Background: A limitation of current facelift techniques is the early postoperative reappearance of anterior midcheek laxity associated with recurrence of the nasolabial fold (NLF).
Objectives: This study was undertaken to examine the regional anatomy of the anterior midcheek and NLF with a focus on explaining the early recurrence phenomenon and to explore the possibility of alternative surgical methods that prolong NLF correction.
Methods: Fifty cadaver heads were studied (16 embalmed, 34 fresh; mean age, 75 years). Following preliminary dissections and macrosectioning, a series of standardized layered dissections were performed, complemented by histology, sheet plastination, and microcomputed tomography. Mechanical testing of the melo fat pad (MFP) and skin was performed to gain insight on which structure is responsible for transmission of the lifting tension in a composite facelift procedure.
Results: Anatomic dissections, sheet plastination, and microcomputed tomography demonstrated the 3-dimensional architecture and borders of the MFP. Histology of a lifted midcheek demonstrated that a composite MFP lift causes a change in connective tissue organization from a hanging-down pattern into a pulled-upward pattern, suggesting traction on the skin. Mechanical testing confirmed that, in a composite lift, despite the sutures being placed directly into the deep aspect of the MFP, the lifting tension distal to the suture is transmitted through the skin and not through the MFP.
Conclusions: The usual method of performing a composite midcheek lift results in the skin, and not the MFP itself, bearing the load of the nondissected tissues distal to the lifting suture. For this reason, early recurrence of the NLF occurs following skin relaxation in the postoperative period. Accordingly, specific surgical procedures for remodeling the MFP should be explored, possibly in combination with volume restoration of the fat and bone, for more lasting improvement of the NLF.
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http://dx.doi.org/10.1093/asj/sjad126 | DOI Listing |
Surg Radiol Anat
June 2024
Oral and Maxillofacial Radiology, Akdeniz University, Antalya, Turkey.
Objectives: This study aimed to determine the prevalence of anterior extensions of the parotid gland (AEPG), namely the accessory parotid gland (APG) and the facial process of the parotid gland (FP), using ultrasonography.
Study Design: A total of 338 parotid glands were scanned bilaterally. APG was defined as a soft tissue mass with the same echogenic features as the main parotid gland (MPG) and not in contact with it, while FP was defined as an extension that exceeded the anterior border of the mandibular ramus and was continuous with the MPG.
Background: A limitation of current facelift techniques is the early postoperative reappearance of anterior midcheek laxity associated with recurrence of the nasolabial fold (NLF).
Objectives: This study was undertaken to examine the regional anatomy of the anterior midcheek and NLF with a focus on explaining the early recurrence phenomenon and to explore the possibility of alternative surgical methods that prolong NLF correction.
Methods: Fifty cadaver heads were studied (16 embalmed, 34 fresh; mean age, 75 years).
J Cosmet Dermatol
February 2023
Shape Clinic, Sydney, Australia.
Background: Tear trough depressions are widely treated with fillers. However, it is questionable whether the same strategies can always be used for Caucasian and Japanese patients, owing to differences in bone and skin structures and epithelial thickness.
Aims: To assess a novel classification system and treatment algorithm for correcting tear trough depressions and eye bags in Japanese patients.
Aesthet Surg J
February 2021
Department of Plastic Surgery, University of Texas Southwestern, Dallas, TX.
Background: Suspension of the superficial muscular aponeurotic system (SMAS) is generally believed to be necessary in facelift surgery. Although many techniques have been suggested, all rely on the viscoelastic properties of the SMAS.
Objectives: The aim of this study was to determine the viscoelastic properties of bursting strength, stress relaxation, and creep in the lateral, mid-cheek, and medial regions of the SMAS.
Aesthetic Plast Surg
December 2019
Apgujeong YK Plastic Surgery Clinic, Nonhyun-ro 836, Gangnam-gu, Seoul, Korea.
Background: The differences between Caucasian and East Asian faces could lead to different age-related bony changes. We analyzed computed tomography (CT) scan images of East Asians to find objective differences in midface rejuvenation strategy between East Asians and Caucasians.
Methods: We reviewed 54 East Asian individuals' charts and facial CT images ranging in age-group: Group A (21-30 years), Group B (41-50 years), and Group C (61-70 years).
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