Facial Plastic Surgery & Aesthetic Medicine最新文献

Background: Creating a tragus in microtia reconstruction is technically difficult, and its importance as a visual landmark is uncertain. Objective: To compare the attention given to ears in photographs with and without a tragus, as measured by eye tracking of gaze patterns. Methods: Participant eye movements were tracked (Tobii Pro) while viewing photographs of a profile face and close-up view of the ear. The tragus was absent in half of the images. Gaze patterns were visualized as heat maps, and t-tests compared areas of interest on the face and ear. Results: Fifty adults (27 female, ages 21-83) without medical training participated. While viewing a profile face for 10 s, participants looked at a normal ear for 2.19 s (1.5-2.9) (mean, 95% CI) and an ear without a tragus for 2.25 s (1.6-2.9) (p = 0.81). On close-up view, the tragus received the least attention (0.19 s, 0-0.19), while gaze at the canal increased from 0.82 s (0.39-1.3) to 1.39 s (0.96-1.8) when the tragus was absent (p = 0.02). Conclusion: When the tragus was absent, gaze patterns of the profile face were not impacted; however, the ear canal was more exposed and received more attention on close-up view of the ear. This may influence aesthetic goals in auricular reconstruction.

Background: Periorbital edema and ecchymosis are frequent complications after rhinoplasty, impacting early recovery and patient satisfaction. Objective: To evaluate the effect of subperiosteal drain placement in patients undergoing ultrasonic piezo-assisted rhinoplasty, as measured by periorbital edema and ecchymosis on postoperative days (POD) 3, 7, and 14. Methods: In this prospective comparative study, 110 adults undergoing open rhinoplasty with piezo-assisted osteotomies were divided into drain (n = 55) and non-drain (n = 55) groups. The drain group received bilateral subperiosteal cannula drains along the osteotomy lines, removed on POD3. Edema and ecchymosis were graded by blinded observers on days 3, 7, and 14 using a 0-4 scale. Results: Patients were 28.2 ± 8.5 years; 76/110 (69.1%) were female; groups were balanced in age (p = 0.224) with a higher female proportion in the drain group (81.8% vs. 56.4%). At POD3 and POD7, total ecchymosis scores were lower with drains (POD3: 2.82 vs. 4.29, p = 0.002; POD7: 0.76 vs. 1.58, p = 0.001), while edema scores were similar between groups at all timepoints. By POD14, edema had resolved and ecchymosis was minimal in both groups. Conclusions: In this study, the use of subperiosteal drains in patients undergoing piezo-assisted osteotomies was found to be associated with a reduction in early postop ecchymosis, but not periorbital edema.

Background: Aesthetic neck contouring is a key component to facial rejuvenation. Objective: To compare patient-reported symptoms after deep neck lift with versus without anterior digastric (AD) myectomy. Methods: Retrospective cohort of patients undergoing neck lift (July 2020-December 2024) grouped by AD myectomy status. Primary outcomes were dysphagia, dysarthria, throat pain, and neck tightness lasting >1 month. Secondary outcomes included hematoma, seroma, scar revision, skin breakdown, and revision neck lift. Results: Of 452 patients with >3 months' follow-up, 142 had no AD myectomy, and 310 had AD myectomy. Median age was 59 (53-65) versus 60 (54-64) years; 92% were female (89% vs. 94%). Median follow-up was 9.60 (4.53-16.69) versus 9.39 (5.78-13.35) months. Combination procedures were performed in 72% (59% vs. 78%), and submandibular gland reduction in 30.5% (0% vs. 44.5%). Primary complaints occurred in 9.9% (95% CI: 6.0-15.9) versus 10.0% (95% CI: 7.1-13.8) with no significant differences in dysphagia, dysarthria, or throat pain. Neck tightness was lower with AD myectomy: 4.8% versus 13.4%, p = 0.0015. Revision neck lift was lower with AD myectomy: 3.9% versus 9.2%, p = 0.027. Conclusions: AD myectomy does not increase functional complications and reduces neck tightness and revision surgery.