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Papers by Dr. Richard Swift

Aesthetic Surgery Journal, 1999

Background: The endoscopic brow lift procedure is gaining acceptance as an effective aesthetic pr... more Background: The endoscopic brow lift procedure is gaining acceptance as an effective aesthetic procedure. Although several authors have described their techniques, none have objectively quantified their result at 1-year follow-up. Objective: The purpose of this study was to objectively evaluate the outcome after an endoscopic brow lift with a minimum of 1 year follow-up. Methods: The amount of brow elevation at three points along the brow, the outcome of corrugator ablation, changes in corrugator and frontalis furrows, sensory changes, temporal branch function, and patient satisfaction in 20 consecutive patients were evaluated. The average time at follow-up was 15 months, with a range of 12 to 23 months. Results: The brow at the lateral canthus was elevated 2.1 ± 2.8 mm (P < .001), 1.9 ± 2.5 mm (P < .001) at the lateral limbus, and 2.4 ± 3.0 mm (P < .001) at the medial canthus. The frontalis furrows improved significantly (P = .002). Eighty-five percent of the patients had normal sensation, and 15% had abnormal sensation. Seventy-five percent had no alopecia or scarring, and 25% had small areas of spot alopecia and scarring. No patients had a temporal branch nerve injury. Conclusions: This study confirms that the endoscopic brow lift procedure is effective and that the results can be objectively quantified at 1-year postoperative follow-up. The procedure had complications including spot alopecia and some sensory changes persistent at 1 year. A high (95%) patient satisfaction rate was noted in our study.

Aesthetic Surgery Journal, 2004

Plastic and Reconstructive Surgery, 2007

Background: According to the American Society for Aesthetic Plastic Surgery's 2004 Cosmetic Surge... more Background: According to the American Society for Aesthetic Plastic Surgery's 2004 Cosmetic Surgery National Data Bank, during the last 7 years, the number of abdominoplasty procedures performed has increased 344 percent. A national report on abdominoplasty has not been since 1977. Grazer and Goldwyn's study reflects the preliposuction era of abdominal contouring surgery. The purpose of this study was to assess current trends in abdominal contouring techniques and associated procedures and the incidence of their complications. Methods: The study was designed as a descriptive correlation survey evaluating the frequency of various abdominal contour techniques and complications among 3300 randomly chosen members of the American Society of Plastic Surgeons. There were 497 respondents, for a response rate of 15 percent. Results: A total of 20,029 procedures were reported in the survey; 35 percent (n ϭ 7010) were liposuction of the abdomen, 10 percent (n ϭ 2003) were limited abdominoplasties, and 55 percent (n ϭ 11,016) were full abdominoplasties. Survey data covered the plastic surgeon's demographics, techniques, and incidence of complications during a 12-month period. Conclusions: The authors report the largest series of local and systemic complication rates and compare them with those of previously published abdominoplasty surveys. With respect to full abdominoplasty, lower complication rates for deep vein thrombosis (0.04 percent) and pulmonary embolus (0.02 percent) were seen. No deaths were reported. There was no correlation between a surgeon's years in practice and complication rates, in concordance with the earlier study by Grazer and Goldwyn. Despite more extensive abdominal contouring techniques and the addition of liposuction to abdominal contouring, the local and systemic complication rates coincided with previous complication rates, as outlined in other studies.

Journal of Reconstructive Microsurgery, 1997

Delayed donor-site healing remains one of the most significant disadvantages of the radial forear... more Delayed donor-site healing remains one of the most significant disadvantages of the radial forearm free flap. In an effort to decrease morbidity at the donor site, the authors adopted a closure technique that utilized the flexor digitorum sublimis (FDS) and flexor pollicis longus (FPL) muscle bellies to cover the flexor carpi radialis (FCR) tendon prior to placement of a split-thickness skin graft. While this approach eliminated tendon exposure, two patients with postoperative median-nerve compression forced a modification of this technique. The authors now detach the radial attachment of the FDS muscle and mobilize the median nerve away from the underside of the muscle, to prevent kinking of the nerve when the FDS and FPL muscle bellies are sewn together. With these modifications, the technique retains its efficacy, but with an improved margin of safety for the median nerve.

Plastic and reconstructive surgery, 1998

Regional blocking techniques as noted in dentistry, anesthesia, and anatomy texts may result in i... more Regional blocking techniques as noted in dentistry, anesthesia, and anatomy texts may result in inconsistent and imperfect analgesia when needed for facial aesthetic surgery. The advent of laser facial surgery and more complicated aesthetic facial procedures has thus increased the demand for anesthesia support. Surgeons should know a fail-safe method of nerve blocks. Fresh cadaver dissections are used to demonstrate a series of eight regional nerve-blocking routes. This sequence of bilateral blocks will routinely provide profound full facial anesthesia. Certain groupings of blocks are effective for perioral or periorbital laser surgery.

Annals of Plastic Surgery, 1997

Aesthetic Surgery Journal, 1999

Background: The endoscopic brow lift procedure is gaining acceptance as an effective aesthetic pr... more Background: The endoscopic brow lift procedure is gaining acceptance as an effective aesthetic procedure. Although several authors have described their techniques, none have objectively quantified their result at 1-year follow-up. Objective: The purpose of this study was to objectively evaluate the outcome after an endoscopic brow lift with a minimum of 1 year follow-up. Methods: The amount of brow elevation at three points along the brow, the outcome of corrugator ablation, changes in corrugator and frontalis furrows, sensory changes, temporal branch function, and patient satisfaction in 20 consecutive patients were evaluated. The average time at follow-up was 15 months, with a range of 12 to 23 months. Results: The brow at the lateral canthus was elevated 2.1 ± 2.8 mm (P < .001), 1.9 ± 2.5 mm (P < .001) at the lateral limbus, and 2.4 ± 3.0 mm (P < .001) at the medial canthus. The frontalis furrows improved significantly (P = .002). Eighty-five percent of the patients had normal sensation, and 15% had abnormal sensation. Seventy-five percent had no alopecia or scarring, and 25% had small areas of spot alopecia and scarring. No patients had a temporal branch nerve injury. Conclusions: This study confirms that the endoscopic brow lift procedure is effective and that the results can be objectively quantified at 1-year postoperative follow-up. The procedure had complications including spot alopecia and some sensory changes persistent at 1 year. A high (95%) patient satisfaction rate was noted in our study.

Aesthetic Surgery Journal, 2004

Plastic and Reconstructive Surgery, 2007

Background: According to the American Society for Aesthetic Plastic Surgery's 2004 Cosmetic Surge... more Background: According to the American Society for Aesthetic Plastic Surgery's 2004 Cosmetic Surgery National Data Bank, during the last 7 years, the number of abdominoplasty procedures performed has increased 344 percent. A national report on abdominoplasty has not been since 1977. Grazer and Goldwyn's study reflects the preliposuction era of abdominal contouring surgery. The purpose of this study was to assess current trends in abdominal contouring techniques and associated procedures and the incidence of their complications. Methods: The study was designed as a descriptive correlation survey evaluating the frequency of various abdominal contour techniques and complications among 3300 randomly chosen members of the American Society of Plastic Surgeons. There were 497 respondents, for a response rate of 15 percent. Results: A total of 20,029 procedures were reported in the survey; 35 percent (n ϭ 7010) were liposuction of the abdomen, 10 percent (n ϭ 2003) were limited abdominoplasties, and 55 percent (n ϭ 11,016) were full abdominoplasties. Survey data covered the plastic surgeon's demographics, techniques, and incidence of complications during a 12-month period. Conclusions: The authors report the largest series of local and systemic complication rates and compare them with those of previously published abdominoplasty surveys. With respect to full abdominoplasty, lower complication rates for deep vein thrombosis (0.04 percent) and pulmonary embolus (0.02 percent) were seen. No deaths were reported. There was no correlation between a surgeon's years in practice and complication rates, in concordance with the earlier study by Grazer and Goldwyn. Despite more extensive abdominal contouring techniques and the addition of liposuction to abdominal contouring, the local and systemic complication rates coincided with previous complication rates, as outlined in other studies.

Journal of Reconstructive Microsurgery, 1997

Delayed donor-site healing remains one of the most significant disadvantages of the radial forear... more Delayed donor-site healing remains one of the most significant disadvantages of the radial forearm free flap. In an effort to decrease morbidity at the donor site, the authors adopted a closure technique that utilized the flexor digitorum sublimis (FDS) and flexor pollicis longus (FPL) muscle bellies to cover the flexor carpi radialis (FCR) tendon prior to placement of a split-thickness skin graft. While this approach eliminated tendon exposure, two patients with postoperative median-nerve compression forced a modification of this technique. The authors now detach the radial attachment of the FDS muscle and mobilize the median nerve away from the underside of the muscle, to prevent kinking of the nerve when the FDS and FPL muscle bellies are sewn together. With these modifications, the technique retains its efficacy, but with an improved margin of safety for the median nerve.

Plastic and reconstructive surgery, 1998

Regional blocking techniques as noted in dentistry, anesthesia, and anatomy texts may result in i... more Regional blocking techniques as noted in dentistry, anesthesia, and anatomy texts may result in inconsistent and imperfect analgesia when needed for facial aesthetic surgery. The advent of laser facial surgery and more complicated aesthetic facial procedures has thus increased the demand for anesthesia support. Surgeons should know a fail-safe method of nerve blocks. Fresh cadaver dissections are used to demonstrate a series of eight regional nerve-blocking routes. This sequence of bilateral blocks will routinely provide profound full facial anesthesia. Certain groupings of blocks are effective for perioral or periorbital laser surgery.

Annals of Plastic Surgery, 1997