Facial Plastic Surgery最新文献

{"title":"Columellolobular Strut: A Biomechanically Validated Technique for Stable Nasal Tip Support.","authors":"Sureyya Seneldir, Alper Yenigun, Remzi Dogan, Ramazan Bahadir Kucuk, Irmak Ucak, Senol Piskin, Orhan Ozturan","doi":"10.1055/a-2925-9637","DOIUrl":"10.1055/a-2925-9637","url":null,"abstract":"<p><strong>Introduction: </strong>Maintaining nasal tip projection and rotation while preserving physiological mobility remains challenging in rhinoplasty.</p><p><strong>Objectives and hypotheses: </strong>This study aimed to evaluate the clinical feasibility and biomechanical behavior of the columellolobular strut. We hypothesized that an angled configuration would demonstrate balanced mechanical behavior under load.</p><p><strong>Study design: </strong>This was a retrospective observational case series (<i>N</i> = 115) supported by finite element modeling, conducted in accordance with STROBE guidelines.</p><p><strong>Methods: </strong>Patients undergoing primary rhinoplasty between January 2021 and April 2024 were included. Finite element modeling assessed deformation and stress at 120, 150, and 180 degrees under standardized compressive loading. Clinical outcomes were evaluated descriptively.</p><p><strong>Results: </strong>Stable nasal tip projection and columellar position were clinically observed during a mean follow-up of 32 months. Finite element analysis demonstrated reduced deformation and stress with decreasing angulation, with the 120 degrees configuration showing the most balanced response.</p><p><strong>Conclusions: </strong>The columellolobular strut represents a biomechanically supported option for nasal tip stabilization while preserving controlled tip mobility.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148619086","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 Role of Oral Isotretinoin in Thick Skin Rhinoplasty: A Systematic Review.","authors":"Hao Meng Yip, Isabel Fernandez-Carrera, Sunil Chopra, Santdeep Paun","doi":"10.1055/a-2697-3029","DOIUrl":"10.1055/a-2697-3029","url":null,"abstract":"<p><strong>Introduction: </strong>Thick skin poses a challenge in rhinoplasty, often resulting in an undefined tip and supratip deformities.</p><p><strong>Objectives and hypotheses: </strong>This study evaluates oral isotretinoin as an adjuvant treatment for thick-skinned rhinoplasty patients.</p><p><strong>Study design: </strong>This is a systematic review conducted in accordance with PRISMA guidelines.</p><p><strong>Methods: </strong>Two independent investigators performed a comprehensive literature search to identify studies that assessed perioperative oral isotretinoin treatment in thick skin rhinoplasty patients. Key outcome measures include skin thickness reduction, cosmetic surgical outcomes, and postoperative patient satisfaction.</p><p><strong>Results: </strong>Five studies met the study inclusion criteria. Their findings demonstrated that oral isotretinoin effectively reduces skin thickness and improves cosmetic outcomes and satisfaction up to 6 months postoperatively, with no major complications reported.</p><p><strong>Conclusion: </strong>Although evidence is limited, oral isotretinoin shows promise in enhancing short-term rhinoplasty outcomes for thick-skinned patients. Further, high-quality trials are needed to confirm these results and develop standardized treatment protocols.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":"457-464"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023093","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":"Evaluating Outcomes of Selective Myectomy of Depressor Anguli Oris, Buccinator, and Platysma in Facial Synkinesis.","authors":"Elise Krippaehne, Bastien A Valencia-Sanchez, Murray J Bartho, Kayva Crawford, Myriam Loyo","doi":"10.1055/a-2741-2508","DOIUrl":"10.1055/a-2741-2508","url":null,"abstract":"<p><strong>Introduction: </strong>Selective myectomy has gained popularity for treating facial synkinesis.</p><p><strong>Objectives and hypotheses: </strong>We examined the combined effectiveness of depressor anguli oris (DAO), partial buccinator, and platysma myectomies.</p><p><strong>Study design: </strong>Retrospective case series.</p><p><strong>Methods: </strong>Pre- and postoperative botulinum toxin-A (BTX-A) treatments of selective myectomy patients were collected. Facial photographs were analyzed using Emotrics + . Facial Asymmetry Index (FAI) and electronic facial paralysis assessment (eFACE) scores were calculated.</p><p><strong>Results: </strong>Twenty patients underwent myectomies. Improvements (mean ± standard error) were seen in several smile metrics, including FAI by 2.80 ± 0.68 mm, nasolabial fold angle by 4.78 ± 1.83 degrees, and smile angle by 4.43 ± 1.18 degrees (all <i>p</i> < 0.05). Postoperative FAI was 2.79 mm. Total BTX-A decreased by 10.85 ± 4.48 units (<i>p</i> = 0.03). eFACE revealed improved oral commissure movement and platysmal synkinesis (<i>p</i> < 0.05 for both).</p><p><strong>Conclusion: </strong>Combined myectomies of the DAO, partial buccinator, and platysma clinically and statistically improve smile in facial synkinesis.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":"517-523"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145471053","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 Role of Triamcinolone in Postrhinoplasty Recovery: A Systematic Review.","authors":"Pedro Pablo Villarroel, Marcelo Davila, Maria Jesus Sanchez, Cristobal Langdon, Diego Arancibia-Tagle","doi":"10.1055/a-2697-3263","DOIUrl":"10.1055/a-2697-3263","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative edema and fibrosis are key concerns following rhinoplasty, affecting outcomes and patient satisfaction. Triamcinolone acetonide (TA) is used for its proven anti-inflammatory and antifibrotic effects.</p><p><strong>Objective: </strong>This study aims to evaluate the efficacy, usage profile, and safety of TA injections after rhinoplasty, focusing on postoperative edema and supratip fullness.</p><p><strong>Methods: </strong>A systematic review was conducted via PubMed and the Cochrane Database to identify studies on corticosteroid injections after rhinoplasty, following PRISMA guidelines and predefined selection criteria.</p><p><strong>Results: </strong>Nine studies were included in the analysis. These studies focused on the postoperative use of TA after rhinoplasty and assessed their impact on key outcomes, such as edema reduction, fibrosis control, and the improvement of supratip fullness following rhinoplasty.</p><p><strong>Discussion: </strong>TA injections were consistently associated with a significant reduction in postoperative edema and the incidence of pollybeak deformities. Current evidence supports the subcutaneous administration of TA at a 10 mg/mL concentration, initiated no earlier than 4 weeks following rhinoplasty. Injections are typically delivered at 4 to 6 week intervals, with a maximum volume of 0.3 mL per session, for a total of two to four administrations, depending on clinical response. TA showed a consistent safety profile with mild and infrequent side effects. Effects appeared within 7 to 14 days and lasted approximately 4 to 6 weeks.</p><p><strong>Conclusion: </strong>TA is an effective adjunct in the postoperative management of rhinoplasty, particularly in patients with thick or reactive soft tissue envelopes. Standardized, personalized protocols are needed, along with better studies and objective outcome tools.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":"465-469"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023183","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":"Pulley-Stitch: An Innovative Technique for Optimizing the Lateral Crus in Rhinoplasty.","authors":"Tito Marianetti, Antonio Iademarco, Luca Perna","doi":"10.1055/a-2695-3697","DOIUrl":"10.1055/a-2695-3697","url":null,"abstract":"<p><strong>Introduction: </strong>Managing nasal tip support and lateral crura malposition remains a challenge in rhinoplasty.</p><p><strong>Objectives and hypotheses: </strong>This study aimed to evaluate the effectiveness of a novel suture technique-the Pulley-Stitch-in correcting lateral crura malposition. Primary outcome: Change in lateral crura angle; secondary outcome: Long-term stability.</p><p><strong>Study design: </strong>Prospective cohort study (<i>N</i> = 42), reported in-line with STROBE guidelines.</p><p><strong>Methods: </strong>Forty-two patients underwent open rhinoplasty. The angle between the caudal margin of the medial crus and the anterior third of the lateral crus was measured from intraoperative images at T0 (prestitch) and T1 (poststitch). Standardized postoperative images were analyzed at 1 month (T2) and 12 months (T3).</p><p><strong>Results: </strong>The angle increased from a mean of 18.2 to 26.9 degrees (<i>p</i> < 0.05), reflecting improved anatomical alignment and external nasal valve patency. Stability was confirmed at 12-month follow-up.</p><p><strong>Conclusion: </strong>The Pulley-Stitch is a safe, effective technique to improve nasal tip structure, cephalic rotation, and ala contour.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":"446-450"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000049","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 Phylogeny and Ontogeny of Facial Superficial Musculoaponeurotic System.","authors":"Gautham Ullas, Shreya Garg, Ullas Raghavan","doi":"10.1055/a-2718-3928","DOIUrl":"10.1055/a-2718-3928","url":null,"abstract":"<p><strong>Introduction: </strong>The superficial musculoaponeurotic system (SMAS), a complex network of fibromuscular tissue, is a fundamental component of facial anatomy, playing a key role in both dynamic function and aesthetic appearance. Although the anatomy of the SMAS has been widely studied, several aspects remain unclear-particularly the presence of its fascial component, the variability in its attachment to deeper tissues, the possibility of distinct SMAS layers, and the association of facial nerve branches with first arch structures. In this study, we propose a hypothesis to explain the anatomical variations in SMAS observed during deep-plane facelift procedures.</p><p><strong>Methods: </strong>A comprehensive review of the literature on the phylogeny and ontogeny of the facial SMAS was conducted. While numerous studies address the development of the face and SMAS, many report conflicting findings. For the purpose of this hypothesis, we have relied on the most widely accepted interpretations.</p><p><strong>Results: </strong>Current understanding suggests that the facial SMAS originates from the primordial panniculus carnosus, a primitive muscular layer present in many lower vertebrates. Our analysis indicates contributions from the platysma myoides, platysma cervicalis, and sphincter colli profundus. The latter two structures undergo regression and are represented in the adult form as fascia. The relationship of the SMAS to deeper tissues appears to depend on whether it lies deep to the platysma cervicalis or the platysma myoides. Additionally, existing literature on the embryology of the facial nerve explains the presence of its branches among first arch structures, as well as their maintained connections with the SMAS.</p><p><strong>Conclusion: </strong>The phylogeny and ontogeny of the facial SMAS represent a complex developmental process that likely accounts for the observed anatomical variations and inconsistencies in its relationship with surrounding fascial planes and facial nerve branches.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":"549-554"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250555","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":"Holding the Lid: Suspension Techniques to Prevent Lower Eyelid Ectropion-A Systematic Review.","authors":"Can Ege Yalcin","doi":"10.1055/a-2695-3754","DOIUrl":"10.1055/a-2695-3754","url":null,"abstract":"<p><strong>Introduction: </strong>Lower eyelid ectropion is a challenging postoperative complication that can affect both function and aesthetics. Preventative strategies are critical, particularly in high-risk periocular and midface surgeries.</p><p><strong>Objectives and hypotheses: </strong>This review aims to evaluate the efficacy and variety of prophylactic suspension techniques used to prevent lower eyelid ectropion. Primary outcome: Incidence of ectropion; secondary outcomes: Technique tolerability and reported complications.</p><p><strong>Study design: </strong>Systematic review conducted in accordance with PRISMA guidelines.</p><p><strong>Methods: </strong>A systematic search was performed through June 2025 using keywords: \"Frost suture,\" \"suspension,\" \"ectropion,\" \"tape,\" and \"prevention.\" Sixteen studies were included (9 clinical, 8 technical). Data on patient indications, techniques, outcomes, and follow-up were extracted.</p><p><strong>Results: </strong>Techniques included Frost sutures, periosteal anchoring, barbed sutures, external splinting, and forehead hitch. Ectropion prevention was generally successful, though one clinical study reported no significant benefit with Frost suture use.</p><p><strong>Conclusions: </strong>Multiple prophylactic strategies appear effective, but evidence quality is low. Higher-level comparative studies are needed.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":"451-456"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144999996","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":"A Multidisciplinary Approach to Rhinoplasty: The Facial Plastic Surgeon and the Psychologist.","authors":"Deborah Auer, Sarup Saroha, Samit N Unadkat, Hesham A Saleh","doi":"10.1055/a-2741-2458","DOIUrl":"10.1055/a-2741-2458","url":null,"abstract":"<p><strong>Introduction: </strong>Rhinoplasty is one of the most frequently requested aesthetic procedures. However, a subset of patients presents with complex psychological profiles that can adversely impact surgical outcomes. Early psychological assessment is crucial to optimizing patient safety and satisfaction.</p><p><strong>Objectives and hypotheses: </strong>This narrative review aims to explore the role of integrated psychological assessment within multidisciplinary facial plastic surgery services. It hypothesizes that early psychological input improves patient selection, manages expectations, and reduces revision rates.</p><p><strong>Study design: </strong>Narrative review.</p><p><strong>Methods: </strong>We conducted a structured narrative review of PubMed/MEDLINE, PsycINFO, Embase, and Scopus (from inception to June 2025), supplemented by clinical experience from a high-volume United Kingdom rhinoplasty center. Search terms included rhinoplasty, psychology, BDD, screening, and multidisciplinary care. Eligible sources comprised peer-reviewed studies, reviews, and guidelines on psychological assessment or outcomes in aesthetic rhinoplasty.</p><p><strong>Results: </strong>Integrated psychological assessment can identify patients at risk of dissatisfaction, enhance patient selection, reduce revision surgeries, and improve overall outcomes.</p><p><strong>Conclusion: </strong>Multidisciplinary collaboration between surgeons and psychologists improves rhinoplasty outcomes, enhances patient safety, and supports the ethical principle of nonmaleficence.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":"510-516"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13364259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145539759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"More Healing Hands Through More Harmonized Voices: The SCALPEL Study.","authors":"Kiran Abraham-Aggarwal, Andrew Yang, Christie Hung, Daniel Spertus, John Frodel","doi":"10.1055/a-2714-3624","DOIUrl":"10.1055/a-2714-3624","url":null,"abstract":"<p><strong>Introduction: </strong>Burnout and declining fulfillment are prevalent among facial plastic surgeons (FPS), yet the organizational drivers of these challenges remain underexplored. Ownership structure, workplace autonomy, and collective representation may influence surgeon well-being and workforce sustainability.</p><p><strong>Objectives and hypotheses: </strong>To assess how autonomy, ownership, and unionization relate to satisfaction and stress among FPS. We hypothesized that private practitioners would report greater autonomy and satisfaction, that academic and hospital-employed surgeons would experience more stress and diminished control, and that prior union exposure would correspond with more favorable views of collective representation.</p><p><strong>Study design: </strong>Cross-sectional observational survey (STROBE).</p><p><strong>Methods: </strong>A 26-item anonymous survey was distributed to all 1,041 members of the American Academy of Facial Plastic and Reconstructive Surgery; 104 responded (10%). Variables included practice type, ownership, union history, autonomy, compensation satisfaction, stressors, and openness to unionization. Analyses employed chi-square tests and qualitative content analysis.</p><p><strong>Results: </strong>Surgeons in private practice reported the highest autonomy and compensation satisfaction and the lowest rates of feeling rushed. Hospital-employed and academic surgeons were more likely to report diminished autonomy, administrative stress, and lack of influence over workplace decisions. Only 11% of respondents expressed interest in unionizing, though prior union members generally described positive experiences. Surgeons' beliefs about whether unionization affects patient care did not vary significantly by practice setting.</p><p><strong>Conclusion: </strong>Structural factors, particularly the autonomy and ownership model, are strongly linked to satisfaction and stress among FPS. Organizational reforms that enhance autonomy and support collective voice may reduce burnout and improve workforce sustainability.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":"481-490"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206050","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":"Bridging the Gap in Facial Aesthetic Surgery Training: A National Survey Study of Canadian Resident and Program Director Perspectives on Resident-Run Clinics in Otolaryngology Residency Programs.","authors":"Justin Shapiro, Alina Zgardau, Sami Khoury, Corey Moore","doi":"10.1055/a-2700-8222","DOIUrl":"10.1055/a-2700-8222","url":null,"abstract":"<p><strong>Introduction: </strong>Resident-run facial aesthetic surgery clinics improve surgical proficiency but are absent in Canadian Otolaryngology-Head and Neck Surgery (OtoHNS) training.</p><p><strong>Objectives and hypotheses: </strong>To evaluate resident and program director (PDs) perspectives on facial aesthetic training and the feasibility of resident-run clinics. We hypothesized residents would report inadequate training and support for clinics, while directors would express caution due to logistical barriers.</p><p><strong>Study design: </strong>National, cross-sectional survey.</p><p><strong>Methods: </strong>Anonymous, bilingual electronic surveys were distributed to Canadian OtoHNS residents and PDs. Quantitative data were analyzed descriptively; qualitative responses underwent thematic analysis.</p><p><strong>Results: </strong>Fifty residents and 11 PDs responded. Most residents (91%) reported performing ≤ 5 core procedures; 82% desired more exposure. Resident-run clinics were supported by 83% of residents but only 30% of PDs. PDs cited supervision, funding, and legal concerns.</p><p><strong>Conclusion: </strong>Significant training gaps exist. Resident-run clinics may enhance education but require structured supervision and institutional support.</p>","PeriodicalId":12195,"journal":{"name":"Facial Plastic Surgery","volume":" ","pages":"470-480"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145091386","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}