leventhal, Douglas; Constantinides, Minas; Krein, Howard
2010 Dec;26(6):445-450, Facial plastic surgery
The external ear is commonly involved in facial trauma. Injuries to the ear can range from simple lacerations to complete avulsions. We review the normal auricular anatomy and vascular supply, as well as the initial management of any auricular injury. Furthermore, we review the literature on soft tissue injuries of the ear and present a simple algorithm for classifying injuries. The classification is based on whether or not cartilage is involved. Injuries to the lobule do not involve cartilage and thus are more easily repaired by simple closure or Z-plasty. Injuries involving cartilage are further classified into partial or complete avulsions. A complete avulsion is then categorized by having a wide or narrow pedicle. There is no standardized, definitive management for the various types of auricular trauma, and this schema may assist in deciding which of the various reconstructive options is most appropriate for a particular case
— id: 134420, year: 2010, vol: 26, page: 445, stat: Journal Article,

Quantitative comparison between microperforating osteotomies and continuous lateral osteotomies in rhinoplasty
Zoumalan, Richard A; Shah, Anil R; Constantinides, Minas
2010 Mar-Apr;12(2):92-96, Archives of facial plastic surgery
OBJECTIVE: To determine the difference in nasal bone narrowing between 2 techniques: the low lateral intranasal perforating osteotomy technique and the low lateral continuous osteotomy technique. METHODS: A retrospective analysis of preoperative and postoperative photographs to determine the changes of the dorsal width of the nose (width of plateau of the nose, or dorsal nasal highlight) and the ventral width (junction of the flattened surface of the maxilla and the ascending nasal process of the maxilla). RESULTS: Twenty patients underwent continuous osteotomies, and 40 underwent intranasal perforating osteotomies. The continuous osteotomy technique had a preoperative to postoperative decrease in the ventral width of 7.0% (P < .01). The perforating osteotomy technique had a decrease in the ventral width of 3.6% (P < .001). Neither technique resulted in a statistically significant change in dorsal width (P < .25). There was no significant difference in ventral and dorsal narrowing when comparing continuous osteotomies to perforating. CONCLUSIONS: Both the continuous and perforating osteotomy technique resulted in a decrease in the ventral nasal bone width. No statistical difference was found between continuous and perforating osteotomy techniques in the amount of nasal bone narrowing (P < .25)
— id: 108436, year: 2010, vol: 12, page: 92, stat: Journal Article,

Cosmetic Rhinoplasty
Constantanides, Minas
Philadelphia, Pa. : Saunders, 2009,
— id: 1797, year: 2009, vol: , page: , stat: ,

Cosmetic Rhinoplasty. Preface
Constantinides, Minas
2009 Feb;17(1):xi-xi, Facial plastic surgery clinics of North America
— id: 137979, year: 2009, vol: 17, page: xi, stat: Journal Article,

The rhinoplasty consultation and the business of rhinoplasty
Constantinides, Minas
2009 Feb;17(1):1-5, v, Facial plastic surgery clinics of North America
The business of rhinoplasty has undergone changes in keeping with increased competitive pressures locally, nationally, and internationally. Patient demands and progress in the field have abolished the 'cookie-cutter' nose, with patients now requesting extensive discussions and predictions with computer photoimaging. The R-Factor Question and The D.O.S. Conversation are effective tools in rhinoplasty consultations. These tools provide patients with the clarity of what surgery can do for their lives and help patients overcome the fear produced by the overwhelming amount of information available. By helping our patients achieve the next level of success in their lives, we guarantee ourselves a busy practice filled with happy patients. The rhinoplasty consultation is the key to beginning this relationship of success
— id: 99586, year: 2009, vol: 17, page: 1, stat: Journal Article,

Trends in functional rhinoplasty 2008
Lee, Judy; Constantinides, Minas
2009 Aug;17(4):295-301, Current opinion in otolaryngology & head & neck surgery
PURPOSE OF REVIEW: This article reviews the recent literature on functional rhinoplasty for the most important contributions in the field. RECENT FINDINGS: Surgical techniques for improving the internal nasal valve include upper lateral cartilage fold-in flap, splay graft, alar batten graft, Z-plasty, and the alloplastic Monarch implant. The Nasal Obstruction Septoplasty Effectiveness (NOSE) score and the Rhinoplasty Outcomes Evaluation score have been applied to objectify outcomes in functional rhinoplasty. Functional endoscopic sinus surgery (FESS) and rhinoplasty continue to be safely used in the same surgical sitting. SUMMARY: The last few years have seen improved perspective on what surgery can do, substantiating the inherent difficulties of establishing reproducible outcomes in form and function of the nose
— id: 100666, year: 2009, vol: 17, page: 295, stat: Journal Article,

Surgical and nonsurgical treatments of the nasal valves
Lee, Judy; White, W Matthew; Constantinides, Minas
2009 Jun;42(3):495-511, Otolaryngologic clinics of North America
Nasal obstruction is known to be associated with a major decrease in disease-specific quality of life, and nasal valve dysfunction can play a considerable role in nasal airflow obstruction. Diagnosis and treatment of nasal valve dysfunction requires a thorough understanding of normal anatomy and function as well as pathophysiology of common abnormalities to properly treat the exact source of dysfunction. As the pathophysiology of the nasal valves has become better understood, surgery designed to treat its dysfunction has evolved. Here, we explore the progress we have made in treating the nasal valves, and the deficiencies we still face
— id: 99244, year: 2009, vol: 42, page: 495, stat: Journal Article,

Face to Face program: the first 17 years
Constantinides, Minas
2008 Nov-Dec;10(6):433-438, Archives of facial plastic surgery
— id: 92173, year: 2008, vol: 10, page: 433, stat: Journal Article,

Aesthetic repair of small to medium-sized nasal defects
Shah, Anil R; Zoumalan, Richard; Constantinides, Minas S
2008 Jan;24(1):105-119, Facial plastic surgery
Reconstruction of small and medium-sized defects of the nose poses a challenge to the facial plastic surgeon. Flaps for small to medium-sized defects most often are closed in single-staged procedures as opposed to larger-sized defects. A variety of techniques can be used including secondary intention, primary closure, full-thickness skin grafts, composite grafts, rhomboid flaps, bilobe flaps, dorsal nasal flaps, island flaps, and inferiorly based meliolabial flaps
— id: 78690, year: 2008, vol: 24, page: 105, stat: Journal Article,

Quantitative analysis of lateral osteotomies in rhinoplasty
Kortbus, Michael J; Ham, Jongwook; Fechner, Frank; Constantinides, Minas
2006 Nov-Dec;8(6):369-373, Archives of facial plastic surgery
OBJECTIVE: To statistically analyze the long-term results of osteotomy after rhinoplasty. DESIGN: In a consecutive series of 51 patients who underwent reduction rhinoplasty from May 1, 2000, through September 30, 2003, all underwent the same method of bilateral lateral osteotomies, performed by one of us. Twenty patients agreed to participate in this study. The follow-up ranged from 7 to 36 months (mean, 12.6 months). By using preoperative and postoperative photographs, comparisons were made of the change in the dorsal width of the nose (the anterior junction of the nasal bones) and of the ventral width of the nose (where the nasal processes of the maxilla meet the body of the maxilla). RESULTS: There was a significant change (P = .003) in the ventral width of the nose after nasal bone osteotomy. There was no significant change (P = .24) in the dorsal width of the nose. CONCLUSIONS: By using this technique of osteotomy, it is possible to narrow the ventral width of the nose with statistical significance. The dorsal width of the nose is maintained in reduction rhinoplasty. To our knowledge, this is the first attempt to quantify the amount of narrowing achieved after nasal osteotomies
— id: 70313, year: 2006, vol: 8, page: 369, stat: Journal Article,

Development of nasal skin necrosis associated with rituximab treatment for Waldenstrom's macroglobulinemia and subsequent spontaneous resolution
Pearlman, Aaron N; Fechner, Frank P; Constantinides, Minas
2006 Jul;85(7):431-433, Ear, nose & throat journal
We report the unusual case of a 72-year-old man who developed acute and extensive necrosis of the nasal skin and soft-tissue envelope while undergoing chemotherapy for Waldenstrom's macroglobulinemia, a lymphoproliferative disorder The patient's treatment involved infusions of rituximab, a chimeric monoclonal antibody that is directed against B cell surface membrane protein CD20. The patient refused surgery to restore the nose, and he was treated conservatively with wet-to-dry dressings and antibiotic ointment. Approximately 5 weeks after admission, the eschar had exfoliated, revealing that the underlying skin was pink and healthy; no significant areas of necrosis remained. Within weeks, the nose had healed completely without scarring. A good aesthetic result was achieved exclusively through healing by secondary intention. We wish to alert the medical community that (1) conservative management of even extensive nasal skin loss should be considered when clinically acceptable, and (2) there may be an association between anti-CD20 antibody therapy for Waldenstrom's macroglobulinemia and skin necrosis
— id: 68778, year: 2006, vol: 85, page: 431, stat: Journal Article,

Aligning the bony nasal vault in rhinoplasty
Shah, Anil R; Constantinides, Minas
2006 Feb;22(1):3-8, Facial plastic surgery
The bony nasal vault represents a complex three-dimensional structure, analogous to a truncated pyramid or pyramidal frustrum. By analyzing the nasal bones and determining the length and width of the nasal bones, appropriate surgical measures can be employed. In addition, a review of several different osteotomy techniques is performed
— id: 64790, year: 2006, vol: 22, page: 3, stat: Journal Article,

Nuances in tip modification: specific applications of cartilage splitting in rhinoplasty
Shah, Anil R; Constantinides, Minas
2006 Feb;22(1):36-41, Facial plastic surgery
Division of the lower lateral cartilages in rhinoplasty has long been maligned for producing unnatural results. However, recognition of medial, intermediate, or lateral crural discrepancies allows for their division and overlay. By identifying variant nasal anatomy and understanding the anticipated postsurgical dynamics, the rhinoplasty surgeon will be able to produce consistent, natural outcomes
— id: 64791, year: 2006, vol: 22, page: 36, stat: Journal Article,

A simple and reliable method of patient evaluation in the surgical treatment of nasal obstruction
Constantinides, Minas; Galli, Suzanne K Doud; Miller, Philip J
2002 Oct;81(10):734-737, Ear, nose & throat journal
We have developed a simple method of evaluating nasal obstruction both before and after corrective surgery. With our system, patients self-rate their nasal patency on a 10-point visual analog scale under different conditions. After a baseline self-assessment, patients rate their breathing while the examiner lifts the lower lateral nasal cartilage with an ear curette and again during lifting of the upper lateral cartilage. Separate assessments during cartilage support are made before and after the patient has received nasal decongestion therapy. The results of these manipulations help identify the specific structural abnormality and its anatomic site, thereby serving as a reliable aid to planning surgery (i.e., open septorhinoplasty, turbinoplasty, external valve surgery with alar batten grafts, and/or internal valve surgery with spreader grafts with or without composite skin/cartilage grafts). We tested our method in preoperative evaluation and surgical planning on 19 patients with nasal obstructions. Our method was just as useful in making postoperative assessments, and it allowed us to judge the effectiveness of specific procedures in restoring nasal patency. Of the 19 patients, 18 (94.7%) reported that their nasal breathing had improved following surgery
— id: 39573, year: 2002, vol: 81, page: 734, stat: Journal Article,

Complications of static facial suspensions with expanded polytetrafluoroethylene (ePTFE)
Constantinides M; Galli SK; Miller PJ
2001 Dec;111(12):2114-2121, Laryngoscope
BACKGROUND: Expanded polytetrafluoroethylene (ePTFE) is a synthetic porous material that has been used for static suspension in facial paralysis. It is manufactured in thin (1-mm or 2-mm) sheets that can be cut into strips and implanted through keyhole facial incisions. Regional deformities are addressed by multiple suspensions that provide cosmetic and functional therapy. The use of ePTFE eliminates donor site morbidity associated with the traditional harvest of fascia from either the temporal area or fascia lata. However, properties unique to this alloplast contribute to the complications that have occurred after its use in facial reanimation. OBJECTIVE: To describe complications with the use of ePTFE for facial suspension. SETTING: Academic medical center. METHOD: Retrospective chart review and review of literature. RESULTS: Six patients with facial paralysis who were treated with the ePTFE sling procedure had complications. Five slings failed because of stretch despite prestretching at implantation. One patient developed a late wound infection requiring removal of the sling. CONCLUSION: An ePTFE facial sling is an option for static facial suspension that can be therapeutic for patients with seventh nerve damage. There is a high rate of complications leading to revision surgery. Future studies are needed to evaluate alloplastic alternatives to ePTFE
— id: 25993, year: 2001, vol: 111, page: 2114, stat: Journal Article,

Vertical lobule division in rhinoplasty: maintaining an intact strip
Constantinides M; Liu ES; Miller PJ; Adamson PA
2001 Oct-Dec;3(4):258-263, Archives of facial plastic surgery
OBJECTIVE: To review the indications for, surgical techniques of, and results of vertical lobule division (VLD) of the alar cartilages. DESIGN: Prospective study of patients assigned to undergo variations of VLD of the lower lateral cartilages. SETTING: Private facial plastic surgery practice in a major university teaching hospital. PATIENTS: Twenty-four patients who underwent variations of VLD of the lower lateral cartilages with re-creation of an intact strip, including 4 patients undergoing revision. MAIN OUTCOME MEASURES: Postoperative photographs were reviewed for tip projection and rotation, tip symmetry, bossae, knuckles, columellar position and length, and alar retraction. Patients were polled about their overall satisfaction with nasal aesthetics and degree of subjective nasal obstruction preoperatively and postoperatively. RESULTS: Vertical lobule division decreased projection in 22 of 22 patients, increased rotation in 12 of 12 patients, decreased rotation in 1 of 2 patients, corrected tip asymmetry in 3 of 4 patients, and shortened a long infratip lobule in 1 patient. Postoperatively, bossae and knuckling developed in 1 patient, and 2 patients demonstrated alar retraction that did not exist preoperatively. One patient undergoing revision noted worsened nasal obstruction not related to VLD. CONCLUSIONS: Vertical lobule division is a reliable, safe technique with predictable outcomes in tip repositioning. It allows for preservation of a strong tip complex while adding versatility to tip refinement
— id: 25994, year: 2001, vol: 3, page: 258, stat: Journal Article,

Midfacial effects of the deep-plane facelift
Miller PJ; Constantinides M; Galli SK
2001 Feb;17(1):49-56, Facial plastic surgery
Rejuvenation of the midface is a challenge in facial plastic surgery. To this end, several techniques have been developed to address the changes seen in the midface with aging. Specifically, ptosis of the malar fat pad and deepening of the nasolabial fold contribute to the aesthetic changes that characterize midfacial aging. The history of modern facelifts and deep-plane facelift techniques to correct the nasolabial fold are presented
— id: 25995, year: 2001, vol: 17, page: 49, stat: Journal Article,

Managing the tension nose
Constantinides M; Levine J
2000 ;8(4):479-486, Facial plastic surgery clinics of North America
— id: 26024, year: 2000, vol: 8, page: 479, stat: Journal Article,

Malar, submalar, and midfacial implants
Constantinides MS; Galli SK; Miller PJ; Adamson PA
2000 ;16(1):35-44, Facial plastic surgery
A resurgence of malar augmentation using alloplastic implants can be attributed to the safety, simplicity of technique, and reliable good results of these implants. As the more sculpted face becomes a common aesthetic goal, malar augmentation plays an increased role in facial plastic surgery practices. It provides a natural, 'unoperated' look that is preferred by most patients today. The history of our current aesthetic and how new alloplasts have contributed is reviewed. The development of simpler techniques of malar analysis will also be reviewed. An indepth look at aesthetic analysis, implant choice, surgical approach, postoperative results, and possible complications will provide a thorough review of current malar implantation
— id: 25991, year: 2000, vol: 16, page: 35, stat: Journal Article,

Softform for facial rejuvenation: historical review, operative techniques, and recent advances
Miller PJ; Levine J; Ahn MS; Maas CS; Constantinides M
2000 ;16(1):23-28, Facial plastic surgery
The deep nasolabial fold and other facial furrows and wrinkles have challenged the facial plastic surgeon. A variety of techniques have been used in the past to correct these troublesome defects. Advances in the last five years in new materials and design have created a subcutaneous implant that has excellent properties. This article reviews the development and use of Softform facial implant
— id: 25992, year: 2000, vol: 16, page: 23, stat: Journal Article,

Curative radiotherapy for anterior commissure laryngeal carcinoma
Persky MS; Lagmay VM; Cooper J; Constantinides M; O'Leary R
2000 Feb;109(2):156-159, Annals of otology rhinology & laryngology
There is continuing controversy surrounding the most effective treatment of glottic carcinoma involving the anterior commissure (AC). Surgery has been the preferred method of treatment, since studies previously indicated early tumor invasion of the thyroid cartilage at the AC, thereby assuming less curability by radiotherapy (RT). Subsequent laryngeal anatomic studies and refinement of RT techniques have brought into question the ineffectiveness of curative irradiation. A retrospective review of 174 patients with early-stage glottic carcinoma treated with standard fractionation curative RT revealed 34 patients with T1 and T2 lesions involving the AC. Allowing for a follow-up of at least 3 years, we observed only a 12% (4 of 34 patients) local recurrence rate after RT alone, with excellent voice quality and no major complications related to the irradiation. The 4 local recurrences were controlled by total laryngectomy, although 2 patients developed distant metastatic disease. Radiotherapy represents an effective method of treating T1 squamous cell carcinoma of the glottis with AC involvement. The small number of T2 glottic carcinomas in this study prevents a meaningful conclusion concerning treatment of these lesions
— id: 8550, year: 2000, vol: 109, page: 156, stat: Journal Article,

An unusual late reaction to facial injections
Constantinides M; Zimbler MS; Jagirdar J
1999 Apr;120(4):557-560, Otolaryngology, head & neck surgery
— id: 6083, year: 1999, vol: 120, page: 557, stat: Journal Article,

Grafting for nasal valve collapse
Miller PJ; Constantinides M
1999 ;10(3):238-242, Operative techniques in otolaryngology, head & neck surgery
— id: 26023, year: 1999, vol: 10, page: 238, stat: Journal Article,

New developments in nasal valve analysis and functional nasal surgery
Constantinides M; Miller PJ
1998 ;6(4):238-245, Current opinion in otolaryngology & head & neck surgery
The nasal valve is the most important region responsible for air flow and nasal resistance. In the past five years, numerous advances have been made in nasal valve analysis and surgery. The discovery that the valve consists of two distinct regions, the external and internal valves, has led to tailored surgical techniques to improve each site independently. Improved objective tests using rhinomanometry, acoustic rhinometry, and magnetic resonance imaging have proven that certain surgical techniques will improve nasal valve function. The roles of septoplasty, inferior turbinate surgery, and cartilage grafting have been objectively analyzed and methodically delineated. The nasal valve is now a prominent factor in planning cosmetic and functional rhinoplasty. This review examines the recent developments in nasal valve surgery and fits them into historical perspective with the evolution of our understanding of the nasal valve
— id: 15967, year: 1998, vol: 6, page: 238, stat: Journal Article,

Simple and serial excisions
Miller PJ; Constantinides M
1998 ;6(2):141-147, Facial plastic surgery clinics of North America
— id: 26022, year: 1998, vol: 6, page: 141, stat: Journal Article,

Vertical lobule division in open septorhinoplasty
Constantinides M; Adamson PA
1997 ;5(2):63-72, Face: facial aesthethic communications in Europe
— id: 26021, year: 1997, vol: 5, page: 63, stat: Journal Article,

Coronoid osteochondroma of the mandible: transzygomatic access and autogenous bony reconstruction
Constantinides M; Lagmay V; Miller P
1997 Dec;117(6):S86-S91, Otolaryngology, head & neck surgery
— id: 12186, year: 1997, vol: 117, page: S86, stat: Journal Article,

Otoplasty for the antihelical fold (chapter 159)
Adamson PA; Constantinides MS
Atlas of head & neck surgery -- otolaryngology Philadelphia : Lippincott-Raven, 1996,
— id: 2750, year: 1996, vol: , page: 430, stat: Chapter,

Otoplasty for the deep conchal bowl (chapter 158)
Adamson PA; Constantinides MS
Atlas of head & neck surgery -- otolaryngology Philadelphia : Lippincott-Raven, 1996,
— id: 2749, year: 1996, vol: , page: 428, stat: Chapter,

Otoplasty refinement techniques (chapter 160)
Adamson PA; Constantinides MS
Atlas of head & neck surgery -- otolaryngology Philadelphia : Lippincott-Raven, 1996,
— id: 2751, year: 1996, vol: , page: 434, stat: Chapter,

The long-term effects of open cosmetic septorhinoplasty on nasal air flow
Constantinides MS; Adamson PA; Cole P
1996 Jan;122(1):41-45, Archives of otolaryngology, head & neck surgery
OBJECTIVE: To determine if elective cosmetic septorhinoplasty impacts on nasal air flow resistance over the long-term. DESIGN: Case series. Mean postoperative follow-up period was 41.5 months (range, 16 to 77 months). PATIENTS: A consecutive sample of 200 patients having undergone cosmetic open septorhinoplasty by one of us (P.A.A.) before July 1992 were contacted by telephone; 50 agreed to participate, and 27 actually participated in the study. INTERVENTIONS: Open cosmetic septorhinoplasty performed by one of us (P.A.A.). MAIN OUTCOME MEASURES: Comparison of preoperative and postoperative nasal resistance values by headout body displacement plethysmography; correlation of preoperative and postoperative nasal valve anatomy with nasal resistance values; and correlation of postoperative nasal resistance values with subjective evaluation of nasal air flow as reported on a 10-point analogue scale. RESULTS: Of the 27 patients, 10 had normal preoperative nasal resistance values and 17 had elevated resistance values. Preoperative Normal Group: Four of the 10 patients' mean resistance values exceeded normal limits postoperatively. One of these four patients reported subjective nasal obstruction. Preoperative Abnormal Group: Of the 17 patients, surgery resulted in normal resistance values postoperatively in six, decreased but still above normal resistance values in eight, and no decrease in postoperative resistance values in three. CONCLUSIONS: (1) Patients with normal nasal resistance values may suffer long-term, asymptomatic increase in nasal resistance values after cosmetic open septorhinoplasty, often with no quantifiable change at the nasal valve. (2) Patients with elevated nasal resistance measurements generally improve with open septorhinoplasty. Patients with isolated septal deformities improve with septoplasty. Patients with upper lateral cartilage collapse improve with spreader grafts. The lasting objective improvement on the nasal valve using spreader grafts is reported herein for the first time. (3) Subjective estimations of nasal patency do not correlate well with objective measures of patency, namely nasal resistance measurements. (4) Cosmetic septorhinoplasty can alter nasal patency. Continued care must be exercised when manipulating the nasal framework for cosmetic purposes, as slight changes to the nasal valve may result in significant alterations in nasal air flow resistance
— id: 6895, year: 1996, vol: 122, page: 41, stat: Journal Article,

Complications of blepharoplasty
Adamson PA; Constantinides MS
1995 ;3(2):211-221, Facial plastic surgery clinics of North America
— id: 26020, year: 1995, vol: 3, page: 211, stat: Journal Article,

Vertical dome division in open rhinoplasty: an update on indications, techniques, and results
Adamson PA; McGraw-Wall BL; Morrow TA; Constantinides MS
1995 ;1995:?-?, Yearbook of plastic, reconstructive, & aesthetic surgery
— id: 26025, year: 1995, vol: 1995, page: ?, stat: Journal Article,

Reduction rhinoplasty
Constantinides M
1995 Oct;105(10):1147-1148, Laryngoscope
— id: 25996, year: 1995, vol: 105, page: 1147, stat: Journal Article,

Vertical dome division in open rhinoplasty. An update on indications, techniques, and results
Adamson PA; McGraw-Wall BL; Morrow TA; Constantinides MS
1994 Apr;120(4):373-380, Archives of otolaryngology, head & neck surgery
OBJECTIVE: A new modification of vertical dome division (VDD) in rhinoplasty using cartilage overlap and suturing to reestablish the integrity of the alar cartilages is analyzed and compared with the more standard technique of cartilage resection and suturing. DESIGN: Retrospective before-and-after trial. SETTING: Private patients of one of the authors (P.A.A.) undergoing surgery in the Department of Otolaryngology of the University of Toronto (Ontario). PATIENTS: A consecutive sample of 116 patients having undergone open rhinoplasty with VDD between 1981 and 1990 were evaluated. Seventy-five had VDD before 1987, when a cartilage resection and suturing technique was used (P.A.A.); 41 had their surgery after 1987, with the cartilage overlap and suturing technique. All patients were available for follow-up. The mean follow-up time was 15.2 months, with a range of 6 to 63 months. INTERVENTION: Indications for VDD were lobule asymmetry (47%), retrodisplacement (24%), wide domal arch (22%), hanging infratip lobule (6%), and rotation (1%). Prior to 1987, VDD was performed by dividing the alar cartilages, resecting certain portions, and then suturing the cartilages together again to recreate the alar margin. After 1987, VDD was revised by overlapping the portions of cartilage that would have been previously resected and suturing the overlapping portions to recreate the alar margin. MAIN OUTCOME MEASURES: Patient satisfaction; physician evaluation; physical examination; blinded comparison of preoperative and postoperative photographs; need for revision surgery. RESULTS: Overall, six (5.0%) of 116 patients required revision surgery or had photographic and/or physical evidence of nasal tip irregularities. Three (4.0%) of 75 patients from the cartilage excision group and one (2.4%) of 41 patients from the overlap group required revision surgery. The other two patients, one in each group, had minor tip irregularities not requiring surgery. The tip irregularities were due to nasal bossae in four patients and lobule asymmetries in two. There was no alar notching or lower nasal third pinching. Tip irregularities were three times as likely to occur in patients presenting for revision rhinoplasty than in those for primary rhinoplasty. CONCLUSIONS: Vertical dome division is a powerful tool in rhinoplasty, allowing for complex manipulations of alar cartilages to selectively enhance projection, rotation, and domal arch width. It also allows for correction of lobule asymmetries and elongation or hanging of the infratip lobule. The cartilage overlap technique reduces the occurrence of several common postoperative tip abnormalities and lowers the need for revision surgery when compared with cartilage resection VDD. The reported results can only be considered trends, as sample sizes in the series were too small to allow for statistical significance
— id: 25997, year: 1994, vol: 120, page: 373, stat: Journal Article,

Aesthetics of blepharoplasty
Constantinides MS; Adamson PA
1994 Jan;10(1):6-17, Facial plastic surgery
— id: 25998, year: 1994, vol: 10, page: 6, stat: Journal Article,

Squamous cell carcinoma in older patients without risk factors
Constantinides MS; Rothstein SG; Persky MS
1992 Mar;106(3):275-277, Otolaryngology, head & neck surgery
Ten patients over sixty years of age with no history of tobacco or alcohol use were treated for squamous cell carcinoma of the upper aerodigestive tract between 1979 and 1991. Nine of these ten patients were women with lesions confined to the oral cavity and oropharynx. Modes of treatment included surgery, radiation, or a combination of surgery and radiation. Followup from 1 to 10 years revealed two deaths from local and distant spread, and eight patients with no evidence of disease. Recurrences after treatment were aggressive and occurred within the same region as the primary lesion. Although most patients with upper aerodigestive squamous cell carcinoma are men with alcohol and/or tobacco exposure, this study demonstrates findings consistent with field cancerization in a group of older women with no risk factors
— id: 13664, year: 1992, vol: 106, page: 275, stat: Journal Article,