Role of Artificial Intelligence in Determining Ideal Nasal Tip Projection in Diverse Populations.

Background: Nasal tip projection ideals have been based on the Caucasian nose; however, many racial groups have underprojected tips. Several methodologies have been described to measure ideal nasal tip projection. This study aimed to compare various methods to racially diverse groups to elucidate those best suited for race-specific facial morphology.

Tranexamic Acid in Rhinoplasty and Septoplasty: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Background: Perioperative bleeding is a challenge in rhinoplasty and septoplasty. Tranexamic acid (TXA) may help reduce this, but its effectiveness is unclear. This systematic review and meta-analysis aimed to evaluate TXA's impact on bleeding in these procedures.

Finesse in Primary Open Rhinoplasty.

Rhinoplasty remains one of the most technically demanding operations in plastic surgery, and it continues to be one of the top 5 aesthetic surgical procedures performed. The focus of this article is open rhinoplasty, the central focus of the practice of the senior author (R.J.

The Relationship Between Glabellar Contraction Patterns and Glabellar Muscle Anatomy: A Magnetic Resonance Imaging-based Study.

Background: Glabellar contraction patterns were introduced to the scientific literature to help guide glabellar neuromodulator injection algorithms. However, the relationship between the underlying musculature and its influence on these glabellar contraction patterns is unclear.

Objectives: The aim of this study was to identify by magnetic resonance imaging (MRI) glabellar muscle parameters that display an influence on the distribution of individual glabellar contraction patterns.

Evolving Role of Exosomes in Plastic and Reconstructive Surgery and Dermatology.

Exosomes, or extracellular vesicles, represent the latest cell-free addition to the regenerative medicine toolkit. In vitro preclinical studies have demonstrated the safety and efficacy of exosomes, which vary based on source and biomanufacturing, for a myriad of potential therapeutic applications relevant to skin and soft tissue reconstruction. Primary search was performed in September 2021 on the MEDLINE database via PubMed and Ovid, with focus on articles about therapeutic application of exosomes or extracellular vesicles.

Pitanguy Ligament Preservation in Structural Precision Rhinoplasty.

The Pitanguy ligament is a crucial structure in nasal tip support and in maintaining the integrity of the soft tissue envelope of the nose. In this cadaveric study, we dissected out the Pitanguy ligament on a series of fresh human cadaver specimens to better elucidate the structure of the ligament and its fate in open rhinoplasty. The Pitanguy ligament can act as a tethering force to the nasal tip when reshaping the nasal tip.

Dead Space - The Final Frontier in Rhinoplasty: Review and 10 Key Recommendations.

Mitigating dead space has been recognized as an essential step towards ensuring a more predictable and aesthetically pleasing outcome in rhinoplasty. The current body of literature leaves a discernible gap in offering a unified, systematic approach to dead space management in rhinoplasty. The aim of our article is to bridge this gap by presenting an integrative approach to surgical and post-surgical techniques.

Preventing Hump Recurrence in Dorsal Preservation Rhinoplasty: The Five Key Tenets.

Preservation rhinoplasty has re-emerged over the past decade and continues to gain traction in the rhinoplasty community. Dorsal preservation rhinoplasty (DPR), one of the tenets of preservation rhinoplasty, centers on preservation of the native osseocartilaginous joint of the dorsum, with changes instead achieved through modification of the underlying septal cartilage and surrounding bony nasal pyramid. However, one complication unique to DPR is the phenomenon of hump recurrence, where tensile forces or memory lead to a recurrent convexity of the dorsal hump.

Isolated Fibrous Dysplasia of the Bilateral Nasal Bones: Complex Management of the Bony Vault.

Fibrous dysplasia is a benign fibro-osseous process affecting the skeletal system, with resulting cystic and fibrous tissue expansion. Craniofacial fibrous dysplasia represents a small subset of monostotic disease, accounting for approximately 10%-25% of all such cases. Involvement of the frontal, temporal, and sphenoid bones has most commonly been described, with a limited number of reported cases citing disease isolated to the nasal bones.

Efficacy and Safety of OnabotulinumtoxinA for the Treatment of Platysma Prominence: A Randomized Phase 2 Dose-Ranging Study.

Background: With aging, repetitive contraction of the platysma leads to an increase in platysma prominence (PP), characterized by the accentuation of vertical neck bands and blunting of the jawline contour.

Methods: This multicenter, double-blind, phase 2 study evaluated onabotulinumtoxinA treatment in adults with moderate to severe PP. Participants were randomized to receive 1 treatment of onabotulinumtoxinA low dose (LD), onabotulinumtoxinA high dose (HD), or placebo, and were followed up for 4 months.

Identifying Levels of Competency in Aesthetic Medicine: A Questionnaire-based Study.

Background: In 2022, the US experienced a significant increase in demand for minimally invasive aesthetic procedures, underscoring its rising acceptance amid an unregulated educational environment for practitioners. The absence of standardized educational pathways and quality control in aesthetic medicine, primarily provided by nonacademic institutions, highlights a critical need for establishing educational standards to ensure practitioner competence and patient safety.

Objectives: The aim of this study was to identify levels of competency for the aesthetic practitioner and necessary achievement milestones during the educational path from novice to expert injector.

The emerging role of biostimulators as an adjunct in facial rejuvenation: A systematic review.

Introduction: Facial aging has long been an area of focus in esthetic surgery. It is the consequence of physiologic and environmental factors, with a trend toward non-surgical modalities. Although volume augmentation has long been a focus of non-surgical facial rejuvenation, there is emerging interest in the use of biostimulators to induce physiologic changes in the skin.

The Seven Step Neck Lift Z-Plasty.

Patients with large amounts of neck skin redundancy who do not desire or are not candidates for traditional face and neck lifts can be managed with direct neck lifts. There are many existing surgical techniques to address central neck laxity. In this article, we aim to clarify our surgical technique in a clear video format to showcase how to address central neck laxity in seven steps with neck lift Z-plasty.

A Multicenter Pilot Study of a Novel Allograft Adipose Matrix in Malar and Prejowl Volume Restoration.

Background: Allograft adipose matrix (AAM) offers a novel, off-the-shelf, and readily available natural option in the treatment of facial soft tissue volume and reconstructive deficits. AAM is a natural soft tissue supplement or replacement that can support cushioning and volume correction. A prospective multicenter pilot study evaluated AAM in facial volume restoration.

Clinical Applications of Tranexamic Acid in Plastic and Reconstructive Surgery.

Background: Tranexamic acid (TXA) has gained increasing recognition as a valuable pharmacologic agent within plastic surgery. This study reviews the scientific evidence regarding the use of TXA in the full range of plastic and reconstructive surgery to provide clinical recommendations for safe and effective use in various plastic surgical procedures.

Methods: A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.

Management of the Posthemangioma Nose: 5 Key Rhinoplasty Components.

Hemangiomas of the nasal tip are a relatively uncommon presentation of a common tumor. While optimal medical and surgical management of nasal tip infantile hemangiomas has been described and debated extensively in the literature, to our knowledge, there is no report of secondary aesthetic and functional rhinoplasty in these patients at skeletal maturity, until now. This special topic article provides an excellent example of the 5 key technical elements to revision rhinoplasty in the skeletally mature patient with a history of nasal tip infantile hemangioma.

The Blocking Points: The Keys to Consistent Success in Preservation Rhinoplasty.

Preservation rhinoplasty is a growing area of interest among rhinoplasty surgeons. Dorsal preservation-a tenet of preservation rhinoplasty-is predicated on maintaining the integrity of the nasal midvault and effecting aesthetic change through alterations to the bony nasal pyramid and underlying septum. A challenge that is unique to dorsal preservation is the phenomenon of hump recurrence, because of the existence of anatomical blocking points.

Refinements in Extended Alar Contour Grafts: Retrograde Approach in Conjunction with Alar Base Surgery.

Alar contour grafts are an excellent adjunct in both primary and revision rhinoplasty for correction and prevention of alar rim irregularities. They are traditionally placed at the conclusion of a rhinoplasty through a vestibular incision along the underside of the alar rim. Alternatively, alar base resection provides an opportunity for precise retrograde placement of alar contour grafts.