Facial Plastic Surgery最新文献

Septorhinoplasty is a complex facial surgery that involves osteotomy, a procedure that can lead to complications such as postoperative edema, ecchymosis, and potential changes in intraocular pressure (IOP). However, there is limited research on how different osteotomy techniques, such as conventional osteotomy versus ultrasonic bone cutting, affect IOP.This study aimed to compare the effects of conventional osteotomy and ultrasonic bone cutting on IOP in patients undergoing septorhinoplasty. We hypothesized that ultrasonic osteotomy would result in less change in IOP compared to conventional osteotomy.Prospective, double-blind, randomized, controlled study conducted at a tertiary referral hospital in Türkiye. The study adhered to the CONSORT guidelines for randomized trials.Sixty patients undergoing septorhinoplasty were randomly assigned to either the conventional osteotomy group or the ultrasonic osteotomy group. IOP was measured preoperatively, on postoperative day 1, and on postoperative day 7 using noncontact tonometry. Statistical analyses were performed using SPSS version 25.0 with repeated measures analysis.No significant difference in IOP was observed between groups on postoperative day 7. However, the conventional osteotomy group showed a significant increase in IOP on postoperative day 1 (p < 0.001), with a subsequent decrease by day 7. The ultrasonic osteotomy group showed no significant IOP change.Ultrasonic bone cutting for osteotomy in septorhinoplasty results in more stable IOP compared to conventional osteotomy, making it potentially safer for patients at risk of glaucoma. Further studies with longer follow-ups are required to confirm these findings.

This study evaluates the aesthetic and psychological outcomes of combining rhinoplasty with a lip lift, focusing on facial harmony and patient satisfaction. To assess whether the combined procedure improves facial proportions and satisfaction. We hypothesize significant aesthetic and psychological benefits. A retrospective cohort study of 50 female patients (aged 18-49) was conducted, compliant with STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) guidelines. Patients underwent combined rhinoplasty and lip lift between April 2021 and October 2024. Pre/post measurements of upper lip length, nasal length, and nasolabial angle were recorded. Patient satisfaction was evaluated via the Visual Analog Scale and composite score. Ethical approval was obtained from Istanbul Aydın University (approval number: 106/2024). Postoperative reductions in lip (-5.72 mm), nasal lengths (-18.8 mm), and an increase in nasolabial angle (+27.36 degrees), were statistically significant. The satisfaction rate was 96%. The combined procedure significantly enhances facial aesthetics and satisfaction, supporting its role in comprehensive facial cosmetic surgery.

Blepharoplasty's psychological effects are well-studied, but its impact on social cognition, particularly gaze behavior, remains unexplored. Understanding how cosmetic surgery alters visual attention to faces has implications for patient counseling and social interaction research.We hypothesized that postblepharoplasty patients would exhibit altered gaze patterns, specifically increased attention to eyes due to heightened self-awareness. Primary outcomes were fixation duration and time to first fixation on facial regions.Case-control study (STROBE guidelines) comparing 20 females who underwent upper blepharoplasty alone with 20 nonoperated controls.Participants viewed standardized AI-generated Asian faces while eye-tracking recorded fixation metrics. ANOVA compared groups (IRB-approved). AI was used solely for image generation.Patients after upper blepharoplasty alone showed longer eye fixation (male: p = 0.03; female: p = 0.041) and faster female eye fixation (p = 0.029). Male forehead fixation increased (p = 0.004). Other regions showed no difference.Blepharoplasty modifies visual attention, potentially reflecting postsurgical self-perception changes. Findings suggest cosmetic procedures may influence social cognition.

Double eyelid surgery has associated complications including fold disappearance over time.To assess a novel surgical method for double eyelid revision.Retrospective study.We analyzed data from 60 patients with disappearing double eyelid folds. The procedure involved suturing the pretarsal fascia, orbicularis oculi muscle, and dermis at the lower incision edge. Aesthetic outcomes and patient satisfaction were assessed during postoperative follow-up.All patients had satisfactory results with no double eyelid crease disappearance during the follow-up period. The eyelid morphology was satisfactory in 59 cases and moderately satisfactory in one case. Patient satisfaction was 98.3%. Crease disappearance was not observed during the follow-up.This study discusses a novel surgical method for stable double eyelid morphology with more secure internal fixation and low fold disappearance risk. Moreover, dynamic force transmission leads to more stability with less noticeable incision scars.

Long-Term COVID-19-related olfactory dysfunction (C19OD) remains a significant challenge with no established treatment providing meaningful improvement. This study aimed to assess the efficacy of functional septorhinoplasty (fSRP) in improving olfactory dysfunction in patients with persistent C19OD compared to a control group undergoing olfactory training (OT). In this prospective study patients with persistent C19OD undergoing fSRP were enrolled while those declining surgery continued with OT as the control group. Patients were followed for six months with olfactory function assessed using Sniffin' Sticks (S'S) and nasal airflow evaluated through peak nasal inspiratory flow (PNIF) and acoustic rhinometry (AR). Among the participants 12 underwent fSRP while 13 were in the control group. Significant improvements (p < 0.05) in all S'S scores were observed in the fSRP group but not in the control group. TDI scores improved above the minimal clinically important difference only in the fSRP group. Strong correlations were found between olfactory scores and nasal measurements. Comparison of olfactory threshold gains between groups revealed a statistically significant benefit in the fSRP group. These findings suggest that fSRP can significantly improve persistent C19OD providing a notable olfactory threshold gain compared to OT.

5-Fluorouracil (5-FU) is an antimetabolite that inhibits fibroblast proliferation and collagen synthesis, making it valuable in facial plastic surgery for scar modulation and other conditions. This systematic review examines the indications, outcomes, and safety of 5-FU in facial plastic surgery. Due to methodological heterogeneity across studies, a narrative synthesis was performed. A comprehensive search of MEDLINE, Cochrane, SCOPUS, EMBASE, PubMed, and Web of Science identified 32 eligible studies (1,456 patients) from 4,772 screened articles. Indications included keloids, hypertrophic scars, contractures, periocular scars, granulomas from filler complications, nasal skin thickening, infections following thread lifts, resistant facial warts, and hypochromic lesions. Most studies reported reductions in scar size, erythema, and recurrence rates, with combination therapies enhancing outcomes. Adverse effects were mild and transient. However, variability in dosing, administration frequency, and follow-up underscores the need for standardized treatment guidelines and long-term studies.

The surgical management of the periocular region in facial palsy is a critical aspect of addressing the ocular morbidity associated with facial paralysis. The reconstruction around the eye in facial palsy should take into account the duration of the facial palsy and underlying ocular pathologies. Exposure keratopathy can develop secondary to lagophthalmos, ectropion, and brow ptosis. Clinicians should optimize the function of the eye with medical treatments in the first instance and where required adjunctive static or dynamic surgical therapy. The cosmesis of the periocular region should also be taken into consideration when surgical reconstruction is being planned. This manuscript aims to provide a review of surgical solutions for patients with chronic eye manifestations of facial palsy.

Neuroplasticity, the brain's ability to reorganize its structure and function, plays a pivotal role in adapting to anatomical changes introduced by surgical interventions such as rhinoplasty. This review explores the interplay between functional and aesthetic outcomes of rhinoplasty and their implications on cognitive and emotional processes. Key findings highlight the involvement of specialized neural circuits, including the fusiform face area, somatosensory cortex, and mirror neuron systems, in adapting to altered facial features. Furthermore, the importance of preoperative expectations, emotional resilience, and breathing patterns in optimizing postoperative outcomes is emphasized. By integrating neuroscience with clinical insights, this paper underscores the transformative potential of rhinoplasty as both a physical and psychological intervention, fostering a holistic approach to patient care.

Fixation of quadrangular septal cartilage is a basic step in low-septal-resection dorsal preservation rhinoplasty. The most commonly used technique for this purpose is the fixation of the septum with a suture to the anterior nasal spine. This study presents the use of a previously described dorsal fixation suture as a second fixation maneuver in addition to anterior nasal spine fixation in low-septal-resection cases.Eighty-six patients who underwent closed-approach low-septal-resection dorsal preservation rhinoplasty between January and December 2022 were included in this retrospective study. Depending on the number of surgical maneuvers performed for stabilization of quadrangular septal cartilage, the patients were divided into two groups as follows: (i) a one-point fixation group in which the septum was fixed only to the anterior nasal spine and (ii) a two-point fixation group in which the septum was fixed to both the anterior nasal spine and the septal mucoperichondrium with dorsal fixation suture. Standardized postoperative 12-month lateral-view photographs were scanned for the presence of hump recurrence. The rhinoplasty outcome evaluation (ROE) scale was applied at 12 months.Hump recurrence was observed in five patients in the one-point fixation group (n = 31) and in one patient in the two-point fixation group (n = 55; p < 0.05). No statistically significant difference was found between the groups (p > 0.05) for the ROE scores and ratio of satisfied patients.The addition of dorsal fixation suture to anterior nasal spine fixation (two-point fixation) may reduce the rate of hump recurrence in low-septal-resection dorsal preservation rhinoplasty. The level of evidence is 4.

Involutional lower eyelid malpositions, such as ectropion and entropion, are frequently encountered in oculoplastic clinics, particularly among elderly patients. These conditions result from age-related weakening of the eyelid structures, leading to eyelid eversion (ectropion) or inversion (entropion). Similarly, lagophthalmos, often caused by facial nerve dysfunction or mechanical factors, presents with incomplete eyelid closure. Aim of this article is to propose a clinical grading and a grade based management algorithm for lower eyelid malpositions.Patients with ectropion may experience tearing, irritation, and conjunctival exposure, while those with entropion often present with foreign body sensation, redness, and corneal damage. Lagophthalmos typically manifests as dryness, exposure keratopathy, and nocturnal eye discomfort.This article proposes a structured, graded algorithm to guide the management of these conditions, offering a systematic, stepwise approach tailored to the severity of eyelid malposition.The algorithms are designed to simplify clinical decision-making by categorizing ectropion, entropion, and lagophthalmos into distinct grades, each with corresponding treatment options. These include both conventional surgical techniques and innovative approaches, allowing for individualized care that addresses both functional and aesthetic concerns.The goal of this graded approach is to optimize patient outcomes, reduce recurrence, and enhance the precision of surgical interventions.By providing a comprehensive framework for managing these complex eyelid disorders, this algorithm serves as an essential tool for ophthalmologists in clinical practice.