Corey S Maas | University of California, San Francisco (original) (raw)

Papers by Corey S Maas

Facial Plastic Surgery, Nov 1, 2009

Facial Plastic Surgery Clinics of North America, Jul 1, 2023

Plastic and Reconstructive Surgery, Oct 1, 2003

Otolaryngology-Head and Neck Surgery, Oct 1, 1997

A number of surgical procedures exist to improve facial symmetry for patients with faciat paralys... more A number of surgical procedures exist to improve facial symmetry for patients with faciat paralysis. Whereas static symmetry is often improved, dynamic asymmetry frequently persists because of the imbalance of complex coordinated movements of facial expression. The paralyzed face is often distorted by the excessive pull of the normal contralateral face during emotional expression. This study reports an expanded clinical indication for botulinum toxin in patients with unilateral facial paralysis. Ten patients with facial paralysis and markedly asymmetric smiles were treated with botulinum toxin A injections into the contralateral zygomaticus major, levators labii superioris and angulii oris, or risorius muscles. Eight of the 10 patients noted improvement in the symmetry of their smiles and underwent repeat injections. The onset and duration of effect averaged 5.9 days and 3 months, respectively. Botulinum toxin therapy provides a safe and efficacious modality for refining the appearance of the paralyzed face during mimetic activity. (©tolaryngoi Head Neck Surg 1997;117:303-7.) T h e management of unilateral facial paralysis present s a significant challenge to the reconstructive surgeon. Once the facial nerve is injured, the paralyzed face never completely regains its coordinated function. A number of techniques of rehabilitation and :reanimation are available to improve lower facial symmetry. Although there are benefits and limitations to each specific modality, all fail to address the deforraing pull of the normal contralateral face on the paralyzed face. This pull becomes most apparent during nonvolitional facial expressions such as laughter. When the excessive pull of the normal face is limited, expressive facial symmetry can be improved, Botulinum toxin is a promising agent for this purpose. This potent neurotoxin, which has a proven record of safety and efficacy in clinical use, 1,2 is specific in its site of action and can be titrated in dose to

Facial Plastic Surgery Clinics of North America, Nov 1, 2003

Archives of Otolaryngology-head & Neck Surgery, Sep 1, 1997

Aesthetic Surgery Journal, Jun 7, 2020

Background: Perioral rhytids are a bothersome sign of aging for many patients. Although multiple ... more Background: Perioral rhytids are a bothersome sign of aging for many patients. Although multiple treatments exist, choosing an optimal modality may be difficult considering that rhytids in this region are fine and the anatomy dynamic. Objectives: The authors sought to compare the efficacy and safety as well as patient satisfaction of a small-particle hyaluronic acid filler with 0.3% lidocaine (SP-HAL, Restylane Silk) and cohesive polydensified matrix hyaluronic acid filler (CPM-HA, Belotero Balance) in reducing superficial perioral rhytids. Methods: The study was double-blinded, and 48 patients with moderate to severe superficial perioral rhytids were enrolled. Patients were randomized to receive either CPM-HA in the left perioral region and SPHAL in the right or vice versa. Rhytid severity was measured by patients utilizing a linear analog scale, and by investigators utilizing a validated 5-point scale, for 180 days following treatment. Results: Both SP-HAL and CPM-HA achieved a reduction in rhytid severity, and neither treatment group returned to baseline after 180 days. Investigator-reported scores for rhytid severity were significantly better for SP-HAL than CPM-HA and remained so at 180 days (P < .05). SP-HAL also proved significantly better for reducing rhytids according to patient scores, although this difference occurred between 120 and 180 days only. Adverse events included rash and mild acne for CPM-HA, and SP-HAL was associated with 1 postinflammatory nodule and 2 occurrences of Tyndall effect. Conclusions: Although both SP-HAL and CPM-HA are effective at reducing perioral rhytid severity and have similar safety profiles, SP-HAL possesses a longer duration of effect.

Aesthetic Surgery Journal, Jun 15, 2022

Background: OnabotulinumtoxinA 20 U reduces glabellar line (GL) severity at maximum frown for app... more Background: OnabotulinumtoxinA 20 U reduces glabellar line (GL) severity at maximum frown for approximately 3 to 4 months. Small studies have suggested that >20-U doses may increase the efficacy and duration of response for GLs. Objectives: The aim of this study was to evaluate safety, pharmacodynamic response, and treatment satisfaction with onabotulinumtoxinA doses ≥20 U for GLs. Methods: This 48-week, double-blind study compared 40, 60, and 80 U onabotulinumtoxinA vs 20 U and placebo in women with moderate or severe dynamic GLs on the Allergan Facial Wrinkle Scale. The following parameters were evaluated: the percentage of subjects with investigator-assessed ≥1-grade Facial Wrinkle Scale improvement from baseline at maximum frown (responders) at Week 24; the estimated median duration of response; the proportion of mostly/very satisfied responders on the Facial Line Satisfaction Questionnaire follow-up Items 1 to 5; and treatment-emergent adverse events. Results: The modified intent-to-treat population (N = 226) had a mean age of 48.0 years, with similar baseline GL severity between treatment groups. Week 24 responder rates were 0% for placebo and 16.0%, 32.0%, 30.6%, and 38.5% for onabotulinumtoxinA 20, 40, 60, and 80 U, with significant (P < 0.05) differences for 40 and 80 U vs 20 U. Median duration of response was longer with all higher doses vs 20 U (≥24.0 vs 19.7 weeks; P < 0.05 vs 20 U at Week 24). Facial Line Satisfaction Questionnaire results indicated high subject satisfaction. The incidence and severity of treatment-emergent adverse events did not exhibit a dose-response effect. Conclusions: GL treatment with onabotulinumtoxinA doses >20 U demonstrated longer duration of response and higher patient-reported satisfaction vs the on-label 20-U dose with no apparent impact on safety variables.

Dermatologic Surgery, Oct 1, 1997

BACKGROUND. Injectabtc synthetic materials have been used for augmentation of soft tissue defects... more BACKGROUND. Injectabtc synthetic materials have been used for augmentation of soft tissue defects, correction of ivrinkles, and augmentation of facial features such as the nasal dorsum. Success has been limited by inflammatory reactions, material migration, and the difficulty of removal should complications oceiir. OBJECTIVE. To evahtate complications resulting from soft tissue augmentation with injectable alloplastic materials. METHODS. Retrospective review of seven cases. Clinical history, treatment, histopathotogic findings, and outcomes are assessed. RESULTS. Inflammatory reaction and tissue damage zvere refrac-tory to antibiotics and steroids, and surgery was required to remove the foreign material Histologic examination revealed giant cell foreign body reaction in ail cases. CONCLUSION. Injectable synthetic polymers can produce significant complications including deformity and inflammatory tissue destruction, the control of which is complicated by the difficulty of removing the materials. Removable tissue fillers, such as e-PTFE, or natural materials such as collagen, autologous, fat, or Alloderm, should be considered instead.

Facial Plastic Surgery Clinics of North America, Nov 1, 2007

This article was published in an Elsevier journal. The attached copy is furnished to the author f... more This article was published in an Elsevier journal. The attached copy is furnished to the author for non-commercial research and education use, including for instruction at the author's institution, sharing with colleagues and providing to institution administration. Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. In most cases authors are permitted to post their version of the article (e.g. in Word or Tex form) to their personal website or institutional repository. Authors requiring further information regarding Elsevier's archiving and manuscript policies are encouraged to visit:

Plastic and Reconstructive Surgery, Mar 1, 2000

American Journal of Rhinology, Sep 1, 1992

In this retrospective study, the computer tomographic scans (CT) and routine sinus x-rays of 57 p... more In this retrospective study, the computer tomographic scans (CT) and routine sinus x-rays of 57 patients with chronic hyperplastic rhinosinusitis who subsequently underwent surgical intervention were reviewed by the otolaryngologist and the radiologist. The diagnostic accuracy of these modalities for each sinus (maxillary, ethmoid, sphenoid, and frontal) were determined by comparison with the operative findings and histopathology. The diagnostic accuracy of CT for the maxillary, ethmoid, sphenoid, and frontal sinuses approached 100%. The diagnostic accuracy of conventional radiographs was 85.59% for the maxillary, 86.84% for the sphenoid, 84.84% for the frontal, and 60.57% for the ethmoid sinuses. The accuracy of routine x-rays for ethmoid sinus disease was even lower when only partial or “patchy” involvement was present. We discuss the importance of CT scans in diagnosing early stages of sinusitis.

Laryngoscope, Oct 1, 1993

Otolaryngology-Head and Neck Surgery, Apr 1, 2003

Paralysis of the marginal mandibular branch of the facial nerve can be a debilitating condition r... more Paralysis of the marginal mandibular branch of the facial nerve can be a debilitating condition resulting in compromised speech and oral incompetence. We describe a static procedure performed to address the functional and cosmetic deficits seen with an adynamic lip. METHODS: Three patients with complete facial nerve paralysis were evaluated after the scarless lip rehabilitation, a modification of the traditional wedge resection of the lower lip. The procedure is novel in that the removal of lip laxity and advancement of the contralateral innervated lip is achieved without an external facial skin incision. RESULTS: All 3 patients in the study reported improvement in oral competence and lip symmetry; however, articulation was less consistently affected. All 3 patients were able to drink from a glass without leaking from their oral commissure. No complications were seen in this series of patients. CONCLUSION: Oral incompetence and asymmetry are often the overlooked sequelae from complete facial nerve paralysis. Scarless lip rehabilitation of the adynamic lip is a novel, safe, and effective means to improve these functional and aesthetic deficits.

Laryngoscope, Aug 1, 1997

Recreation of a functional and aesthetically acceptable nose after partial nasal defect requires ... more Recreation of a functional and aesthetically acceptable nose after partial nasal defect requires accurate reproduction of nasal lining, support, and coverage. Most authors recommend an approach to reconstruction with cantilevered bone grafting and paramedian forehead flap placement. The authors propose an alternative approach for selected patients with total or near-total nasal defects combining both alloplastic and autogenous tissues. This method uses vitallium or titanium mesh for the dorsal framework formation, tissue-expanded paramedian forehead flap for soft tissue coverage, and composite chondrocutaneous auricular grafts for tip reconstruction. Nine individuals underwent nasal reconstruction using this method. The indications, details, and potential advantages of this technique are described with accompanying photographic results. A flexible approach using a combination of alloplastic materials and autogenous tissues provides additional reconstructive options for individuals with total or near-total nasal defects.

Archives of Facial Plastic Surgery, May 1, 2012

To report and discuss the outcome of a prospective, internally controlled, randomized, doubleblin... more To report and discuss the outcome of a prospective, internally controlled, randomized, doubleblind, split-face study comparing the onset of action of 2 commercially available botulinum neuromodulators. Methods: Ninety individuals with moderate-to-severe lateral orbital rhytids were treated with onabotulinum-toxinA, 10 U, and abobotulinumtoxinA, 30 U, for the treatment of lateral orbital rhytids. Participants were assessed live with a validated 5-point photographic scale before treatment and on days 2, 4, and 6 after treatment. Photographs were taken at each encounter. Statistical analysis was applied to evaluate for any significant difference in onset of action between the 2 products. Results: AbobotulinumtoxinA and onabotulinum-toxinA demonstrated statistically significant change from baseline at day 2 in the treatment of lateral orbital rhytids at maximal contraction and rest when evaluated independently by investigator and participant (PϽ.001). Also at day 2, the improvement with abobotulinumtoxinA was better than that with onabotulinumtoxinA for the primary end point of maximal contraction graded by the investigator, although this did not reach statistical significance (P = .21); by day 4, the greater improvement achieved with abobotulinumtoxinA reached statistical significance (P=.02) and remained superior at day 6 (P=.02). The primary findings were strengthened by similar results in the secondary end points of patient self-grade at maximal contraction and at rest and of investigator grade at rest. Conclusions: In conclusion, both abobotulinum-toxinA and onabotulinumtoxinA achieved statistically significant onset of action at day 2. This improvement was seen in all end points, with abobotulinumtoxinA demonstrating a trend toward greater improvement than ona-botulinumtoxinA at day 2 and a statistically significant greater improvement at days 4 and 6 when looking at maximal contraction.

Archives of Facial Plastic Surgery, Nov 1, 2011

To compare 2 commercially available botulinum neuromodulators in a randomized, double-blind, spli... more To compare 2 commercially available botulinum neuromodulators in a randomized, double-blind, split-face study. Methods: Ninety patients were treated with 10 U of ona-botulinumtoxinA and 30 U of abobotulinumtoxinA for the treatment of lateral orbital rhytids. Patients were assessed live with a validated 5-point photographic scale prior to treatment and at 30 days. Patients were also photographed at each visit. Results: AbobotulinumtoxinA demonstrated a statistically significant advantage compared with onabotulinum-toxinA in the treatment of lateral orbital rhytids at maximal contraction, as evaluated independently by the investigator (P = .01) and patient (P = .03). Abobotu-linumtoxinA was also favored by the patient over ona-botulinumtoxinA 67% of the time. While abobotulinum-toxinA seemed to treat lateral orbital rhytids better at rest, as evidenced by the data and photographs, this difference was not statistically significant (P =.42). Conclusions: AbobotulinumtoxinA offers superior efficacy in the treatment of lateral orbital rhytids compared with onabotulinumtoxinA. Further studies are needed to compare the 2 products in different muscle groups and for other indications.

Facial Plastic Surgery, Jun 1, 2012

Botulinum neuromodulators and injectable dermal fillers have become part of the armamentarium in ... more Botulinum neuromodulators and injectable dermal fillers have become part of the armamentarium in the treatment of facial aging. Their successful use requires a fundamental knowledge of anatomy and physiology and a sound understanding of their risks and complications. Although neuromodulators and fillers continue to demonstrate a strong record of safety, several notable risks exist.