Facial Plastic Surgery最新文献

{"title":"Considerations for maximizing perioral aesthetics in gender affirming surgery.","authors":"Torin Thielhelm, Katherine Liu, Maria Mavrommatis, Joshua D Rosenberg","doi":"10.1055/a-2605-7963","DOIUrl":"https://doi.org/10.1055/a-2605-7963","url":null,"abstract":"<p><p>Not prAims and Background: 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.</p><p><strong>Anatomy: </strong>Masculine appearance is typically associated with greater upper lip height, labial volume, and mouth width, while female appearance exhibits increased upper incisor show with a softer, tapered chin shape. The masculine chin is wider and taller with greater anterior projection, while 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.</p><p><strong>Techniques: </strong>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 (VSP). 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.</p><p><strong>Conclusions and clinical relevance: </strong>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. ovided.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063141","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":"Enhanced SJ Tripod Suspension Technique: Achieving Comfort and Predictable Outcomes in Severe Nasal Fracture Treatment.","authors":"Sujai Joshi, Sidrah Mirza, Rajesh Yadav, Anbuchezian Ranganathan","doi":"10.1055/a-2593-3307","DOIUrl":"https://doi.org/10.1055/a-2593-3307","url":null,"abstract":"<p><p>Managing comminuted and complicated nasal fractures is challenging because it requires obtaining both functional and cosmetic satisfaction.This research examines patient satisfaction with the closed reduction strategy paired with the use of SJ tripod suspension and splintage technique for severe nasal fractures. Our hypothesis is that proper duration of internal and external splintage is the key to satisfying results.Case series.A total of 186 consenting individuals presenting over 10 years with severe nasal fractures underwent this technique. The average duration of splintage was 10 days. Patients assessed their satisfaction using a visual analog scale.Out of the total 186 cases, 183 cases were highly satisfied with both functional (98.91%) and cosmetic (91.39%) outcomes.The tripod suspension and splintage approach is an effective and comfortable technique for the closed reduction and splintage of comminuted and complicated nasal fractures.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970605","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":"Feasibility and Efficacy of Transdermal Skin Contour Sutures: A Retrospective Propensity Score Matched Study.","authors":"Emilie Lavrysen, De Beukelaer Maarten, Laura Pingnet, Valérie Verkest, Erik Fransen, Frank Declau","doi":"10.1055/a-2593-4919","DOIUrl":"https://doi.org/10.1055/a-2593-4919","url":null,"abstract":"<p><p>Achieving optimal contour and projection of the nasal tip is one of the most challenging aspects of rhinoplasty. The skin-soft tissue envelope (STE) plays a pivotal role in determining the final outcome, as its thickness and elasticity significantly impact the predictability of postoperative results. Avoiding dead space in the lower third of the nose is essential to ensure consistent outcomes. Recently, transcutaneous skin contour sutures (TSCS) have been proposed to enhance the precision of tip definition and contouring, particularly in patients with thick STE. To mitigate risks such as skin necrosis or scarring associated with traditional TSCS techniques, we modified the approach by placing the knot of the transdermal contour suture on the internal nasal surface.A retrospective, propensity-score matched analysis was conducted on 159 patients who underwent rhinoplasty. After matching, two cohorts of 120 patients were retained: 60 patients underwent rhinoplasty with TSCS, while the control cohort of 60 patients underwent rhinoplasty without TSCS. Patient-reported outcome measures (PROMs) were utilized to evaluate functional and aesthetic outcomes.Using PROMs, we found significant improvements in mean preoperative scores for all PROMs in both cohorts. Postoperative assessments revealed that while the overall healing trajectories were not significantly different, TSCS offered notable early benefits in nasal contour and patient satisfaction, especially during the first 3 to 6 months postoperatively.The modified TSCS technique shows significant early postoperative benefits, particularly in the first 3 to 6 months. However, the overall healing trajectories over 12 months of follow-up were similar between both groups. This suggests that while TSCS has a short-term impact, the natural healing processes in both groups likely converge over time, leading to a diminishing of observable differences. Future research should focus on identifying patient subgroups that experience the greatest benefits from TSCS. The level of evidence is 3.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975600","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":"Patient Satisfaction in Functional Rhinoseptoplasty: The Role of Nonsurgical Factors.","authors":"Miguel Arede Antunes, Rita Fernandes, Rita Peça, Paulo Martins, Leonel Luís","doi":"10.1055/a-2585-5426","DOIUrl":"https://doi.org/10.1055/a-2585-5426","url":null,"abstract":"<p><p>Functional rhinoseptoplasty (FRS) is a surgical procedure with both functional and aesthetic impacts, significantly affecting patients' quality of life. The influence of nonsurgical factors on FRS outcomes remains a debated topic in the literature. For instance, some authors deny the long-term impact of gender, age, inferior turbinectomy, or active smoking on the results. The rhinoplasty outcome evaluation (ROE) questionnaire is a useful tool for assessing patients' satisfaction once submitted to this surgery.To evaluate the subjective impact of nonsurgical factors on the long-term outcomes of FRS.The authors conducted a retrospective study of all patients who underwent FRS at a tertiary hospital between 2019 and 2023. Patients with less than 1 year of postoperative follow-up were excluded. The ROE questionnaire was used to quantify subjective surgical satisfaction. Various variables were analyzed, including previous nasal pyramid trauma, age, known hematologic pathology, psychiatric history, allergic rhinitis, smoking habits, and inferior turbinectomy. Statistical calculations were performed using the Kruskal-Wallis formula.The sample included 75 patients with an average age of 33.4 years, mostly female (51%; <i>n</i> = 38). The average ROE score in the sample was 79.6%. Thirty-eight point seven percent (<i>n</i> = 29) of the procedures were performed after nasal pyramid trauma, with these patients reporting higher ROE scores than others (85.78% in the trauma group; 75.6% in the nontrauma group; <i>p</i>-value = 0.01394). Even though no statistical correlation was demonstrated, ROE scores were also higher in patients with allergic rhinitis (82.1% vs. 78.1% on the healthy group), psychiatric disorders (85.8% vs. 75.6% on the healthy group), hematological disorders (91.7% vs. 78.9% on the healthy group), nonsmokers (81.7% vs. 74.0% on smokers), younger patients (81.7% vs. 76.8% on patients older than 33.4 years) and patients that underwent inferior turbinectomy (81.0% vs. 75.9%).This study established a correlation between the subjective degree of surgical satisfaction and previous nasal trauma in patients undergoing FRS.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985357","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":"H-index or Hype Index? Are High H-Index Surgeons the Real Influencers on Social Media?","authors":"Kiran Abraham-Aggarwal, Andrew B Yang, Daniel J Spertus, John L Frodel","doi":"10.1055/a-2593-9968","DOIUrl":"https://doi.org/10.1055/a-2593-9968","url":null,"abstract":"<p><strong>Introduction: </strong>Social media platforms, particularly TikTok and Instagram Reels, have transformed professional visibility in medicine. Facial plastic surgeons (FPS) leverage these platforms for public education and patient outreach. However, the relationship between social media popularity and scholarly impact remains unclear. Objectives & Hypotheses: This study examines whether an otolaryngologist's social media presence correlates with their H-index, a measure of academic credibility. We hypothesize that higher H-index scores predict greater social media engagement on Instagram and TikTok.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>We extracted HypeAuditor data for TikTok and Instagram engagement metrics among users with otolaryngology content with ≥25,000 followers. H-index was retrieved from Scopus, Web of Science, and Google Scholar. Correlation analyses were performed.</p><p><strong>Results: </strong>Instagram H-index correlated positively with follower count and quality audience, while TikTok showed no significant association.</p><p><strong>Conclusions: </strong>Academic credibility influences Instagram engagement but not TikTok, highlighting platform-specific differences in professional influence.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989614","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":"Functional Outcomes After Feminizing Rhinoplasty.","authors":"Luv Amin, Arthur W Wu, Henry H Chen","doi":"10.1055/a-2588-6903","DOIUrl":"https://doi.org/10.1055/a-2588-6903","url":null,"abstract":"<p><p>Feminizing rhinoplasty, as part of facial feminization surgery (FFS), aims to align nasal appearance with gender identity. While nasal obstruction is a known complication of rhinoplasty, its impact on feminizing rhinoplasty is unclear.This study investigates if feminizing rhinoplasty causes nasal obstruction secondary to structural modifications.Prospective cohort study.IRB-approved study included males and females undergoing cosmetic rhinoplasty and transgender females undergoing feminizing rhinoplasty at Cedars-Sinai Medical Center. Nasal obstruction was assessed using the nasal obstruction and symptom evaluation (NOSE) survey preoperatively and 3-, 6-, and 12-months postoperatively, analyzed with a <i>t</i>-test.NOSE scores significantly decreased in all groups, with transgender females showing a 78, 84, and 77% reduction at 3-, 6-, and 12-months. No significant difference was found between cosmetic rhinoplasty and FFS groups postoperatively.Decreases in average NOSE scores across groups suggest that feminizing rhinoplasty does not worsen nasal obstruction and may improve functional outcomes.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993799","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":"Structural Rhinoplasty through the Endonasal Approach.","authors":"Anil Shah, Onyekachi Ezinna Nnabue","doi":"10.1055/a-2575-3772","DOIUrl":"https://doi.org/10.1055/a-2575-3772","url":null,"abstract":"<p><p>Structural endonasal rhinoplasty, unlike traditional reductive rhinoplasty, achieves aesthetic and functional objectives while maintaining key structural anatomical elements and minimizing complications.Previously, rhinoplasty was performed using primarily reductive techniques that frequently led to poor functional and cosmetic consequences.Pertinent nasal framework anatomy is reviewed in select highlighted cases.Preferred tools/technology are reviewed for each procedure, including the use of ultrasonic devices.Indications for each endonasal technique are systematically outlined.The most common techniques are reviewed: dorsal hump reduction, spreader graft placement, alar batten and rim grafts, and columellar strut, and caudal extension grafts.Endonasal rhinoplasty allows for reduced postoperative swelling, loss of nasal tip support, as well as decreased scar tissue/contracture formation.Structural endonasal techniques continue to evolve and become more refined with studies demonstrating cosmetic and functional outcomes similar to that of open surgery while achieving less operating time, postoperative complications, and long-term complications. As a result, structural endonasal rhinoplasty is an important surgical principle and approach for the modern rhinoplasty surgeon.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992799","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":"Reduction Structured Rhinoplasty.","authors":"Hailey M Juszczak, George Ferzli, Thomas Romo","doi":"10.1055/a-2575-3159","DOIUrl":"https://doi.org/10.1055/a-2575-3159","url":null,"abstract":"<p><p>Reduction structured rhinoplasty is a rhinoplasty technique that combines elements from two rhinoplasty philosophies: simple reductive rhinoplasty and structural rhinoplasty. The goal is to achieve decreased nasal size while supporting a life-long, lasting nasal shape by employing the use of structural grafts.Reducing nasal size without replacing disrupted nasal support structures has historically led to poor outcomes.Structural grafts include spreader grafts, onlay tip grafts, columellar strut grafts, caudal septal extension grafts, and more. They are utilized to prevent internal nasal valve collapse, provide tip support, and prevent tip ptosis, retraction, or poor healing outcomes due to scarring. Different materials, including autologous cartilage and allogenic implants (i.e., high-density porous polyethylene) can be used as graft material. Preference for specific graft use differs from surgeon to surgeon, and continuous debate exists surrounding which grafts provide the most optimal results.This study outlines Romo III's tenured approach to reduction structured rhinoplasty and discusses various trends and debates in grafts that are currently utilized.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975601","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":"Two-Point Fixation in Low-Septal-Resection Dorsal Preservation Rhinoplasty.","authors":"Ayhan Işık Erdal, Mehmet Fatih Özçiler, Serhat Şibar","doi":"10.1055/a-2575-3105","DOIUrl":"10.1055/a-2575-3105","url":null,"abstract":"<p><p>Fixation of quadrangular septal cartilage is a basic step in low-septal-resection dorsal preservation rhinoplasty. The most commonly used technique for this purpose is the fixation of the septum with a suture to the anterior nasal spine. This study presents the use of a previously described dorsal fixation suture as a second fixation maneuver in addition to anterior nasal spine fixation in low-septal-resection cases.Eighty-six patients who underwent closed-approach low-septal-resection dorsal preservation rhinoplasty between January and December 2022 were included in this retrospective study. Depending on the number of surgical maneuvers performed for stabilization of quadrangular septal cartilage, the patients were divided into two groups as follows: (i) a one-point fixation group in which the septum was fixed only to the anterior nasal spine and (ii) a two-point fixation group in which the septum was fixed to both the anterior nasal spine and the septal mucoperichondrium with dorsal fixation suture. Standardized postoperative 12-month lateral-view photographs were scanned for the presence of hump recurrence. The rhinoplasty outcome evaluation (ROE) scale was applied at 12 months.Hump recurrence was observed in five patients in the one-point fixation group (<i>n</i> = 31) and in one patient in the two-point fixation group (<i>n</i> = 55; <i>p</i> < 0.05). No statistically significant difference was found between the groups (<i>p</i> > 0.05) for the ROE scores and ratio of satisfied patients.The addition of dorsal fixation suture to anterior nasal spine fixation (two-point fixation) may reduce the rate of hump recurrence in low-septal-resection dorsal preservation rhinoplasty. The level of evidence is 4.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788238","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":"When Reductive Rhinoplasty Goes Wrong and How to Make it Right.","authors":"Ethan Moritz, Jamil Asaria","doi":"10.1055/a-2577-2805","DOIUrl":"10.1055/a-2577-2805","url":null,"abstract":"<p><p>Over-resection leads to many complications in rhinoplasty. Here, we detail the most common of these pitfalls and strategies to both avoid and repair them.The nose is frequently divided into thirds. The nasal bones represent the upper third. The middle third is composed of the dorsal septum and upper lateral cartilages. The lower third is comprised of the lower lateral cartilages and tip-supporting structures.The commonly seen sequelae of over-resection include a deep radix, saddle nose deformity, inverted-V deformity, pollybeak deformity, alar retraction, a pinched nasal tip, bossae, deep alar grooves, and external nasal valve collapse. The major mechanism to avoid these issues is avoidance; however, several grafting techniques are described here to correct overly aggressive reduction.It is critical to avoid the complications described in this manuscript. Just as important, it is necessary to know how to correct these deformities when patients present for revision rhinoplasty.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810876","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}