Facial Plastic Surgery最新文献

A patient's ethnicity and culture need to be considered prior to male facial rejuvenation. Here, we describe the most important factors across ethnicities that affect the analysis, treatment, and postoperative considerations of commonly performed procedures.There are some traits commonly associated with certain ethnicities that differ from each other. These span skeletal structure, skin characteristics, predisposition to poor scarring, periorbital and nasal anatomy, and hair qualities.As they pertain to the described differences in traits, certain variations exist within procedures to accommodate non-Caucasian patients. This is to make results more natural, fitting to a patient's ethnicity and goals, and to account for differences in postoperative healing.An integral part of every patient encounter is to listen to the patient's perspective and goals prior to developing a treatment plan. Their facial analysis should subsequently be performed in the context of their ethnicity. The management of non-Caucasian facial rejuvenation patients should not be taught as a variation of the norm but rather as unique considerations to modify known surgical techniques for each individual ethnicity and culture. Training needs to emphasize and popularize these differences.

Standardized photography is foundational in facial plastic surgery (FPS) for accurate documentation of outcomes. The increased use of smartphones and social media introduces challenges such as variable lighting, filters, and digital manipulation that can distort results.To examine current FPS photography standards and propose updated guidelines that address the influence of digital platforms. We hypothesize that modern adaptations are required to ensure accuracy and patient trust.Perspective on FPS photography standards in the age of social media.We reviewed published recommendations, historical practices, and recent studies on perioperative FPS photography, including the impact of smartphone technology and social media on standardization.Findings highlight that smartphone photography and social media images often introduce bias through inconsistent angles, lighting, and digital enhancements.Revised photographic guidelines that integrate digital-era considerations are necessary to maintain accuracy, transparency, and ethical standards in FPS.

In recent years, the advancements of minimally invasive, energy-based facial treatments have been followed by an increase in male patient's demand. This article presents a review of current energy-based devices for male facial rejuvenation, aiming to inform clinicians on evidence-based treatment options.A search of the scientific literature in the PubMed database from inception to June 2025 was conducted. Articles were included if they discussed energy-based options for male facial rejuvenation. Out of 70 articles screened, 23 met the inclusion criteria. In included articles, 18 energy-based options used for male facial rejuvenation were reported.This review provides an overview of the wide array of energy-based devices available for male facial rejuvenation. The literature suggests that these technologies can be effectively and safely used to tighten skin, improve contouring while reducing adiposity, enhance skin quality and tone, and manage cosmetic vascular lesions.

Burnout and declining fulfillment are prevalent among facial plastic surgeons (FPS), yet the organizational drivers of these challenges remain underexplored. Ownership structure, workplace autonomy, and collective representation may influence surgeon well-being and workforce sustainability.To assess how autonomy, ownership, and unionization relate to satisfaction and stress among FPS. We hypothesized that private practitioners would report greater autonomy and satisfaction, that academic and hospital-employed surgeons would experience more stress and diminished control, and that prior union exposure would correspond with more favorable views of collective representation.Cross-sectional observational survey (STROBE).A 26-item anonymous survey was distributed to all 1,041 members of the American Academy of Facial Plastic and Reconstructive Surgery; 104 responded (10%). Variables included practice type, ownership, union history, autonomy, compensation satisfaction, stressors, and openness to unionization. Analyses employed chi-square tests and qualitative content analysis.Surgeons in private practice reported the highest autonomy and compensation satisfaction and the lowest rates of feeling rushed. Hospital-employed and academic surgeons were more likely to report diminished autonomy, administrative stress, and lack of influence over workplace decisions. Only 11% of respondents expressed interest in unionizing, though prior union members generally described positive experiences. Surgeons' beliefs about whether unionization affects patient care did not vary significantly by practice setting.Structural factors, particularly the autonomy and ownership model, are strongly linked to satisfaction and stress among FPS. Organizational reforms that enhance autonomy and support collective voice may reduce burnout and improve workforce sustainability.

This article reviews surgical techniques and considerations in the male browlift. Proper understanding of the subtle, gender specific details of browlifting procedures allows for optimal correction in men.Throughout the evolution of various browlifting techniques, certain ones have stood out for their ability to correct brow ptosis in various patients. Browlift techniques, including temporal, endoscopic, pretrichial, direct, and midforehead, are reviewed. Discussion of these techniques begins with a review of our brow rating scale, common considerations, and bilaminar browlift concepts. Additionally, adjunct procedures are discussed for optimization of browlift results.Mastery of male browlifting begins with an objective assessment of the brow, allowing proper technique selection for natural and masculine results.

Direct submentoplasty remains a valuable alternative to rhytidectomy in male patients, addressing cervical laxity and fullness while avoiding feminization, periauricular scars, and prolonged recovery associated with traditional rhytidectomy.Since the early 20th century, submental skin excision has undergone refinement, progressing from horizontal ellipses to advanced configurations such as the Grecian urn pattern. These modifications aim to optimize scar camouflage while correcting horizontal and vertical redundancy.Key anatomic contributors to cervical aging include skin and platysmal laxity, supra- and subplatysmal fat, anterior belly of the digastric hypertrophy, ptotic submandibular glands, and a low-lying hyoid. Comprehensive preoperative analysis is required to address these factors.For patients presenting with submental fullness accompanied by good skin elasticity and minimal skin laxity, an isolated deep structural neck lift without skin excision may be sufficient. Optimal candidates for direct cervicoplasty (skin excision) demonstrate submental laxity limited to above the thyroid cartilage, minimal jowling, and acceptance of an anterior cervical scar.The isolated deep structural neck lift addresses the platysma and its underlying structures without the need for skin excision. A direct cervicoplasty with skin excision affords wide exposure for addressing the skin, platysma, and the subplatysmal anatomy. Skin excision patterns are varied and tailored to the patient's needs.Scar modulation strategies, drain management, lymphatic assistance with positioning/massage, and salivary flow management are key to a hastened recovery.Direct submentoplasty remains an essential tool in the aging male patient, offering reproducible results in appropriately selected patients who are willing to accept its limitations.

The quest to achieve younger and media-driven facial aesthetics has resulted in an exponential increase in the use of facial fillers. Inevitably, this has meant that it is now commonplace for facial plastic surgeons to have patients with fillers in the face. In the senior author's experience (A.R.D.), it was observed that patients with facial fillers experienced persistent edema post-rhinoplasty. It was, therefore, hypothesized that this prolonged edema may be related to fillers affecting the lymphatic drainage impacting postoperative edema following facial surgery.This article aims to gather evidence from wider literature to support the hypothesis that fillers do indeed compromise lymphatic drainage. A narrative literature review was performed using selective articles on fillers and post-rhinoplasty edema. A methodological analysis was then followed to develop a standard theory characterized through the discussion.It is theorized that due to their hydrophilic characteristics, hardness, volume, and backflow phenomena, hyaluronic acid fillers can lead to prolonged edema. In addition, they can either directly block or indirectly exert pressure on the lymphatic pathways and hinder drainage.The research findings support the hypothesis that facial fillers impact postoperative facial edema. Further research is required to objectively measure the effect of fillers on facial lymphatic drainage.The level of evidence is IV.

The chin plays a critical role in establishing facial balance and proportions. Abnormalities of chin projection, height, width, and symmetry can affect perioral aesthetics, gender alignment, and aging.Patients who present for aesthetic perioral enhancement should have a complete evaluation of the perioral bony anatomy. Chin excess may occur in the horizontal, vertical, and transverse dimensions. Surgical chin contouring may require both deprojection and shortening.The technique for both horizontal and vertical chin reduction will be reviewed in addition to complications.The chin is a critical component of facial harmony and should be evaluated and addressed during aesthetic enhancement and rejuvenation.

This study presents a simplified guideline for corner lip lifting (cheiloplasty), a procedure aimed at enhancing the lateral lip's appearance by addressing vermilion deficiency, philtral hooding, and angular depression.Despite the evolution of cosmetic cheiloplasty, with numerous techniques developed to enhance lip aesthetics, tailoring the procedure to individual patients and selecting suitable candidates remain significant challenges for surgeons.Utilizing detailed anatomical mapping based on relaxed skin tension lines and the Diagonal ("D") line, we outline precise surgical techniques to optimize vermilion exposure, elevate the chelion, and improve facial character.Key considerations include dental influences and aging-related ptosis, with specific endpoints and pitfalls highlighted to ensure reproducible outcomes.We introduce three types of corner lip lifts-1, 2a, and 2b-designed to treat varying degrees of lateral lip deficiencies in both younger and older patients, either alone or in combination with subnasal lip lifts using the Cupid Lift® algorithm.Sutures are removed at days 3 and 5, and incisions are lasered with a low-energy CO₂ at 6 and 12 weeks.Our findings demonstrate that these procedures effectively restore lateral lip aesthetics, balance stomion and chelion positions, and ameliorate aging-related changes, offering a versatile approach for practitioners. This work advances cosmetic surgery by providing a streamlined framework for corner lip lifting, enhancing patient outcomes in facial rejuvenation and aesthetic harmony.

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. 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. A total 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. 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.