Cyanoacrylate derivatives have been used as surgical adhesives for many years. Shorter-chain derivatives (methyl- and ethyl-cyanoacrylate) have proved to be histotoxic. Longer-chain derivatives (butyl- and isobutyl-cyanoacrylate) are much less histotoxic. Many surgeons continue to use ethyl-2-cyanoacrylate (Krazy Glue) despite the availability of a less toxic derivative, butyl-2-cyanoacrylate (Histoacryl). In this study, the histotoxicity and bone graft-cartilage binding ability of Krazy Glue and Histoacryl were compared. Bone grafts harvested from the anterior wall of the maxillary sinus were placed in a subcutaneous pocket and glued to auricular cartilage in the rabbit. Krazy Glue and Histoacryl were used in opposite ears, harvesting specimens at 1, 2, 4, 12, 24, and 48 weeks. The Krazy Glue-treated ears developed seromas with histologic evidence of acute inflammation, tissue necrosis, and chronic foreign body giant cell reaction. The Histoacryl-treated ears showed mild acute inflammation and mild foreign body giant cell reaction. The Krazy Glue was completely degraded within 12 months, while some Histoacryl was still present at 1 year. Histoacryl had minimal histotoxic effect and good bone graft-cartilage binding ability, whereas Krazy Glue demonstrated severe histotoxicity.

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This paper deals with the long-term follow-up of cartilage autografts taken from various parts of the body to reconstruct areas of the nose, ear, trachea, eyelid, and other areas of the body which require augmentation, effacement, and long-term support. Our thesis will be that the cartilage autograft is the implant of choice in many of these areas, and that fate of autogenous cartilage is well known and should be given strong priority in facial grafting.

Histoacryl (butyl‐2‐cyanoacrylate) is one of the least histotoxic cyanoacrylate derivatives and is used as a tissue adhesive. Clinical applications primarily include skin closure (blepharoplasty incisions, etc.). In a recent study, we demonstrated that Histoacryl elicits minimal histotoxicity when used to glue bone grafts to rabbit‐ear cartilage. Acute inflammation was limited to areas where Histoacryl escaped from between the bone graft and ear cartilage to contact well‐vascularized soft tissue. In this study, Histoacryl was applied between bone graft and cartilage in one rabbit ear and adjacent to well‐vascularized soft tissue with no graft in the opposite ear. Histologic analysis revealed minimal if any inflammation when small amounts of glue was used in the nonvascular region between bone graft and cartilage. However, subcutaneous implantation contacting well‐vascularized soft tissue resulted in increased acute inflammation and prolonged foreign‐body giant‐cell response. Further studies are required to rule out any long‐term problems associated with subcutaneous implantation of Histoacryl.

Photographic images in facial plastic surgery play a critical role in photodocumentation, patient education, preoperative planning, and self-education. Consistent, uniform, high-quality photography allows the best opportunity for critical self-assessment and self-education. The purpose of this article is to review important elements in the production of standardized, uniform photographs with a 35-mm camera or with a digital camera. Equipment, lighting and background, film selection, and a standardized photographic technique are detailed. Principles of intraoperative photography are also reviewed.