Facial Plastic Surgery最新文献

Platelet-rich plasma has been increasingly used for facial rejuvenation in conjunction with other modalities such as microneedling or on its own. Nanofat grafting to the face has also been utilized for skin quality improvements. Our group previously described the novel combined Platelet Hybridized Adipose Transplant (PHAT) technique for hair restoration. In this series, we describe our experience with the PHAT technique for lip and facial rejuvenation to improve the quality of facial skin and superficial musculoaponeurotic system, and enhancing surgical results.

Deep neck contouring can achieve dramatic results in young and old patients. Both genetic predisposition and aging contribute to the malposition of deep neck structures and a poorly contoured neckline. Depending on the patient's anatomy, deep neck contouring should involve a combination of submental liposuction, platysmaplasty, subplatysmal fat lipectomy, resection of the anterior belly of the digastric muscle, and either cautery or resection of the submandibular glands. Resorption of the facial bony skeleton that occurs with aging affects the ultimate postoperative mandibular contour, and postoperative results thus differ in the young versus old patient. In patients in which there is concern for excess skin laxity, a concurrent facelift is necessary to excise excess neck skin. This article includes a discussion on how a combination of aging and genetics influence a patient's neck anatomy, critical preoperative considerations prior to performing deep neck contouring, intraoperative technique, and adjunct procedures that can further improve a patient's neckline.

Exosomes have emerged as a promising therapeutic frontier in facial plastic surgery. Preclinical studies have demonstrated their ability to modulate wound healing, skin rejuvenation, hair growth, and nerve regeneration. Early clinical evidence suggests potential benefits in enhancing recovery after laser resurfacing, treating acne scars, and promoting hair growth. Despite their potential, there are currently no exosome products that are FDA-approved for medical use, and they should be considered experimental until receiving regulatory approval and robust clinical validation. As research advances, exosomes may offer valuable tools for facial plastic surgeons to improve patient outcomes and expand regenerative medicine applications in facial aesthetics and reconstruction.

Optimal results in complex nasal reconstruction, particularly in the context of post-traumatic and revision septorhinoplasty, often require the use of cartilage grafts to provide additional structural support to the nose. While autologous costal cartilage (ACC) has been traditionally used, this can be limited by donor site morbidity, increased operative time, and in some cases, lack of suitable cartilage for grafting. There has been a trend towards using irradiated homologous costal cartilage (IHCC) as an alternative source of graft material. We review our departmental experience of using IHCC in functional septorhinoplasty surgery. We performed a retrospective review of electronic medical records of all patients who underwent septorhinoplasty using IHCC at a tertiary referral center between May 1, 2022, and April 30, 2024. Demographic data, surgical details, and postoperative outcomes, including rates of infection, resorption, warping, and revision were recorded and analyzed. Fifty-seven patients (34 males, 23 females) with a mean age of 41.0 years (range: 18-65 years) were included. Forty-one were revision septorhinoplasty operations, while 16 were primary cases. Almost all were performed via an open approach (98.2%). Three patients developed postoperative infection (5.3%) while one developed columellar dehiscence needing further revision surgery (1.8%). Functional and aesthetic results were otherwise satisfactory in all patients. We observed no cases of warping, resorption, or extrusion. The median length of follow-up was 279 days (interquartile range: 171-527 days). We present the largest United Kingdom series to date on the use of IHCC in septorhinoplasty surgery. Our findings support its use as a safe and effective graft material and a viable alternative to autologous sources, offering the benefits of a robust reconstructive material and shortened operative time, without the risk of donor site complications. A longer follow-up period is ideally required to evaluate its long-term structural stability.

In the last few years, the Deep Plane Face Lift (DPFL) has gained great popularity among plastic surgeons, even if its origins are traced back to the 1970s. Certainly, it could have some advantages but based on our experience, it can reveal some unpleasant features in the long term. For this reason, the senior authors have adopted the high superficial musculoaponeurotic system (SMAS) Face Lift for many years in their surgical practice.The goal of our study is to analyze the DPFL critical aspects in the long term and show how the High SMAS Face Lift (HSFL) technique can help to improve them.

Frontal view morphing is needed for better preoperative consultation and simulation process in rhinoplasty. Restoration of the correct light-shadow interactions in rhinoplasty demands a firm appreciation of the underlying nasal structures. Chiaroscuro is a painting technique of dark and light contrasts that can be utilized in the morphing process, enabling the surgeon to explain possible results. Patients undergoing surgery in 2019. Encounters were divided into three. First visit: history taking, a list of desires and physical examination, photography. Second visit: photo analysis was presented as well as the hypothesis of correction expressed by morphing (morphing with Adobe Photoshop software). We termed the differences between light and shade of the lateral nasal walls, the dorsum and the brow dome line and nose cheek line as the "Chiaroscuro of the nose." This term is significant in the process of morphing of the frontal view. We used this method of morphing in the simulation process of 126 patients. The age range was 15 to 59 years old. A total of 67% (84) were females and 33% (42) were males. A total of 43% (54) of the cases were revision cases. At the postoperative visits, all patients were more satisfied with their operative result than with their "morphed" simulation. The chiaroscuro concept of the nose is an essential step in the analysis and morphing processes of the frontal view, and a logical tool in creating a realistic surgical game plan. The morphing of the frontal view enables the surgeon and patients to discuss the possible result with more details and refinements. Morphing may be a good option to educate young surgeons in both preoperative consultation and at the operating theater.

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.

Prominent ear deformities often result from a combination of hypertrophic conchal cartilage and an underdeveloped antihelical fold. Traditional otoplasty techniques, such as antihelical folding sutures and conchal setback maneuvers, may introduce tension and risk of relapse, leading to suboptimal aesthetic outcomes. The PILLARS CONCEPT: represents an alternative surgical approach specifically designed to address hypertrophic concha, ensuring stable and natural results.This study aimed to present the Pillars Concept as an alternative method for correcting hypertrophic conchal cartilage, highlighting its advantages over traditional techniques, and evaluating its effectiveness in maintaining long-term stability of the ear's position without relapse.A retrospective analysis was conducted on 89 patients who underwent otoplasty utilizing the Pillars Concept. The technique involves selective transection of two supporting pillars located in the superior and inferior conchal regions after partial resection of the hypertrophic concha. This releases the conchal cartilage and enables tension-free repositioning of the auricular framework.Of the 89 cases, no hypertrophic concha recurrences were noted during follow-up periods. Complications were minimal, with only two patients (2.2%) experiencing a sensation of "glued ears" following complete conchal resection. Retroauricular fullness was observed in two cases (2.2%) after conchal setback, primarily due to inadequate management of the residual cartilage length. Patient satisfaction was high, and the natural aesthetic of the auricle was consistently preserved.The Pillars Concept provides a reliable, tension-free method for addressing hypertrophic conchal cartilage in otoplasty, preserving the natural ear anatomy and ensuring long-term stability without the risk of relapse. This technique should be considered a valuable addition to the armamentarium of otoplasty procedures.