Facial Plastic Surgery最新文献

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.

Lip augmentation is a popular cosmetic procedure aimed at enhancing lip volume, symmetry, and contour, which significantly influences overall facial aesthetics.Historically, lip enhancement dates back centuries, with various cultures emphasizing the allure of fuller lips. Lip Augmentation with alloplastic implants like silicone and Gore-Tex was favored for a time for their versatility and consistency, but modern practice has increasingly favored biologically derived implants due to their natural integration, reduced complications, and desirable texture. Autologous tissues, such as superficial muscular aponeurotic system grafts, offer additional benefits including minimal immune response, high compatibility, and lasting enhancement.The technique is consistent across most implants which includes making vertical stab incisions just medial to the oral commissure, dissecting in an intramuscular plane within the orbicularis marginalis just under the white roll, and then tunneling the implant to the other side with a tendon passer. The lips are stretched to incorporate the implant and inspected for irregularities prior to closing the incisions.Augmentation with implants offers the appeal of a more permanent augmentation minimizing the need for repeated interventions. Successful lip augmentation enhances lip volume and contour while preserving facial aesthetic harmony and respecting the dynamic anatomical function of the lips.

Neurotoxins and fillers have become increasingly popular for restoring age-related changes in the perioral region. This review examines their roles in optimizing perioral rejuvenation.The perioral region composes the lower third and middle three-fifths of the face. It includes the lips, surrounding perioral skin, chin, muscles of facial expression, maxilla, and mandible. Changes in the perioral region are significant contributors to the visible signs of aging.Ideal candidates for perioral rejuvenation with toxin and filler are individuals experiencing age-related rhytids or volume loss who are interested in minimally invasive, nonsurgical interventions.Neurotoxins like Botox, Xeomin, Dysport, Jeuveau, and Daxxify are used to relax muscles that contribute to rhytids. Common treatment areas and techniques include perioral rhytids, lip flip, oral commissure elevation, dimpled chin, and gummy smile. Dermal fillers such as hyaluronic acid, calcium hydroxyapatite, and poly-L-lactic acid restore volume in areas like the nasolabial folds, lips, marionette lines, chin, prejowl sulcus, and perioral rhytids.Neurotoxins and dermal fillers offer effective, minimally invasive solutions for perioral rejuvenation. With an understanding of underlying anatomy, proper patient selection, and precise injection techniques, facial plastic surgeons can achieve natural, youthful results with minimal downtime.

Dimple creation surgery, or dimpleplasty, recreates the dynamic cheek indentations found in approximately 30% of faces. This review highlights current evidence and provides surgical insights for predictable, natural outcomes.Since 1962, successive refinements of the technique have focused on smaller incisions and precise dermomuscular fixation.Awareness of zygomaticus major variants, orbicularis oculi bands, Stenson's duct, and buccal branches of the facial nerve underpins safe practice.Bipolar cautery may assist with hemostasis.Healthy adults with realistic expectations benefit most. Those with keloid tendency warrant caution.A 5-mm intraoral incision, selective muscle fenestration, and dermomuscular plication produce an immediate dimple that softens with healing.Brief oral antibiotics support recovery.AI-assisted 3D smile simulation is being conducted and refined to boost dimple creation precision and predictability.With surgical precision and careful patient selection, dimpleplasty remains a low-risk procedure that can deliver high patient satisfaction.

To evaluate the effectiveness of a comprehensive surgical approach addressing perioral mounds-the "mouth pouch"-through modified buccal fat pad sculpting, targeted mucosal and muscle resection, and focal skin tightening for enhanced lower facial contouring.Conventional techniques often fall short in resolving contour irregularities in the perioral region due to intricate anatomy and high functional mobility.The perioral area includes a complex interplay of superficial and deep fat compartments, musculature, vasculature, and nerves. Aging-related atrophy of superficial fat and pseudoherniation of buccal fat contribute to soft tissue compartmentalization and visible mounding.Radiofrequency-assisted dermal tightening is combined with intraoral fat sculpting to promote further definition.Ideal candidates have distinct perioral mounds, robust buccal fat pads, thickened oral mucosa, and visible lines of parakeratosis.A seven-step intraoral technique under local anesthesia include mucosal resection, buccinator stripping, buccal fat pad sculpting, and radiofrequency treatment.Dual compression with intraoral packing and external head wrap minimizes hematoma and infection risk.Combining bony augmentation (e.g., chin implants) with soft tissue contouring yields comprehensive lower face rejuvenation.This technique for treating perioral mounds, in carefully selected patients, provides a reproducible, and safe method for lower facial contour enhancement.

This study discusses the surgical technique and the ideal candidates for lip reduction as well as highlights the low-risk, yet efficacious nature of this in-office procedure.Lip augmentation procedures such as hyaluronic acid fillers and lip lift surgery are the most common cosmetic lip treatments; however, lip reduction is growing in popularity.The lips are highly vascularized and sensitive tissue supplied by the superior and inferior labial arteries and innervated by the trigeminal nerve.Patients may be ideal candidates for lip reduction surgery if they possess a large upper and/or lower lip and desire decreased lip volume and projection.The senior author's surgical technique entails marking an elliptical incision along the wet-dry border, excising the mucosal tissue en bloc, and closing the wounds following the rule of halves.Patients are instructed to follow a soft diet for 1 week and activity restrictions for 2 weeks as well as to frequently apply Aquaphor or Vaseline to the wounds.Lip reduction surgery is a cosmetic procedure intended to decrease lip size and projection. Lip reduction is a safe and relatively quick in-office procedure that is associated with minimal downtime.

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.

Perioral aesthetics are a critical component of facial gender-affirming surgery (FGAS). The goal of this paper is to review the philosophy, techniques, and evidence supporting perioral aesthetics in FGAS with specific attention to the lips, chin, and submentum.Masculine appearance is typically associated with greater upper lip height, labial volume, and mouth width, whereas female appearance exhibits increased upper incisor show with a softer, tapered chin shape. The masculine chin is wider and taller with greater anterior projection, whereas the feminine chin is typically more narrowed. The contour of the submentum is impacted by skeletal and soft tissue differences, with males displaying a more angular profile.Techniques for lip feminization include the subnasal lip lift and various injectables for altering lip contour. For chin contouring, several genioplasty techniques exist, including the T-genioplasty. These procedures may utilize virtual surgical planning. Submental liposuction and platysmaplasty can refine the submental area to highlight underlying osseous structures. Augmentation of the mandible, typically using implants, can be utilized for masculinization of the perioral region.Careful attention to the lips, chin, and submentum can help achieve desired outcomes in both facial feminization and masculinization. A comprehensive understanding of perioral anatomy and an individualized technique selection are vital for achieving optimal FGAS outcomes.