Facial Plastic Surgery最新文献

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.

This study focuses on interventions to improve the contour of the submentum. Various therapies for the submentum are available to the conscientious provider. To partner with patients effectively in today's aesthetic landscape, a provider must be well-versed in both surgical and minimally invasive techniques. This study aids decision-making and provides therapeutic options for a diverse patient population.Given the wide array of options for treating the submentum, this study differentiates based on invasiveness. Transcutaneous therapies include cryolipolysis, ultrasound, microwave, and laser. Percutaneous treatments include Kybella or enzymatic mixture injection and transcutaneous energy delivery. Liposuction with or without adjunctive treatments and deep neck lifts are the subcutaneous and structural options.Submental interventions, whether percutaneous, transcutaneous, or subcutaneous, amplify the natural characteristics and beauty of the patient. Aligning the proper technique with the proper patient is the mark of a perceptive surgeon who accounts for underlying anatomy and treatment goals.

The chin and prejowl areas play a critical role in the perception of facial harmony. This paper explores nonsurgical approaches for chin and prejowl rejuvenation, emphasizing anatomy, aesthetic concerns, and the plethora of available treatment modalities.Bony landmarks such as the pogonion, menton, and mental protuberance define the chin, while muscles like the mentalis, depressor anguli oris (DAO), and depressor labii inferioris (DLI) influence facial expression and rhytid development. Aging induces volume loss, tissue laxity, and bony absorption, leading to the formation of the prejowl sulcus and reduced jawline definition.Injectable fillers and biostimulators such as hyaluronic acid, calcium hydroxylapatite, and poly-L-lactic acid address volume loss, enhance contours, correct chin underprojection, and fill both deep and superficial rhytids. Neuromodulators like botulinum toxin reduce muscle hyperactivity to smooth dynamic wrinkles. Energy-based modalities, including radiofrequency, ultrasound, and laser, offer options for skin tightening, fat reduction, and improving skin texture.The paper highlights the benefits and limitations of nonsurgical techniques available to treat the chin and prejowl, emphasizing the need for anatomical precision to optimize safety and efficacy. Although nonsurgical treatments cannot replace surgical interventions, they often provide effective, temporary solutions for patients seeking low-downtime alternatives.

The goal of the article is to help surgeons understand the anatomy and surgical technique of alloplastic and osseous genioplasty.The article provides a brief history of cosmetic osseous genioplasty and the rise of alloplastic genioplasty after the 1950s.This study describes the vertical thirds of the face with anatomic landmarks and the zero meridian assessment for chin deficiencies.Use of virtual surgical planning for custom genioplasty advancements and hardware and the ultrasonic bone saw for bony cuts.This article also describes how to evaluate patients for genioplasty and determine if alloplastic or osseous genioplasty will result in the best patient desired outcome, including the degree of advancement desired, any change in vertical height, correction in horizontal asymmetry, or reduction of the chin.The surgical technique is described for both osseous and alloplastic genioplasty. An intraoral approach is described for osseous genioplasty, while external and intraoral is described for alloplastic.Brief discussion of postoperative care, including compressive dressings, postoperative edema, and duration of liquid diet.Improvement of custom planning with virtual surgical plans as well as development of implants with low risk of infection and extrusion.This study summarizes the anatomic importance of genioplasty with the advantages and disadvantages of osseous and alloplastic genioplasty.

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.

Aesthetic rejuvenation of the perioral, submental, and neck regions is a complex topic with multiple different treatment approaches. Aging changes in the skin, muscles, fat and soft tissue, and bones are driven by multiple internal and external factors. To obtain the best cosmetic outcome, a deep understanding of the perioral, submental, and neck region and proper patient evaluation are necessary. Here, we discuss the process of evaluating patients and planning treatment for perioral, submental, and neck rejuvenation.Patients presenting for evaluation of perioral, submental, and neck aging may have multiple aesthetic complaints. The approach to evaluating patients should be comprehensive and consistent. This involves careful history taking and consideration of medical co-morbidities, a thorough evaluation of the skin, tone, dynamic movement, and soft-tissue distribution of each subunit, and individualized pretreatment counseling to discuss risks and set expectations.An individualized plan may consist of either nonsurgical, surgical or a combination of approaches. Nonsurgical approaches excel at addressing aging skin, volume deficits, and overactivation of facial musculature. Surgical approaches address more severe manifestations of skin aging, uneven volume distribution, loss of contour in the jaw and neck, and bony deformities.

Submental fat can be addressed using both surgical and nonsurgical techniques. Cryolipolysis is a noninvasive treatment that uses cold temperatures to trigger apoptosis in adipose tissue.This study aims to evaluate the efficacy and safety of cryolipolysis for submental fat reduction, specifically analyzing changes in submental fat thickness and volume. It is hypothesized that cryolipolysis leads to measurable improvements in submental fat among patients.This is a systematic review and meta-analysis conducted in accordance with the PRISMA reporting guidelines.A literature search was performed across PubMed, Scopus, and Web of Science from 1973 to 2025. A total of 951 articles were screened, and eight pre-post studies involving 206 patients met inclusion criteria.Pooled analysis showed a mean reduction in submental fat thickness of -2.78 mm and volume of -19.57 cm³.Cryolipolysis significantly reduces submental fat with minimal, transient side effects.

The purpose of this study is to investigate facial symmetry aesthetics (FSA) in the Saudi Arabian population using artificial intelligence (AI).Two hundred and ten 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. Webceph software (Korea) with AI was used to evaluate macro, micro, and tiny aesthetic factors. The data were analyzed using paired t-tests, post hoc Bonferroni testing, analysis of variance (ANOVA), and descriptive statistics. The computation of intraclass correlation coefficients (ICCs) was utilized to assess the dependability of AI evaluations.All variables had ICCs of 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.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 emphasizes how AI might improve the accuracy of assessments of face aesthetics and our knowledge of facial features connected to malocclusion.

Men have distinct facial anatomy and facial patterns. Autologous fat grafting techniques can be tailored to maintain masculine features.Interest in male facial rejuvenation has grown in recent decades. Autologous fat grafting is favored for its natural, durable results and regenerative benefits.Men have angular facial structures with prominent brows, wider jaws, and thinner fat layers. Aging leads to forehead rhytids, midface hollowing, nasal lengthening, jawline blunting, and a more rectangular profile due to bone loss and skin laxity.Thorough preoperative evaluation and facial analysis are important for successful planning and outcomes.There are various commercially available tools for fat harvesting and processing. The Tulip cannula and PureGraft systems are described in this article. Microfat (1,000-1,500 microns) is preferred in facial grafting for its balance of volume restoration and low nodularity risk. The brow, infraorbital region, midface, jawline, and chin can be targeted to restore a youthful, masculine contour.Research on male-specific outcomes, including hormonal and weight effects on graft longevity and patient-reported outcomes, is limited and is an area ripe for future investigation.As interest in male aesthetics increases, tailoring facial rejuvenation techniques to their anatomy and aging is essential for successful outcomes.