Facial Plastic Surgery最新文献

Assessing the proportionality of extended facelift surgery across surgeons is not an easy task. Risks and assumed benefits need to be weighted, yet, especially the latter is difficult to objectify. Reverse engineering the pathway of two leading facelift surgeons suggest that excellent training and focused high-volume facelift surgery preceded their leadership. Yet these conditions are not available to all surgeons. Hence defining extended facelift techniques as the professional standard, could promote novice surgeons into a path that may not correspond to safe practice.

The aim of this study was to examine the role of forehead flaps in the reconstruction of orbital defects after exenteration. Patients undergoing orbital exenteration and reconstruction using median forehead flaps from January 2002 to August 2019 were enrolled in this retrospective study. All the patients were evaluated for wound complications, functional results, and tumor relapse. In total, 105 patients completed the study. Twenty-nine complications in 24 of these patients were assessed. The most common complications were wound dehiscence (11%), partial necrosis of the flap (6%), and bleeding (4%). A major complication occurred in two patients (2%), necessitating surgical correction. Only one patient had a local relapse. Sixty patients received osseointegrated implants, and 58 of them were treated with facial prostheses. The follow-up periods ranged from 6 to 189 months. Thus, forehead flap reconstruction after exenteration is a reliable method with a low complication rate. This technique can be used for primary or secondary reconstruction, and excellent long-term functional results can be achieved. A relapse-oriented follow-up is certainly possible.

I converted to the extended deep plane facelift and neck lift with a shorter skin flap elevation in the face to achieve a more complete release of the facial ligaments to obtain more mobilization of the skin/superficial musculoaponeurotic system composite flap, and a more medial suspension resulting in improved correction of the midface, nasolabial fold, marionette fold and jowl. Treatment of the deep neck structures allowed for more refinement of the submentum in the deep neck lift procedures as well. In this article, we shall review the surgical technique of the deep plane facelift and neck lift as well as postoperative management pearls, the management of complications from the procedure, and the incorporation of ancillary procedures.

The diagnosis and management of intracapsular condylar fractures (ICFs) are crucial, and if left untreated, they can cause facial asymmetry, limited mouth opening, and even temporomandibular joint (TMJ) ankylosis, which may affect the physical function and mental health of patients. Various procedures have been described for the ICFs, but there is no consensus on the therapeutic methods. This study aimed to compare the clinical efficacy of conservative and surgical management of ICFs.

Creating tight and durable profile neck results has perhaps become the principal objective of many surgeons. On social media such results are quickly recognized by colleagues and potential clients alike, much more so than "en-face" results. Yet individual patient characteristics play an essential role in determining if such results are technically possible and also dictate which techniques are required to achieve it. In many patients, these techniques involve manipulation of the deeper neck structures and are oriented more laterally than the direct submental region. Each surgeon needs to decide which technique feels proportionate in terms of an individualized risk-benefit analysis.

Perioral rejuvenation is a critical component in the comprehensive approach to the aging face. The perioral region-comprising the lips, philtrum, and areas surrounding the oral commissures-plays a significant role in an individual's perceived age, attractiveness, and emotional expressions. However, the perioral region is often the "forgotten area" and has the potential to undermine the success of otherwise outstanding rejuvenation surgeries. This article will shed light on 40 years of experience in perioral rejuvenation surgery, demonstrating techniques and methodologies that have consistently yielded long-term, reliable results in my practice.

In the First World War (WW1), different types of injuries became both political and economic factors for the main belligerent countries. This work illustrates the special role facial injuries played during and after the war and the profound impact they had on the field of Plastic Surgery in Britain and Germany.This is a historical work based on primary and secondary sources. English and German material was used to compile an overview of the development of Plastic and Reconstructive Surgery as a specialty during WW1 and up to the Second World War (WW2).Plastic and Reconstructive Surgery had the task of reconstructing male beauty and personalities, restoring the most intense, disfigured reminders of a terrible war in homes and the public. Looking at the significant role the specialty played during the war, remarkably, most of the contributors struggled to find financial support to develop designated specialized departments in the inter-war period. The specialty's connection to the emotional subject of facial disfigurement did not work in its favor at a time when people wanted to forget the horrors of the war.The developments in Britain and Germany during the WW1 were less isolated than often described and the inter-war period saw much effort for international collaboration. The different developments of WW2 further illustrate how essential the efforts of a strong group of individuals and support from authorities were for the evolution of Plastic Surgery as a specialty.

Prominauris, often known as prominent ears, is one of the most frequent congenital deformities of the head and neck. Therefore, otoplasty has gained significant popularity and is now one of the most performed procedures in the field of facial plastic surgery.Reconstructing and correcting ear abnormalities remains a challenging procedure in facial plastic and reconstructive surgery. These deformities, whether congenital or acquired, have a substantial influence on patients' lives and inflict psychological harm. Addressing the deformity and tissue loss will improve the overall quality of life.Throughout history, various surgical techniques have been reported for treating external ear abnormalities. While most of these surgeries are considered safe, a comprehensive preoperative evaluation and understanding of the different techniques and risks can minimize potential complications.

Background: In the quest of achieving younger and media driven facial aesthetics, the use of fillers in the face has recently expanded exponentially. Therefore, it is inevitable that every facial plastic surgeon (FPS) will be facing patients with facial fillers. A consequence of fillers is a sub-optimal/altered lymphatic drainage, which has a direct impact on post-operative oedema following facial surgery including rhinoplasty. In the senior author's experience (AD), it was observed that patients with facial fillers had persistent oedema post-rhinoplasty. This research hypothesizes that prolonged post-rhinoplasty oedema may be related to fillers and aims to gather evidence from the literature to support this hypothesis. It also investigates whether fillers compromise lymphatic drainage.

Methods: A narrative review was performed on selective articles based on fillers and post-rhinoplasty oedema. Then, it is methodologically analyzed to look for a standard theory and categorize it throughout the discussion.

Discussion: Theoretically, with inherent characteristics of hydrophilic nature, hardness, volume and back-flow phenomena, fillers can lead to prolonged oedema. Additionally, they can either directly block or indirectly exert pressure on the lymphatic pathways and hinder drainage.

Conclusion: This research findings support the hypothesis that facial fillers can impact post-operative facial oedema. Future research is required to objectively measure the effect of fillers on facial lymphatic drainage.

Abbreviations: Facial plastic surgeon (FPS), Hyaluronic acid (HA), submandibular (SM), Lymph nodes (LN), ultrasonography (US).

Key words: Hyaluronic acid fillers, dermal oedema, prolonged post-filler oedema, recurrent oedema, persistent oedema, facial oedema, face lymphatics. 'Conflict of Interest: 'none declared'. No commercial interest or financial support.