Discussion-Cervico-Mental Angle Suspensory Ligament: The Keystone to Understand the Cervico-Mental Angle and the Aging Process of the Neck.

This is a commentary and discussion in response to a cadaveric study entitled, "Cervico-mental angle suspensory ligament: The keystone to understand the cervico-mental angle and the aging process of the neck." While highlighting the cervico-mental angle suspensory ligament has the potential to give rise to new surgical technique in neck rejuvenation surgery, the authors caution readers of the study's major limitation. Without well-documented results aligning with aesthetic ideals or reports of the safety and longevity of the procedure, it seems too early to consider this ligament the keystone to understand the aging neck.

Finesse in forehead and brow rejuvenation: modern concepts, including endoscopic methods.

Background: The brow and forehead are essential elements of the facial aesthetic architecture. Although frequently overlooked in youth, signs of facial aging are often most noticeable in the upper third of the face. Ptosis and loss of contour in the brows, along with temporal volume loss, sagging of periorbital tissue, and rhytides in the forehead, are common presenting complaints for aesthetic surgery.

Evidence-based medicine: Blepharoplasty.

Learning Objectives: After studying this article, the participant should be able to: (1) Identify the essential preoperative considerations for patients undergoing blepharoplasty. (2) Describe upper and lower eyelid anatomy and the relevance to blepharoplasty techniques. (3) Discuss a standard approach to upper and lower lid blepharoplasty, beginning with preoperative assessment, planning, and marking.

Extended lower lid blepharoplasty for eyelid and midface rejuvenation.

Unlabelled: Many techniques have been described for lower eyelid surgery, and the evolution of these procedures has seen significant advances, from simple skin excision to fat preservation and repositioning. Lower lid blepharoplasty can address lid-cheek junction and tear-trough deformities, which cause significant aesthetic concerns for patients, giving the appearance of fatigue and sadness. However, there is potential for serious functional and aesthetic complications, including dry eyes, scleral show, and ectropion.

An anatomical evaluation and surgical approach to the perioral mound in facial rejuvenation.

Background: Premature aging of the perioral soft tissues of the face is a common complaint of patients seeking facial rejuvenation, although its cause is unclear. The subcutaneous fat compartments of the face may be differentially affected by facial aging. Despite efforts to study and rejuvenate the aging periorbit, midface, and jowls, the effects of aging on the perioral mound have been less studied.

Contouring the aging neck with submandibular gland suspension.

Submandibular gland suspension, a procedure designed to complement surgical rejuvenation of the aging neck, uses largely blunt dissection and suspension to the mandibular periosteum to elevate the gland, improving neck contour without excision of submandibular gland tissue. Although there is an increase in operative time, the risk of intraoperative and postoperative bleeding problems is very low, and the authors report high patient satisfaction.

The importance of the retaining ligamentous attachments of the forehead for selective eyebrow reshaping and forehead rejuvenation.

Background: Forehead rejuvenation procedures can lead to excessive elevation of the medial brow, resulting in the "surprised look." Differential treatment of the medial and lateral brow allows more precise positioning. The purpose of this study was to determine whether retaining structures exist in the forehead that would permit this differential elevation.

Submandibular gland I: an anatomic evaluation and surgical approach to submandibular gland resection for facial rejuvenation.

Submandibular gland resection for aesthetic reasons has been hotly debated. Detractors maintain that the procedure is dangerous because it puts too many important structures at risk, notably motor nerves. The present study was undertaken to elucidate the neurovascular and soft-tissue anatomy of the digastric triangle via cadaver dissections so that a surgical approach to achieve safe aesthetic submandibular resection could be performed.

A morphometric study of the external ear: age- and sex-related differences.

The human ear is a defining feature of the face. Its subtle structures convey signs of age and sex that are unmistakable yet not easily defined. With analysis of normative cross-sectional data, this study explored anatomic and aesthetic differences in the ear between men and women, as well as changes in ear morphology with age.