Bio

Clinical Focus


  • Osteogenesis, Distraction
  • Nose surgery
  • Facial rejuvination
  • Facial implants
  • Abdominoplasty
  • Breast Lift (Mastopexy)
  • Breast Reconstruction
  • Facial Trauma
  • Breast Augmentation
  • Craniosynostoses
  • Skin cancer reconstruction
  • Eyelid surgery (Blepharoplasty)
  • Hemangioma
  • Facial Asymmetry
  • Breast Asymmetry
  • Fat grafting
  • Cosmetic Reconstructive Surgical Procedures
  • craniofacial surgery
  • Cleft Lip
  • Nasal Reconstruction
  • Ear pinning (Otoplasty)
  • Facial Paralysis
  • Facial Bones
  • Infant ear molding
  • Craniofacial trauma
  • Cosmetic Surgery
  • Chin augmentation
  • Ear reconstruction
  • Pediatric Plastic Surgery
  • Rhinoplasty
  • Plastic and Reconstructive Surgery
  • Nevus
  • Liposculpture
  • Tummy tuck (Abdominoplasty)
  • septoplasty
  • Craniofacial Abnormalities
  • Facial Fractures
  • Facial Reanimation
  • Acquired Nasal Deformities
  • Aesthetic Surgery
  • Facelift
  • Craniomandibular Disorders
  • Vascular Malformations
  • Nasal Septum
  • Body Contouring
  • Microsurgery
  • Microtia
  • Cleft Palate
  • Breast Implants
  • Neck lift
  • Liposuction
  • Breast Reduction
  • Gynecomastia
  • Mohs reconstruction
  • Chemical Face Peeling
  • Brow lift

Academic Appointments


Professional Education


  • Medical Education:University of Connecticut-School of Medicine (2002) CT
  • Residency:University of Texas Southwestern Medical Center (2007) TX
  • Board Certification: Plastic and Reconstructive Surgery, American Board of Plastic Surgery (2009)
  • Fellowship:University of Washington (2008) WA
  • Residency:University of Texas Southwestern Medical Center (2005) TX

Teaching

2013-14 Courses


Publications

Journal Articles


  • A National Study on Craniosynostosis Surgical Repair CLEFT PALATE-CRANIOFACIAL JOURNAL Christine Nguyen, C., Hernandez-Boussard, T., Khosla, R. K., Curtin, C. M. 2013; 50 (5): 555-560

    View details for DOI 10.1597/11-324

    View details for Web of Science ID 000327536100011

  • Emergency surgical treatment of an ulcerative and hemorrhagic congenital/infantile fibrosarcoma of the lower leg: case report and literature review JOURNAL OF PEDIATRIC ORTHOPAEDICS-PART B Kraneburg, U. M., Rinsky, L. A., Chisholm, K. M., Khosla, R. K. 2013; 22 (3): 228-232

    Abstract

    Fibrosarcomas are rare malignant soft-tissue tumors occurring mostly in infants younger than 1 year of age. Fibrosarcomas can ulcerate and cause various complications, which could threaten a fetus in utero or a child in the early neonatal period. We report a unique case of congenital infantile fibrosarcoma of the lower leg, its treatment and pathology. The large expansive and destructive lesion was not appreciated on routine prenatal ultrasound exams at 20 and 33 weeks gestation. The newborn required immediate emergency surgical intervention after delivery to prevent death by hemorrhagic shock. Initial debulking of the tumor was performed and hemostasis was attained on the day of birth. The child was resuscitated and definitive treatment of the leg was deferred until a pathologic diagnosis was obtained. Given the extent of the fibrosarcoma, the lower leg was not salvageable and the patient received a through-the-knee amputation in the neonatal period. The patient is free of disease at 2 years of age.

    View details for DOI 10.1097/BPB.0b013e3283536908

    View details for Web of Science ID 000316801200010

    View details for PubMedID 22568962

  • Microsurgical reconstruction of the smilecontemporary trends MICROSURGERY Momeni, A., Chang, J., Khosla, R. K. 2013; 33 (1): 69-76

    Abstract

    The treatment of facial palsy is a complex and challenging area of plastic surgery. Microsurgical innovation has introduced the modern age of dynamic reconstruction for facial palsy. This review will focus on microsurgical reconstruction for smile restoration in patients with long-standing facial palsy. The most common donor muscles and nerves will be presented. The advantages and disadvantages of single-stage versus multi-stage reconstruction will be discussed. Contemporary trends will be highlighted and the authors' preferred practice outlined.

    View details for DOI 10.1002/micr.22042

    View details for Web of Science ID 000313812600013

    View details for PubMedID 22976539

  • Contemporary concepts for the bilateral cleft lip and nasal repair. Seminars in plastic surgery Khosla, R. K., McGregor, J., Kelley, P. K., Gruss, J. S. 2012; 26 (4): 156-163

    Abstract

    The bilateral cleft lip and nasal deformity presents a complex challenge for repair. Surgical techniques continue to evolve and are focused on primary anatomic realignment of the tissues. This can be accomplished in a single-stage or two-stage repair early in infancy to provide a foundation for future growth of the lip and nasal tissue. Most cleft surgeons currently perform a single-stage repair for simplifying patient care. Certain institutions utilize presurgical orthopedics for alignment of the maxillary segments and nasal shaping. Methods for the bilateral cleft lip repair are combined with various open and closed rhinoplasty techniques to achieve improved correction of the primary nasal deformity. There is recent focus on shaping the nose for columellar and tip support, as well as alar contour and alar base position. The authors will present a new technique for closure of the nasal floor to prevent the alveolar cleft fistula. Although the alveolar fistula is closed, alveolar bone grafting is still required at the usual time in dental development to fuse the maxilla. It is paramount to try and minimize the stigmata of secondary deformities that historically have been characteristic of the repaired bilateral cleft lip. A properly planned and executed repair reduces the number of revisions and can spare a child from living with secondary deformities.

    View details for DOI 10.1055/s-0033-1333885

    View details for PubMedID 24179448

  • Nonsyndromic craniosynostosis. Seminars in plastic surgery Garza, R. M., Khosla, R. K. 2012; 26 (2): 53-63

    Abstract

    Nonsyndromic craniosynostosis is more commonly encountered than syndromic cases in pediatric craniofacial surgery. Affected children display characteristic phenotypes according to the suture or sutures involved. Restricted normal growth of the skull can lead to increased intracranial pressure and changes in brain morphology, which in turn may contribute to neurocognitive deficiency. Management has primarily focused on surgical correction of fused sutures prior to 12 months of age to optimize correction of the deformity and to ameliorate the effects of increased intracranial pressure. However, emphasis has recently shifted to better understanding the pathogenesis of neurocognitive impairment observed in these children, along with genetic mutations that contribute to premature suture fusion. Such understanding will provide opportunities for earlier and more specific neurocognitive interventions and for the development of targeted genetic therapy to prevent pathologic suture fusion. The authors review the common types of nonsyndromic craniosynostosis and the epidemiological, genetic, and neurodevelopmental details that are currently known from the literature. In addition, they present the rationale for surgical correction, offer suggestions for timing of intervention, and present some nuances of techniques that they find important in producing consistent results.

    View details for DOI 10.1055/s-0032-1320063

    View details for PubMedID 23633932

  • Current Concepts for Eyelid Reanimation in Facial Palsy. Annals of plastic surgery Momeni, A., Khosla, R. K. 2012

    Abstract

    ABSTRACT: The treatment of facial palsy is a complex and challenging area of plastic surgery. Two distinct anatomical regions and functions are the focus of interest when managing facial palsy: (1) reanimation of the eyelids and (2) reconstruction of the smile. This review will focus on the treatment of ocular manifestations of facial palsy. The principles of eyelid rehabilitation will be presented along with a discussion of surgical and nonsurgical treatment options.

    View details for PubMedID 23241787

  • Combination Jessner's Solution and Trichloroacetic Acid Chemical Peel: Technique and Outcomes PLASTIC AND RECONSTRUCTIVE SURGERY Herbig, K., Trussler, A. P., Khosla, R. K., Rohrich, R. J. 2009; 124 (3): 955-964

    Abstract

    Trichloroacetic acid is a commonly utilized agent for chemical resurfacing of the face. Jessner's solution in combination with trichloroacetic acid has been previously described for the treatment of facial rhytids in the dermatology literature. The purpose of this study was to describe the application technique and examine the clinical results of Jessner's solution in combination with trichloroacetic acid in a diverse plastic surgery patient population.A retrospective chart evaluation of 105 patients undergoing combination Jessner's and 35% trichloroacetic acid facial peel procedures by the senior author was performed. Patient demographics, anatomic location of peel, concomitant surgical procedures, and postoperative complications were noted. Technique and endpoints are described.Between January of 2000 and April of 2007, 115 chemical peels were performed by the senior author. All patients were female, ranging in age from 32 to 83 years (mean, 54 years). Of the 115 chemical peels performed, 104 were done with concomitant procedures. Eleven peels were performed alone. The most significant complications related to the combination peel were fungal infections (7.8 percent overall rate). In addition, the senior author performed 27 face/neck lifts with superficial musculoaponeurotic system (SMAS)-ectomy or SMAS plication along with full face combination peel, with minimal postoperative complications and no evidence of hypertrophic scarring.The combination of Jessner's solution and 35% trichloroacetic acid is an effective, safe resurfacing tool that can treat superficial to moderate rhytids. Despite the apparent simplicity of the procedure, there is a significant learning curve to understand the intricacies of chemical penetration in the skin. Consistency in results is achieved with experience and proper preoperative patient evaluation and selection.

    View details for DOI 10.1097/PRS.0b013e3181addcf5

    View details for Web of Science ID 000269485200033

    View details for PubMedID 19730318

  • Bilateral cleft lip and nasal repair PLASTIC AND RECONSTRUCTIVE SURGERY Byrd, H. S., Ha, R. Y., Khosla, R. K., Gosman, A. A. 2008; 122 (4): 1181-1190

    Abstract

    The bilateral cleft lip and nasal repair has remained a challenging endeavor. Techniques have evolved to address concerns over unsatisfactory features and stigmata of the surgery. The authors present an approach to this complex clinical problem that modifies traditional repairs described by Millard and Manchester. The senior author (H.S.B.) has developed this technique with over 25 years of surgical experience dealing with the bilateral cleft lip. This staged lip and nasal repair provides excellent nasal projection, lip function, and aesthetic outcomes. Lip repair is performed at 3 months of age. Columellar lengthening is performed at approximately 18 months of age. A key component of this repair focuses on reconstruction of the central tubercle. A triangular prolabial dry vermilion flap is augmented by lateral lip vermilion flaps that include the profundus muscle of the orbicularis oris. This minimizes lateral lip segment sacrifice and provides improved central vermilion fullness, which is often deficient in traditional repairs. The authors present the surgical technique and examples of their clinical results.

    View details for DOI 10.1097/PRS.0b013e3181858f33

    View details for Web of Science ID 000259811700025

    View details for PubMedID 18827654

Conference Proceedings


  • Changes in Frontal Morphology after Single-Stage Open Posterior-Middle Vault Expansion for Sagittal Craniosynostosis Khechoyan, D., Schook, C., Birgfeld, C. B., Khosla, R. K., Saltzman, B., Teng, C. C., Ettinger, R., Gruss, J. S., Ellenbogen, R., Hopper, R. A. LIPPINCOTT WILLIAMS & WILKINS. 2012: 504-516

    Abstract

    There is controversy regarding whether the frontal bossing associated with sagittal synostosis requires direct surgical correction or spontaneously remodels after isolated posterior cranial expansion. The authors retrospectively measured changes in frontal bone morphology in patients with isolated sagittal synostosis 2 years after open posterior and midvault cranial expansion and compared these changes with those occurring in age-comparable healthy control groups.Forty-three patients age 1 year or younger (mean, 6 months) with sagittal synostosis underwent computed tomography scan digital analysis immediately after and 2 years after posterior-middle cranial vault expansion. Quantitative angular and linear measures were taken along the midsagittal and axial planes to capture both aspects of frontal bossing. The change in values over the 2 years were compared with healthy controls with normal computed tomography scans taken to rule out head trauma.All measures indicative of frontal bossing decreased significantly from the time of posterior-middle vault expansion to 2 years postoperatively. Whereas the majority of patients at time of the operation had frontal bossing measures greater than two standard deviations outside the age-comparable control mean, almost all patients were within two standard deviations of the norm 2 years later. Lateral forehead bossing and anterior cranial growth was greater the older the patient was at the time of the operation, suggesting that the more time that passed before the operation, the more compensatory anterior fossa growth occurred. Central forehead position relative to the anterior cranial base was greatest in the younger patients at the time of operation, suggesting that a central forehead bulge was an early compensatory response to premature sagittal fusion.As a group, patients with sagittal synostosis start to normalize their forehead morphology within 2 years if an isolated posterior operation is performed at 1 year of age or younger, and this occurs by a combination of restriction of growth and reduction relative to patients without synostosis. This protocol decreases the risks of intraoperative positioning, forehead contour deformities, and two-stage operations.Therapeutic, III.

    View details for DOI 10.1097/PRS.0b013e31823aec1d

    View details for Web of Science ID 000300240000086

    View details for PubMedID 22286431

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