Facial Plastic Surgery最新文献

Background:  The shape of the forehead is primarily determined by the frontal bone, which holds significance for health and aesthetics. This study evaluated the morphology of the frontal bone in different age groups and genders using computed tomography (CT).

Methods:  This cross-sectional study was conducted on CT scan results of 220 patients divided into three age groups: 20-29.27, 29.27-47.54, and 47.54-95 years. The investigation explored the lower and upper angles compared with the Sella-Nasion (SN) line, the maximum frontal projection with Nasion in the SN plan, and the variations in frontal thickness across different angles (15, 30, 45, 60, 75, and 90 degrees) relative to the SN plane. All data were analyzed using R software, considering the significance level p < 0.05.

Results:  Of 220 patients, 119 were men, and the mean age of the participants was 41.09 ± 18.06 years. The average upper frontal slope (UFS) angle was 56.96 ± 8.17 degrees, which was 59.35 ± 7.92 degrees in females and 54.94 ± 7.86 degrees in males. The mean lower frontal slope (LFS) angle was 86.30 ± 7.96 degrees, which was 90.71 ± 6.67 degrees in females and 82.55 ± 7.00 degrees in males. The average contour nasion (C-N) distance was 7.51 ± 3.72 mm. Also, the frontal thickness at an angle of 15 degrees had the highest value of 13.08 ± 2.68 mm and at 30 degrees had the lowest value of 5.81 ± 1.56 mm. A significant difference was observed between the UFS and LFS among males and females (p < 0.001). Across all age groups, men exhibited a steeper angle, indicating a greater posterior inclination than women. Moreover, males with upper ages reported a significant increase in C-N distance and frontal projection (p < 0.05).

Conclusion:  Our findings emphasize the importance of considering gender-specific variations in frontal bone structure when planning cosmetic or reconstructive procedures involving the forehead.

While Asian noses are generalised as having smaller bones and softer cartilages, thicker skin and soft tissue envelop (SSTE), there exists a diversity of morphology amongst Asian noses. The over-simplification of Asian noses diminishes the validity or generalizability of rhinoplasty research findings and makes comparison of outcomes challenging. A classification system is proposed that reflects the different structures and SSTEs of the nasal subtypes, the techniques required in the management of each of the subtypes, the challenges the surgeon will face intra- and post-operatively, allows for pre-operative counselling of expected outcomes and facilitate valid and fair comparison of study outcomes by comparing like for like. The classification system stratifies noses into four subtypes based on i. the size and strength of the nasal bone and cartilages, and ii. the thickness of the SSTE. Type I noses have thinner SSTE and stronger structure. Type II noses have thinner SSTE and weaker structure. Type III noses have thicker SSTE and stronger structure. Type IV noses have thicker SSTE and weaker structure. Inter-rater variability in classifying noses amongst rhinoplasty surgeons was found to be very high with a kappa coefficient of 0.933 (95% confidence interval 0.852 to 1.014; variance 0.013).

Lop ear deformity is the most common head and neck congenital malformation with an estimated incidence of 5% among newborns. Otoplasty is the surgical procedure designed for its correction. More than 200 surgical techniques have been described so far to treat this condition, most of them including a cartilage weakening maneuver to avoid the relapse of the original auricle shape a few months after surgery. Classic techniques, such as like Mustarde's, describe this maneuver through scoring the posterior side of the cartilage and stabilizing the new shape with sutures. Cartilage biomechanical properties work against posterior scoring since cartilage folding occurs in the contralateral side of the scoring. This critical point may explain the high rates of relapse in the posterior scoring otoplasty techniques. In this paper, we present our surgical otoplasty technique with anterior scoring and we discuss specific tips and its nuances. We believe that the anterior scoring otoplasty technique achieves natural ears with both low complication rates and significant reduced long-term relapses.

Objective: The purpose of this study is to investigate the facial symmetry aesthetics (FSA) in the Saudi Arabian population using AI.

Materials and methods: 210 people from a range of demographic backgrounds participated in an observational cross-sectional study that was done at a hospital. Standardized posed photos of the face and smile were taken using a Canon camera utilizing a stratified random sample approach. A Webceph software (Korea) with artificial intelligence was used to evaluate macro, micro, and tiny aesthetic factors. The data were analyzed using paired t-tests, posthoc Bonferroni testing, ANOVA, and descriptive statistics. The computation of intra-class correlation coefficients (ICCs) was utilized to assess the dependability of AI evaluations.

Results: All variables had ICCs more than 0.97, indicating exceptional dependability for the AI-based evaluations. Between the Class I and Class III malocclusion groups, there were significant variations in right mandibular body length (p < 0.001), with Class III patients exhibiting greater values. While no significant changes were identified for other characteristics, paired t-tests showed a significant divergence in mandibular body length between the right and left sides (p = 0.001). In Class III malocclusion, there was a significant preference for right deviation in the direction of mandibular deviation (p = 0.005). These results imply that AI is capable of accurately identifying some anatomical characteristics associated with face aesthetics, especially when it comes to differentiating between Class III malocclusions.

Conclusion: In conclusion, the Saudi Arabian population's facial symmetry assessments via AI have demonstrated a high degree of reliability and consistency. Notably, the length of the mandible on the right side has emerged as a crucial feature in discriminating between malocclusion classes. The study emphasises how AI might improve the accuracy of assessments of face aesthetics and our knowledge of facial features connected to malocclusion.

Background and objective: Pterygium colli or webbed neck is a congenital deformity mainly found in Turner syndrome. It appears as a bilateral triangular fold extending from the mastoid to the acromion with hairy skin abnormality. Structural variation of the fold, as described by Mehri Turki's webbed neck classification, implies appropriate surgical repair. Despite the availability of a range of surgical techniques, it remains difficult to choose the most suitable one. Thus, this report aims to compare the lateral approach techniques by selecting those providing the best results.

Material and methods: A literature search using PubMed and Google Scholar Database identified lateral approach techniques for pterygium colli. A critical reading led us to select criteria for comparison, linked to procedures and results. Moreover, according to aesthetic results, surgical techniques were classified into three categories.

Results: 16 articles were published from 1937 to 2020 and enrolling 48 patients were selected. The neck contour was obtained with all procedures. However, scars were hidden at the posterior neck in only 10 reports. Otherwise, the posterior hairline was corrected in only 6 reports. According to these outcomes, a classification of surgical technique was made allowing their pragmatic assessment.

Conclusion: An objective assessment of lateral approach techniques was realized to help surgeons choose the most convenient one. From this study, a classification arises, based on aesthetic results, distinguishing three groups of surgical techniques and allowing their comparison. Techniques belonging to Group 2, using cervical advancement flap, were the most suitable, mainly both techniques described by Reichenberger and Mehri Turki.

Rhinoplasty is undergoing a transformation with the reemergence of dorsal preservation rhinoplasty (DPR) techniques. This article introduces a novel addition to the DPR repertoire, "bony dorsal preservation" (BDP), which has particular application for the correction of crooked noses.This comprehensive overview summarizes current DPR concepts and techniques, the intricate considerations that go into the dorsal osseocartilaginous vault and septal management, and how these are modified to treat the crooked nose. However, current DPR techniques, particularly the low septal strip (LSS), have drawbacks, and the desire to address such issues led to the development of BDP.BDP is ideal for cases where there is no septal base pathology. It maintains the core principle of DPR by lowering dorsal humps without creating open roof deformities. Its unique feature is that it temporarily separates the upper lateral cartilages from the septum while leaving the septal base attachment intact, thus allowing the entire osseocartilaginous vault to be adjusted independently before reconnecting the preserved upper lateral cartilages. This technique offers direct visualization during septal excision and fixation and enables cartilaginous vault movement without sacrificing stability. Compared with LSS, there is more septal cartilage available for harvesting, the risks of a single point of septal fixation are eliminated, and there is the potential to transition to component reduction techniques, if needed. With shared indications and contraindications with other DPR methods, BDP emerges as a valuable addition to the evolving field of rhinoplasty, particularly in addressing the challenges of the crooked nose.

Otoplasty has been described for nearly 200 years for children and adults. Although auricular deformity has been recognized in newborns, treatment options were lacking. With the development of ear molding techniques, newborn ear deformities can now be corrected non-surgically. However, these techniques have distinct limitations with much dependent on the age of initiation of treatment and deformities present. Awareness of these early interventions is therefore crucial in order to initiate treatment in the early developmental period when the ear is still malleable. During the first few weeks of life, the ears are malleable, and the ears are rapidly growing, relatively. Therefore, the neonatal period provides a unique opportunity to contour the ears properly. Different techniques have been developed. However, the premise is that the ears are stabilized in a favorable contour continuously for several weeks to hold into proper position. This procedure carries minimal risk and can be quite efficacious, preventing a child from needing surgery later in life.

The auricle is susceptible to various injuries due to its location and projection from the scalp. The unique contours of the external ear makes reconstruction a challenging endeavor. This chapter provides a comprehensive overview of auricular reconstruction, based on the depth, location, and size of injury. Strategies for reconstructing superficial, composite, and full-thickness injuries are discussed in relation to the location of the defect. Targeted reconstructive options for injuries of the upper, middle, and lower thirds of the auricle are outlined. Methods for total auricular reconstruction and auricular prosthesis are discussed. Options for managing traumatic injuries are reviewed, including avulsion/amputation injuries, burns, electrical injuries, frostbite, and human/animal bites. This chapter provides a practical framework for surgeons faced with complex auricular defects, offering insights to recreate a discreet, harmonious ear.

Genioplasty is a surgical technique that modifies the projection of the chin in three dimensions to achieve symmetry and facial harmonization. Virtual 3D planning is increasingly used, supplanting the conventional surgical technique due to the precise and predictable results obtained.The definition of the objective of the study was first carried out using the PICO (Patient, Intervention, Comparison, Outcome) question method. Posteriorly, an updated literature review was carried out in the "PubMed" database using the keywords "Genioplasty and Virtual 3D Planning," obtaining 11 articles for the study with the objective of defining the advantages and disadvantages of performing a virtually planned genioplasty, comparing it with the conventional technique.In the results, it is observed that virtually planned genioplasty presents greater precision, a reduction in surgical time, and a lower rate of complications than the conventional technique. Virtual planning using computer-aided design/computer-aided manufacturing technology presents good reproducibility in the patient with <2 mm variations between what was planned and what was obtained postoperatively, with statistically significant results (p < 0.001).In conclusion, virtually planned genioplasty with customized cutting guides and osteosynthesis plates achieves very precise surgery results with good reproducibility, reducing surgical time, intraoperative complications, and the difficulty of the surgical technique.

The correction of prominent ears is a rewarding operation. When choosing a surgical technique, we prefer a cartilage-sparing technique to a cartilage-splitting technique in order to achieve natural-looking long-term results. In this article, we present our preferred technique of an anterior scoring technique combined with concha-mastoid sutures step by step.