Facial Plastic SurgeryPub Date : 2024-08-01Epub Date: 2023-08-28DOI: 10.1055/s-0043-1773768
Cornelia Spatz, Thomas Kühnel, Achim Stegmann, Franziska Schwan, Klaus Bumm, Christopher Bohr
{"title":"Closure of Nasal Septal Perforations Using a Diced Cartilage in Fascia Graft.","authors":"Cornelia Spatz, Thomas Kühnel, Achim Stegmann, Franziska Schwan, Klaus Bumm, Christopher Bohr","doi":"10.1055/s-0043-1773768","DOIUrl":"10.1055/s-0043-1773768","url":null,"abstract":"<p><p>The spectrum of surgical techniques in the repair of nasal septal defects is wide. The objective of this study was to assess the feasibility of using a diced cartilage in fascia (DC-F) graft for successful closure of nasal septal perforations and to evaluate symptom reduction. This was a retrospective study of 18 patients undergoing surgical repair of symptomatic nasoseptal perforations of different etiologies using a DC-F graft from 2020 until 2021. The procedure was feasible in all of the 18 patients. Reconstruction of septal defects with a DC-F graft led to reduction of crust formation, reduction of epistaxis, and improvement of nasal breathing in 13 out of the 18 patients when seen for their 2-month follow-up. Reperforation occurred in three cases, leaving defects of 1, 7, and 5 mm in diameter. In one case, the reperforation was symptomatic. A DC-F graft proved to be a reliable and reproducible method for the closure of nasoseptal perforations of variable sizes, of different locations, and of different etiologies.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":"476-484"},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10113666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Facial Plastic SurgeryPub Date : 2024-08-01Epub Date: 2024-05-03DOI: 10.1055/a-2318-6989
Jessica M Winter, Eleonora O F Dimovska, Chieh-Han John Tzou, Andres Rodriguez-Lorenzo
{"title":"Rethinking Oncologic Facial Nerve Reconstruction in the Acute Phase Through Classification of the Level of Injury.","authors":"Jessica M Winter, Eleonora O F Dimovska, Chieh-Han John Tzou, Andres Rodriguez-Lorenzo","doi":"10.1055/a-2318-6989","DOIUrl":"10.1055/a-2318-6989","url":null,"abstract":"<p><p>Early facial nerve reconstruction should be offered in every patient with oncological resections of the facial nerve due to the debilitating functional and psychosocial consequences of facial nerve palsy. Oncologic pathology or oncologic resection accounts for the second most common cause of facial nerve palsy. In the case of these acute injuries, selecting an adequate method for reconstruction to optimize functional and psychosocial well-being is paramount. Authors advocate consideration of the level of injury as a framework for approaching the viable options of reconstruction systematically. Authors breakdown oncologic injuries to the facial nerve in three levels in relation to their nerve reconstruction methods and strategies: Level I (intracranial to intratemporal), Level II (intratemporal to extratemporal and intraparotid), and Level III (extratemporal and extraparotid). Clinical features, common clinical scenarios, donor nerves available, recipient nerve, and reconstruction priorities will be present at each level. Additionally, examples of clinical cases will be shared to illustrate the utility of framing acute facial nerve injuries within injury levels. Selecting donor nerves is critical in successful facial nerve reconstruction in oncological patients. Usually, a combination of facial and nonfacial donor nerves (hybrid) is necessary to achieve maximal reinnervation of the mimetic muscles. Our proposed classification of three levels of facial nerve injuries provides a selection guide, which prioritizes methods for function nerve reconstruction in relation of the injury level in oncologic patients while prioritizing functional outcomes.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":"450-458"},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140850754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Facial Plastic SurgeryPub Date : 2024-08-01Epub Date: 2024-05-28DOI: 10.1055/s-0044-1786824
Amirpouyan Namavarian, Emily YiQin Cheng, Justin Shapiro, Hedyeh Ziai, Benjamin Talei, Akshat Pai, Danny Enepekides, Andres M Gantous
{"title":"Selective Neurectomy for Postfacial Paralysis Synkinesis: A Systematic Review.","authors":"Amirpouyan Namavarian, Emily YiQin Cheng, Justin Shapiro, Hedyeh Ziai, Benjamin Talei, Akshat Pai, Danny Enepekides, Andres M Gantous","doi":"10.1055/s-0044-1786824","DOIUrl":"10.1055/s-0044-1786824","url":null,"abstract":"<p><p>Facial synkinesis is characterized by unintentional contractions of facial musculature secondary to aberrant facial nerve healing. The associated impairment in facial functioning results in a significant decrease in patients' quality of life. The mainstay treatment for postfacial paralysis synkinesis (PFPS) is chemodenervation and physiotherapy, which requires long-term maintenance neurotoxin injections. This can lead to treatment resistance. Selective neurectomy of the distal branches of the facial nerve has been suggested as an effective surgical treatment of PFPS. This study aims to provide a comprehensive systematic review evaluating the efficacy of selective neurectomy for patients presenting with PFPS. Ovid MEDLINE, Ovid Embase, PubMed, Web of Science, and CINAHL were searched from inception until July 2022. Studies that investigated postoperative outcomes of pediatric and/or adult patients who underwent selective neurectomy as a treatment for PFPS were included. The database search identified 1,967 studies, and 11 were ultimately included based on inclusion and exclusion criteria. These 11 studies represented 363 patients. Studies reported on outcomes following selective neurectomy with or without adjuvant therapies for patients with PFPS. The main outcome categories identified were clinician-reported outcomes and patient-reported outcomes. The studies that used clinician-reported outcomes found an improvement in both synkinesis and facial nerve paralysis (FNP) outcomes following selective neurectomy according to their respective grading systems. Three studies looked at patient-reported outcomes and found increased patient-reported quality of life and satisfaction following selective neurectomy. The most reported complications were upper lip contracture, uneven cheek surface, lagophthalmos, and temporary oral incompetence. Selective neurectomy has demonstrated stable or improved synkinesis, FNP, and quality of life outcomes in patients with PFPS. This approach should be considered for patients with PFPS, particularly for patients with refractory symptoms or those who are unable to undergo continued medical management.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":"525-537"},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141161728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Impact of Tongue-in-Groove Technique on Smile and Lip Position: A Comparative Analysis with and without Septal Extension Graft.","authors":"Farbod Farhbaksh, Amir Arvin Sazgar, Babak Saedi","doi":"10.1055/a-2353-3477","DOIUrl":"10.1055/a-2353-3477","url":null,"abstract":"<p><p>This study was conducted to compare the outcomes of the tongue-in-groove (TIG) technique with and without septal extension graft (SEG) on smile and lip position in rhinoplasty. Fifty-eight rhinoplasty patients, treated at a tertiary referral center between 2020 and 2022, underwent preoperative and 12-month postoperative evaluations, using the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) and the visual analog scale (VAS). The preoperative and 12-month postoperative photographs were analyzed using Adobe Photoshop to assess changes in lip and smile positions. The study included 38 patients in the TIG with SEG group and 20 patients in the TIG without SEG group. The participants, with an average age of 32.12 ± 7.97 years, comprised 81% females. In terms of surgical outcomes, postoperative evaluations revealed significant improvements in the VAS aesthetic score, SCHNOS-O score, and SCHNOS-C score compared with preoperative scores (<i>p</i> < 0.001) for both groups. Notably, both groups demonstrated significant improvements in the upper lip length, nasolabial angle (NLA), columellar inclination (CI) angle, and smile NLA. Patients in the SEG group exhibited markedly superior SCHNOS-O results, as well as distinctions in smile NLA and smile CI, compared with the group without SEG. The impact of rhinoplasty techniques on lip and smile remains complex requiring further evaluation. Both of the TIG techniques, with and without SEG, resulted in positive outcomes in terms of improving lip and smile positions, with the use of SEG demonstrating greater stability during a smile.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141456120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muhammad Adil Abbas Khan, Yangmyung Ma, Dallan Dargan, Noemi Kelemen, Dujanah Bhatti, Armaan Riaz, Muhammad Riaz
{"title":"Open Neck Lift: Surgical Technique and A Clinical Classification for Cervical Rejuvenation.","authors":"Muhammad Adil Abbas Khan, Yangmyung Ma, Dallan Dargan, Noemi Kelemen, Dujanah Bhatti, Armaan Riaz, Muhammad Riaz","doi":"10.1055/s-0044-1788325","DOIUrl":"https://doi.org/10.1055/s-0044-1788325","url":null,"abstract":"<p><p>Careful evaluation of the neck and its relationship to the lower third of the face is fundamental to provide appropriate recommendations for procedures. The authors propose a modified Baker \"clinical\" classification as a more reliable and reproducible evaluative basis for the treatment of the aging neck. A total of 450 patients underwent procedures for cervical rejuvenation between December 2012 and December 2022 by the senior author. These included 9 cases of neck liposuction, 6 isolated neck lifts, 15 minimal access cranial suspension face lifts, 94 face lifts with open neck lifts, and 326 extended R-face and neck lifts. The male-to-female ratio was 1:20. The mean patient age was 59.1 years and the mean follow-up was 14 months (range 11.5-20 months). From the data, a modified Baker clinical classification for the aging neck was formulated along with recommendations for possible solutions. Ninety-four percent of the patients expressed high satisfaction on the Owsley Facelift Satisfaction Survey at 1-year follow-up. The complication rate was 1.78% (8 patients), including 1 hematoma, 1 skin edge necrosis (1 cm), 1 slow healing site (postauricular), 3 limited postauricular/earlobe scar revisions, and 2 mild contour irregularities. Cervical rejuvenation can be achieved by a spectrum of interventions and approaches. A comprehensive preoperative assessment and a clinical neck lift classification are the keys to selecting the correct surgical technique for achieving reliable and consistent results. The authors propose a pragmatic approach for both isolated and integrated neck lift procedures with excellent aesthetic outcomes and minimal complications.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141747848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Lateral Wall of the Inferior Meatus as a New Graft Source for Rhinoplasty: Radiological Study and Surgical Technique.","authors":"Yury Rusetsky, Zhanna Mokoyan, Margarita Dutova, Anar Sadigov, Natalia Balybina, Olga Chernova","doi":"10.1055/a-2353-3380","DOIUrl":"10.1055/a-2353-3380","url":null,"abstract":"<p><p>Generally, revision rhinoplasty cases require the use of stiff grafts to restore the lost support. However, the majority of patients indicated for revision surgery present with a lack of a bony cartilaginous framework of the septum, especially after previous septoplasty. Thus, surgeons are compelled to harvest costal cartilage. At the same time, rib graft harvesting is associated with additional trauma and a risk of serious complications. Being ENT surgeons, we often resect a part of the lateral wall of the inferior nasal meatus during the extended endoscopic approach to the maxillary sinus. We supposed that this bone plate could be used as a donor site for rhinoplasty graft harvesting. The aim of our study was a radiological assessment of the feasibility and limits of using the inferior meatus lateral wall (IMLW) as a donor site for rhinoplasty bone graft.A retrospective evaluation of 100 CT scans of sinuses was conducted. Further measurements of the IMLW were performed: average length and width (28.06 ± 4.03 mm and 19.73 ± 3.08 mm, respectively), thickness (0.62 ± 0.21 mm), and average deviation from the sagittal plane (17.7 ± 9.53 degrees). According to the obtained measurements, the described donor site is appropriate for harvesting nice straight bony fragments.The IMLW bone graft was used in four revision rhinoplasty cases. There were no postoperative complications. During the long-term follow-up, patients reported significant improvement in aesthetics, function, and social aspects according to Rhinoplasty Outcome Evaluation. Thus, the described technique is an easy and safe method for bone harvesting for revision rhinoplasty. Our first experience demonstrated the convenience and stability of IMLW grafts for revision rhinoplasty during the follow-up period of up to 2 years.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141456121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ophthalmic Assessment and Management in Acute Facial Palsy.","authors":"Mohsan Malik, Raheej Shamim Khan, Eamon Shamil","doi":"10.1055/a-2359-5280","DOIUrl":"10.1055/a-2359-5280","url":null,"abstract":"<p><p>This article aims to provide insights into emerging concepts in ophthalmic manifestations in patients with facial palsy and discusses considerations used to develop patient-specific management plans in acute management.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141497542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gabriela Casabona, Konstantin Frank, Rui Zeng, Sebastian Cotofana, Michael Alfertshofer, Charlotte Weinmann, Nicholas Moellhoff, Kai O Kaye
{"title":"Investigating Facial Muscle Physiology Following Soft Tissue Filler Injections-A Surface-derived Electromyographic and Skin Vector Displacement Analytic Study.","authors":"Gabriela Casabona, Konstantin Frank, Rui Zeng, Sebastian Cotofana, Michael Alfertshofer, Charlotte Weinmann, Nicholas Moellhoff, Kai O Kaye","doi":"10.1055/a-2338-0581","DOIUrl":"10.1055/a-2338-0581","url":null,"abstract":"<p><p>The use of hyaluronic acid-based soft tissue fillers has often been reported to modulate the muscle, that is, to cause myomodulation. To our knowledge, there has been so far no scientific study investigating the potential of hyaluronic acid-based soft tissue fillers to modulate or actually alter the function of facial muscles. To further assess this three-dimensional (3D) surface imaging and electromyography (EMG)-based prospective study investigated the changes of facial muscle contraction after injection of strategically placed hyaluronic acid-based soft tissue fillers to assess the actual validity of the term myomodulation. A total of 13 subjects with a mean age of 37.8 years (12 females, 1 male) were injected according to a predefined injection protocol. Surface EMG and 3D surface imaging were performed prior to the injection and 5 days after the injection. The results showed no significant change in the strength of the muscles (measured in μV) after injection of hyaluronic acid-based soft tissue fillers. However, horizontal and vertical skin displacement upon contraction of the zygomaticus major muscle changed significantly between baseline and follow-up, with a mean horizontal skin displacement increase from 3.2 to 4.1 mm. Upon contraction of the depressor anguli oris muscle, the horizontal skin displacement did not change significantly (2.15 vs. 2.05 mm), while vertical skin displacement increased significantly from 2.9 to 4.3 mm. The modification of the surrounding tissue caused an alteration of the vectorial skin displacement upon contraction of the muscle. A potential explanation could be the increased distance between the origin and insertion of the muscle due to the material deposition in the proximity of the relevant facial muscles, leading to a change of contraction vector.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emre Ilhan, Diego Arancibia-Tagle, Hüseyin Özay, Jose Carlos Neves
{"title":"Corrigendum: Precision Rhinoplasty Cylindric Burrs-Sidewall Aesthetics.","authors":"Emre Ilhan, Diego Arancibia-Tagle, Hüseyin Özay, Jose Carlos Neves","doi":"10.1055/s-0044-1787968","DOIUrl":"https://doi.org/10.1055/s-0044-1787968","url":null,"abstract":"","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141456119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Evolution of the Surgical Net.","authors":"Thomas G O'Daniel, Milind D Kachare","doi":"10.1055/a-2334-4448","DOIUrl":"10.1055/a-2334-4448","url":null,"abstract":"<p><p>The surgical net technique, originally conceptualized to mitigate postoperative hematomas, has evolved into a versatile tool, transcending its initial purpose, and signaling a new era of surgical innovation. This article provides a comprehensive overview of the surgical net's journey from a targeted solution to a multifaceted surgical asset and explores its burgeoning applications, challenges, and future trajectories. Despite early reluctance due to anatomical concerns and unfamiliarity with the novel technique, the surgical net's consistent success in various surgical contexts from facial surgeries to gynecological applications has catalyzed its widespread global adoption. The technique's integration of the progressive tension method and enhanced skin redraping capabilities underscores its contribution to optimal aesthetic outcomes and improved surgical control. Noteworthy is its role in the innovative concept of gliding surgery, marked by procedures like the gliding brow lift and Glidelift, demonstrating the surgical net's adaptability and effectiveness in diverse surgical environments.Contributions from international surgeons have expanded its applications to areas like axillary space obliteration after breast implant, postmastectomy closure, and the management of postpartum hemorrhage, showcasing the surgical net's global impact and universal commitment to optimizing surgical outcomes. The article delves into the anatomical considerations essential for adapting the surgical net technique to various surgical contexts, emphasizing the need for continuous research, clinical trials, and multidisciplinary collaboration to navigate emerging challenges and ensure its sustained efficacy and safety.In conclusion, the article highlights the surgical net technique's unwavering potential for further advancements, greater procedural efficiency, and the continued elevation of patient care standards. The consistent evolution of its applications, paired with a dedicated approach to addressing emergent challenges, reinforces the surgical net's enduring contribution to surgical innovation and global patient welfare.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141161722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}