Facial Plastic Surgery最新文献

Resident-run facial aesthetic surgery clinics improve surgical proficiency but are absent in Canadian Otolaryngology-Head and Neck Surgery (OtoHNS) training.To evaluate resident and program director (PDs) perspectives on facial aesthetic training and the feasibility of resident-run clinics. We hypothesized residents would report inadequate training and support for clinics, while directors would express caution due to logistical barriers.National, cross-sectional survey.Anonymous, bilingual electronic surveys were distributed to Canadian OtoHNS residents and PDs. Quantitative data were analyzed descriptively; qualitative responses underwent thematic analysis.Fifty residents and 11 PDs responded. Most residents (91%) reported performing ≤ 5 core procedures; 82% desired more exposure. Resident-run clinics were supported by 83% of residents but only 30% of PDs. PDs cited supervision, funding, and legal concerns.Significant training gaps exist. Resident-run clinics may enhance education but require structured supervision and institutional support.

This article presents a comprehensive, anatomically precise approach to deep plane facelift surgery in male patients, a demographic with increasing interest in facial rejuvenation but historically underserved by techniques optimized for female anatomy. While foundational facelift principles are shared between genders, the male patient presents unique structural, vascular, and aesthetic demands that necessitate specific modifications to technique, planning, and execution.Key anatomical distinctions in the male face, including denser subcutaneous tissue, increased vascularity, prominent subplatysmal structures, and horizontally oriented submuscular aponeurotic system (SMAS)-platysma continuity, require surgical planning that respects and preserves masculine facial definition. The submental region is often complicated by hypertrophic digastric musculature and submandibular gland visibility, necessitating targeted management to optimize the cervicomental angle.This article outlines a male-specific technique emphasizing extended deep plane dissection, ligamentous release, SMAS repositioning with minimal subcutaneous dissection, and submental access. Deep plane neck procedures, including conservative subplatysmal fat reduction, digastric contouring, partial submandibular gland reduction, and corset platysmaplasty, supplement the facial portion of the procedure.When performed with anatomical precision and gender-specific adaptation, preservation-based techniques with extended deep plane facelift surgery yield consistent, natural, and structurally restorative outcomes in male patients.

Thick skin poses a challenge in rhinoplasty, often resulting in an undefined tip and supratip deformities.This study evaluates oral isotretinoin as an adjuvant treatment for thick-skinned rhinoplasty patients.This is a systematic review conducted in accordance with PRISMA guidelines.Two independent investigators performed a comprehensive literature search to identify studies that assessed perioperative oral isotretinoin treatment in thick skin rhinoplasty patients. Key outcome measures include skin thickness reduction, cosmetic surgical outcomes, and postoperative patient satisfaction.Five studies met the study inclusion criteria. Their findings demonstrated that oral isotretinoin effectively reduces skin thickness and improves cosmetic outcomes and satisfaction up to 6 months postoperatively, with no major complications reported.Although evidence is limited, oral isotretinoin shows promise in enhancing short-term rhinoplasty outcomes for thick-skinned patients. Further, high-quality trials are needed to confirm these results and develop standardized treatment protocols.

While facelift literature has largely focused on female patients, recent research highlights unique anatomical and psychosocial considerations in male facial rejuvenation. The short scar neck lift is explored to present the indications, technique, and outcomes as an alternative to the deep plane facelift in selected male patients.The short scar neck lift employs limited periauricular incisions to address submental fullness, platysmal banding, and mild-to-moderate cervical skin laxity. Ideal candidates demonstrate localized cervical and mandibular aging without significant midface descent. The procedure may be combined with submental liposuction, platysmaplasty, and energy-based devices to enhance skin contraction.In appropriately selected patients, the short scar neck lift achieves meaningful improvement in cervicomental angle definition with reduced operative time, morbidity, and recovery compared with deep plane facelifts. The short scar neck lift is a versatile, lower-morbidity alternative for male patients with localized cervical aging. Its targeted approach, adaptability, and favorable recovery profile make it a valuable addition to the male facial rejuvenation surgical algorithm.

Postoperative edema and fibrosis are key concerns following rhinoplasty, affecting outcomes and patient satisfaction. Triamcinolone acetonide (TA) is used for its proven anti-inflammatory and antifibrotic effects.This study aims to evaluate the efficacy, usage profile, and safety of TA injections after rhinoplasty, focusing on postoperative edema and supratip fullness.A systematic review was conducted via PubMed and the Cochrane Database to identify studies on corticosteroid injections after rhinoplasty, following PRISMA guidelines and predefined selection criteria.Nine studies were included in the analysis. These studies focused on the postoperative use of TA after rhinoplasty and assessed their impact on key outcomes, such as edema reduction, fibrosis control, and the improvement of supratip fullness following rhinoplasty.TA injections were consistently associated with a significant reduction in postoperative edema and the incidence of pollybeak deformities. Current evidence supports the subcutaneous administration of TA at a 10 mg/mL concentration, initiated no earlier than 4 weeks following rhinoplasty. Injections are typically delivered at 4 to 6 week intervals, with a maximum volume of 0.3 mL per session, for a total of two to four administrations, depending on clinical response. TA showed a consistent safety profile with mild and infrequent side effects. Effects appeared within 7 to 14 days and lasted approximately 4 to 6 weeks.TA is an effective adjunct in the postoperative management of rhinoplasty, particularly in patients with thick or reactive soft tissue envelopes. Standardized, personalized protocols are needed, along with better studies and objective outcome tools.

Managing nasal tip support and lateral crura malposition remains a challenge in rhinoplasty.This study aimed to evaluate the effectiveness of a novel suture technique-the Pulley-Stitch-in correcting lateral crura malposition. Primary outcome: Change in lateral crura angle; secondary outcome: Long-term stability.Prospective cohort study (N = 42), reported in-line with STROBE guidelines.Forty-two patients underwent open rhinoplasty. The angle between the caudal margin of the medial crus and the anterior third of the lateral crus was measured from intraoperative images at T0 (prestitch) and T1 (poststitch). Standardized postoperative images were analyzed at 1 month (T2) and 12 months (T3).The angle increased from a mean of 18.2 to 26.9 degrees (p < 0.05), reflecting improved anatomical alignment and external nasal valve patency. Stability was confirmed at 12-month follow-up.The Pulley-Stitch is a safe, effective technique to improve nasal tip structure, cephalic rotation, and ala contour.

Lower eyelid ectropion is a challenging postoperative complication that can affect both function and aesthetics. Preventative strategies are critical, particularly in high-risk periocular and midface surgeries.This review aims to evaluate the efficacy and variety of prophylactic suspension techniques used to prevent lower eyelid ectropion. Primary outcome: Incidence of ectropion; secondary outcomes: Technique tolerability and reported complications.Systematic review conducted in accordance with PRISMA guidelines.A systematic search was performed through June 2025 using keywords: "Frost suture," "suspension," "ectropion," "tape," and "prevention." Sixteen studies were included (9 clinical, 8 technical). Data on patient indications, techniques, outcomes, and follow-up were extracted.Techniques included Frost sutures, periosteal anchoring, barbed sutures, external splinting, and forehead hitch. Ectropion prevention was generally successful, though one clinical study reported no significant benefit with Frost suture use.Multiple prophylactic strategies appear effective, but evidence quality is low. Higher-level comparative studies are needed.

Blepharoplasty is among the fastest-growing aesthetic procedures in male patients, reflecting shifting cultural norms and increasing demand for facial rejuvenation that preserves masculine features. This review outlines the anatomical and aging patterns specific to the male periorbital region and discusses contemporary surgical techniques tailored to this population.The gender-specific anatomical differences in the periorbital region influence both surgical planning and outcomes are highlighted.Aging in men involves distinct patterns that must be addressed to preserve masculine facial identity.Surgical strategies emphasize conservative tissue excision, preservation of eyelid fullness, and avoidance of feminizing features.Men are predisposed to complications like lower lid malposition, visible scarring, and wound dehiscence due to anatomical factors and skin characteristics. Overcorrection may lead to feminization, necessitating a conservative surgical philosophy and meticulous technique.A deep understanding of sex-specific anatomy and aging, coupled with meticulous surgical technique, is essential for achieving natural, harmonious outcomes that align with the male aesthetic ideal.

Columellar strut graft (CSG) and septal extension graft (SEG) are commonly used in septorhinoplasty for nasal tip support.We aimed to systematically review and compare CSG and SEG in achieving a desired nasolabial angle (NLA) and Goode's ratio (GR).Several databases were systematically searched from inception to August 2024. A two-arm meta-analysis of the pooled means was conducted with a random-effects model. This review was registered in PROSPERO (CRD42024574909).Eligible studies included primary septorhinoplasty patients (≥17 years) receiving CSG or SEG.Eight studies met eligibility criteria including 256 CSG and 371 SEG patients. Intergroup comparison of long-term postoperative NLA favored SEG (p < 0.05) while GR showed no differences. However, SEG patients had significant improvement in GR postoperatively (p < 0.05), unlike CSG patients.SEG may provide superior long-term nasal tip rotation and projection stability.

Patients frequently ask questions after Mohs facial reconstruction. AI tools, particularly large language models (LLMs), may optimize this communication.We evaluated four LLMs-Claude AI, ChatGPT, Microsoft Copilot, and Google Gemini-on responses to postoperative questions, hypothesizing variation in quality, accuracy, comprehensiveness, and readability.Prospective observational study following STROBE guidelines.A total of 31 common postoperative questions were created. Each was submitted to all four LLMs using a standardized prompt. Responses were evaluated by blinded facial plastic surgeons using validated scoring tools (EQIP, Likert scales, readability formulas). IRB exemption was granted.Claude AI outperformed others in quality (EQIP: 90.3), accuracy (4.55/5), and comprehensiveness (4.60/5). All LLMs exceeded the recommended 6th-grade reading level.LLMs show potential for supporting postoperative communication, but variation in readability and content depth highlights the continued need for physician oversight.