Facial Plastic Surgery & Aesthetic Medicine最新文献

Importance: Artificial intelligence (AI) has made invaluable contributions to the technologic advancements across many fields. It is transforming health care and may have a role in improving patient outcomes in facial plastic and reconstructive surgery (FPRS). Observations: In recent years, new automated approaches to simulating and analyzing outcomes using AI have emerged. Advances in rhinoplasty, facelifts, orthognathic surgery, facial reanimation, and preoperative consultation are currently being developed in FPRS. Conclusions and Relevance: Applications of AI have been applied to assist facial plastic surgeons in the preoperative stage, intraoperative planning process, and objective assessment of postoperative outcomes. The application of AI provides avenues to improve postoperative outcomes, while also optimizing patient care.

Background: Studies suggest that mood disorders may affect perception of facial synkinesis, though none have analyzed effects on perceived benefit from chemodenervation. Objective: To measure the effect of depression, appearance anxiety, and other variables on chemodenervation benefit among patients with post-paralytic facial synkinesis. Design Type: Prospective cohort. Methods: Patients volunteered and completed: Synkinesis Assessment Questionnaire (SAQ), Facial Clinimetric Evaluation Scale (FaCE), Center for Epidemiological Studies Depression Scale (CES-D), and Fear of Negative Appearance Evaluation Scale (FNAES). Multivariate regression was used to analyze the effect of CES-D, FNAES, and demographics on pre- and post-chemodenervation SAQ and FaCE. Results: In total, 100 patients participated, 90% were female. Mean age was 56.4 (SD 12.3) years. The most common paralysis etiology was idiopathic (47%). Average synkinesis duration was 7.6 (6.2) years and treatment duration 4.9 (4.8) years. Older age and prior treatment (p < 0.05) were associated with reduced SAQ improvement; worse CES-D approached significance (p = 0.09). Reported history of anxiety was associated with greater SAQ improvement (p = 0.05). Factors associated with reduced FaCE improvement included higher baseline CES-D and prior treatment (p < 0.05). Conclusions: Older age, worse depression scores, and prior treatments may be associated with reduced patient-graded improvement following chemodenervation. History of anxiety may be associated with greater improvement.

Background: Zygomaticomaxillary complex (ZMC) fractures are repaired using a variety of surgical approaches. Utilization of intraoperative computed tomography (CT) may reduce the number of surgical approaches. Study Objective: To compare the use of intraoperative CT for the operative repair of ZMC fractures, as measured by the number of surgical approaches. Method: A retrospective review was completed on patients who underwent surgical repair of ZMC fractures by facial plastic and reconstructive surgeons at a tertiary hospital. Results: Eighty-four patients underwent open ZMC repair between 2009 and 2022. Patients had a median age of 42 years (range: 19-93, interquartile range 29-59), were 76.2% Male (n = 64) and 78.6% (N = 66) White. There were 38 and 46 patients in the pre- and post-intraoperative CT cohorts, respectively. The most common incision utilized was a gingivobuccal incision (98.8%), followed by a transconjunctival approach (47.6%). Cases in which CT was utilized had a significantly reduced number of incisions (mean incisions: 2.45 pre vs. 1.67 post, p < 0.001), with large reductions in the rate of transconjunctival incisions (pre-intraoperative CT: 73.7%; post-intraoperative CT: 26.1%, p < 0.001) and lateral canthotomy incisions (23.7% vs. 4.3%, p < 0.001). Conclusion: Intraoperative CT reduces the number of surgical approaches in patients with ZMC trauma.

Introduction: Surgical rhinoplasty is a complex procedure with a high revision rate. Nonsurgical rhinoplasty (NSR) could avoid secondary rhinoplasty allowing the correction of postsurgical defects. A systematic review has been performed among adult patients who had previously undergone surgical rhinoplasty and now presenting for NSR with filler, demonstrated most common indications, fillers, and complications in this technique. Materials and Methods: A systematic review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) system guidelines. Primary outcomes included indications for NSR in patients with prior rhinoplasty and complication rate. Secondary outcomes included filler material and degree of patient satisfaction. Results: Twenty articles met the inclusion criteria, obtaining 2,048 patients analyzed in the review. Hyaluronic acid was the most used filler, found in 67% of patients. Indications were highly variable, considering deformities of the middle third of the nose the most remarkable. A high degree of satisfaction was found in the analyzed studies and the rate of major complications was low. Discussion and Conclusions: NSR in patients with prior rhinoplasty is a useful option for correcting a range from subtle aesthetic defects to severe nasal deformities. However, this technique is not exempt from complications, since an increased risk of skin necrosis has been observed.