Rhytidectomy techniques have evolved significantly since the procedure was first described in the early twentieth century. Techniques vary based on surgeon preference, patient characteristics, and the desired outcome. As facelifts are embraced by the general public and the frequency of rhytidectomy increases, attention to male patient-specific technique is critical. Male and female facelift techniques are fundamentally similar; however, there are nuances to patient selection and technique in males that guide the surgeon to improved postoperative outcomes. Attention to incision placement, trichophytic technique, and adjunct procedures will improve overall cosmesis in the male patient. Understanding of potential risks and their likelihood in the male patient will also minimize complications and allow for rapid recovery.

Nasal bone osteotomies are commonly performed in rhinoplasty to manipulate the upper third of the nose. In patients with a dorsal hump, reduction is often performed, followed by lateral osteotomies to medialize the nasal bone complex. However, fracture patterns are often unknown in vivo. We intend to map nasal bone osteotomies and describe a novel and minimally invasive method of performing medial scoring osteotomies to improve fracture patterns and surgical speed, and decrease complications. In total, 19 formalin-fixed cadavers were dissected to reveal nasal bone architecture. The nasal dorsum (bony and cartilaginous) was reduced to form an open roof deformity. Osteotomies were then performed on all 19 specimens, followed by digital infracture. Medial scoring osteotomies were performed unilaterally, along with a lateral osteotomy. On the contralateral side, only lateral osteotomies were performed. Fracture patterns were mapped and compared. Of 19 cadaver specimens, 38 sides were examined in total: 19 sides underwent medial scoring and 19 sides served as controls. Fracture patterns were linear with less comminution on sides with medial scoring osteotomies. Sides with medial scoring osteotomies also achieved uniform closure of the open roof deformity, compared with 73% in sides without. Rocker deformity was not seen in either group. Osteotomies are integral to nasal dorsum reduction and modification of the upper third of the nose in rhinoplasty. Scoring of the medial nasal bone prior to lateral osteotomy and digital infracture allows for an increased rate of open roof closure. Furthermore, medial scoring osteotomies create smooth, linear fracture patterns that prevent bony spicules, comminution, and irregularities that may be evident in patients with thin nasal skin. Performing the medial scoring osteotomy is a fast, safe method of achieving consistent nasal bone infracture during rhinoplasty.

Minimally invasive in-office procedures are a fast growing field in plastic surgery. Patients often notice and complain about their neck at an earlier age. Modern treatments for the aging neck have continued to evolve over the past decade, with more options continuing to become available. In this article, we describe our noninvasive approach to the aging neck through the combination of submental liposuction, radiofrequency (RF) microneedling, and percutaneous RF as a safe and effective option. Through appropriate patient selection, preoperative counseling, and good surgical technique, appropriate results can be achieved with minimal downtime. Patient selection, counseling, appropriate anesthesia, procedure details, and results are discussed in this article.