The hands are one of the most visible parts of the body, and prominent dorsal veins and extensor tendons are the most readily recognized signs of the aging process. Fat grafting has been demonstrated to be a safe and effective method of hand rejuvenation by restoration of subcutaneous fat. Despite some variability in the technical approach, fat grafting techniques are consistent in their use of low-pressure injection with standard cannula sizes, small aliquots of graft, and a total volume of graft greater than or equal to 15 mL per hand. While distribution of the fat is an area of debate and a topic of active research, published studies have shown high patient satisfaction rates, suggesting that perhaps the restoration of volume alone is paramount. In this article, we will review the applications of fat grafting to the hand, focusing primarily on its role in hand rejuvenation.

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Breast augmentation with or without mastopexy can be performed safely, with minimal discomfort and complications, by employing local anesthesia with intravenous sedation. Although augmentation-mastopexy requires more operating time than augmentation alone, the recovery times are comparable.

While the nasopharynx is most commonly regarded by the otolaryngologist as a primary site of neoplastic involvement, it is also an avenue of spread of base-of-the-skull tumors presenting as bulging nasopharyngeal masses. The temporal sequence of clinical signs and symptoms may reliably predict the origin of a ventrally extending sphenooccipital chordoma seen on a nasopharyngeal examination. This tumor may cause extensive bony erosion of the petrous apex, sphenoid sinus, and clivus and may suggest a more rapidly growing and aggressive tumor type. The extent of the tumor may be accurately determined by conventional tomography, computerized axial tomography, and arteriography. Severl surgical approaches including the infratemporal fossa approach, transoral transpalatal approach and rhinoseptal transphenoidal approach may be appropriately utilized singly or in combination to remove this tumor in whole or part; however, the rhinoseptal transphenoidal approach is emphasized and regarded as the most rational treatment plan for subtotal resection, recognizing the usual futility of an en bloc resection with its associated high morbidity.