Facial Plastic Surgery & Aesthetic Medicine最新文献

The objective of this study was to describe the surgeons who have incorporated dorsal preservation (DP) into their practice and their techniques. An anonymous form reviewed by the Evidence-Based Rhinoplasty Research Group board was shared on its Telegram group. The study population was divided into three groups based on their answers: "Preservers," "Mainly Structural," and "Structural exclusively." This study included the answers of 145 worldwide surgeons. DP was more common among plastic surgeons than otolaryngologists/facial plastic surgeons; DP techniques were mostly preferred by surgeons with 10-20 years of experience, while structural techniques were mostly preferred by surgeons with > 20 years of experience; 50.8% of the surgeons who prefer DP techniques use it in more than 90% of primaries; surface techniques (ST) have been more used, mainly by surgeons who prefer structural techniques (p < 0.001). ST were considered more stable (p < 0.001), more predictable (p < 0.001), and shorter learning curve (p < 0.001). Many surgeons using DP still perform structural rhinoplasty. The most cited concern was hump persistence/recurrence. DP rhinoplasty is gaining acceptance, and ST are favored for their perceived short learning curve, stability, and predictability. However, concerns about hump recurrence cause some to continue using structural methods alongside DP.

Importance: Systematic review will improve understanding of nonsurgical facial feminization techniques, which are useful alternatives or adjuncts to surgical gender affirmation. Objective: To determine the effectiveness of nonsurgical facial feminization techniques in patients seeking gender-affirming feminization by reviewing the literature for patient-reported, subjective, and objective outcomes of feminization. Evidence Review: A comprehensive database search was conducted through July 28, 2022. A total of 264 titles and abstracts were screened by two independent reviewers in Covidence. Of all, 48 met the inclusion criteria for full-text review, and 20 articles were included in the final data extraction. Findings: The most described nonsurgical facial feminization techniques were neurotoxins, fillers, and hair removal. Techniques were derived from cisgender cosmetic procedures to achieve feminine qualities. The most common study type was expert opinion or literature reviews. There were only two studies that analyzed measurable nonsurgical facial feminization techniques. Conclusions and Relevance: There is a lack of high-quality prospective research and randomized, controlled trials specific to the transgender patient population that evaluate outcomes, patient satisfaction, or complications. Such studies are needed to inform evidence-based practices.

Background: Facial aberrant reinnervation syndrome is characterized by aberrant facial muscle reinnervation after facial nerve injury producing facial synkinesis, hypertonicity, and muscle spasm. Objective: To systematically review the surgical treatments for facial aberrant reinnervation syndrome and assess their effectiveness as measured by patient-reported outcomes, physician-graded outcomes, or computer-automated grading systems. Methods: We conducted a systematic review using PubMed, Embase, and Cochrane CENTRAL in accordance with PRISMA guidelines. Texts reporting outcomes of any surgical treatment for facial aberrant reinnervation syndrome from 2003 to 2023 were included. Results: After screening, 25 studies with 731 patients were included. Surgical procedures included selective neurectomy (SN), selective myectomy (SM), cross-facial nerve graft, masseter nerve transfer, and gracilis muscle transfer. All surgical techniques and combinations showed significant improvement in at least one clinical outcome measure from baseline (p < 0.05), although one study found no significant improvement. Thirty different outcome measures were used, the most common being the FaCE and eFACE scales (seven studies each). Conclusions: All surgical procedures in this review yield improved clinical outcome measures for facial aberrant reinnervation syndrome, with SN and SM being the dominant surgical treatments. Standardized outcome assessment and more nuanced patient evaluation are necessary to determine the most effective surgical treatments.

Dorsal preservation rhinoplasty techniques can be surface or foundation techniques and respect the philosophy of preserving the osteocartilaginous nasal vault. A spare roof technique (SRT) aims to preserve the upper lateral cartilages through surface techniques. In tension noses with considerable caudal septum deviations, the septal can be repositioned after a low strip of septal cartilage is removed, and the SRT-B is used to reduce the osteocartilaginous hump. This inclusion of the low septal cartilage strip in the SRT-B rhinoplasty is termed as SRT-B3 and builds upon the previously reported philosophy advocated in SRT-A and SRT-B. Correction of moderate deviations of the nasal axis and/or the caudal septum can be addressed with this modification.

Objective: To analyze the quality of artificial intelligence (AI) and machine learning (ML) tools developed for facial aesthetic surgery. Data Sources: Medline, Embase, CINAHL, Central, Scopus, and Web of Science databases were searched in February 2024. Study Selection: All original research in adults undergoing facial aesthetic surgery was included. Pilot reports, case reports, case series (n < 5), conference proceedings, letters (except research letters and brief reports), and editorials were excluded. Main Outcomes and Measures: Facial aesthetic surgery procedures employing AI and ML tools to measure improvements in diagnostic accuracy, predictive outcomes, precision patient counseling, and the scope of facial aesthetic surgery procedures where these tools have been implemented. Results: Out of 494 initial studies, 66 were included in the qualitative analysis. Of these, 42 (63.6%) were of "good" quality, 20 (30.3%) were of "fair" quality, and 4 (6.1%) were of "poor" quality. Conclusion: AI improves diagnostic accuracy, predictive capabilities, patient counseling, and facial aesthetic surgery treatment planning.

Background: A novel single-unit septal extension-columellar strut graft was designed to overcome limitations of traditional techniques in rhinoplasty. Objective: To evaluate the outcomes of rhinoplasty utilizing the novel graft, focusing on nasal support, obstruction, and cosmetic results. Methods: A retrospective analysis included patients who underwent rhinoplasty with this graft between 2020 and 2022, with a minimum 1-year follow-up. Pre- and postoperative nasal obstruction symptom evaluation (NOSE) surveys and standardized photographic assessments were employed. Results: A total of 32 patients (mean age 32.8 ± 11.9 years; 96.9% female, 87.5% Caucasian) underwent primary rhinoplasties (68.8% cosmetic, 31.3% functional). Mean follow-up was 13.4 ± 4.9 months (range 12 to 29). Postoperatively, NOSE scores significantly decreased from 34.4 to 4.84 (p < 0.001). Independent reviewers observed improved nasal aesthetics (preop mean 11.96 ± 3.53, postop 1.83 ± 1.6, p < 0.001) without a loss of nasal tip support. No revisions were required. Conclusions: Rhinoplasty using the septal extension-columellar strut graft, in combination with other techniques, provides durable support to nasal tip structures and contributes to improved nasal tip aesthetics.

Facial plastic and reconstructive surgery has historically been a male-dominated field. It is critical to assess the current state of female representation within our Society to better gauge how we reflect the changing needs of our community and our patients. Although we have made headway in fostering a community ripe for progress, we must continue to create and promote equal opportunities, dissuade microaggressions, address burnout, and capitalize on the innate strengths of our female constituents. With the data presented in this study, we hope to further illuminate the benefits of women engagement in our Academy while recommending sustainable actions to create a culture of allyship.