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Committeri U, Magliulo R, Carraturo E, Arena A, Abbate V, Salzano G, Troise S, Barone S, Germano C, Vaira LA, Giovacchini F, Cataldo R, Grassia MG, Califano L, Piombino P. Virtual surgical planning in tripod zygomatico-maxillary complex fractures: A prospective comparison between two different strategies. J Craniomaxillofac Surg 2024:S1010-5182(24)00248-8. [PMID: 39349348 DOI: 10.1016/j.jcms.2024.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 05/19/2024] [Accepted: 08/20/2024] [Indexed: 10/02/2024] Open
Abstract
Multifragmentary and displaced zygomaticomaxillary complex (ZMC) fractures are often a challenge for the maxillofacial surgeon. The aim of this study was to evaluate the improved performance in the management of patients with tripod fracture of the orbito-zygomaticomaxillary complex, using two different methods of virtual surgical planning - virtual reduction and mirroring - compared with traditional management. A cohort of 60 patients was selected and divided into three groups, each consisting of 20 individuals. Patients in the first group were managed using the virtual reduction method, those in the second group using the mirroring method, and those in the third group using a traditional surgical approach. Having achieved virtual fracture reduction, a stereolithographic model was printed, on which preplating of the plates was performed. The results showed that virtual reduction was the most accurate in absolute terms, with a mean discrepancy in juxtaposition of the preoperative and postoperative CT images of 0.175 mm (SD ± 0.147), compared with 0.403 (SD ± 0.166) for the mirror method (and traditional method (0.875, SD ± 0.112; p > 0.0001). The average surgical time for virtual reduction (89.5 min) was faster than for mirroring (94.25 min) and for the traditional approach (96.75 min). In conclusion, the use of virtual surgical planning allows greater intraoperative accuracy, reduced surgical time, and reduced postoperative complications compared with traditional surgery. Of the two methods, virtual reduction performed best for the outcomes decribed.
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Affiliation(s)
| | - Roberta Magliulo
- Department of Maxillofacial Surgery, AOU 'Federico II', Naples, Italy
| | | | - Antonio Arena
- Department of Maxillofacial Surgery, AOU 'Federico II', Naples, Italy
| | - Vincenzo Abbate
- Department of Maxillofacial Surgery, AOU 'Federico II', Naples, Italy
| | - Giovanni Salzano
- Department of Maxillofacial Surgery, AOU 'Federico II', Naples, Italy
| | - Stefania Troise
- Department of Maxillofacial Surgery, AOU 'Federico II', Naples, Italy
| | - Simona Barone
- Department of Maxillofacial Surgery, AOU 'Federico II', Naples, Italy
| | - Cristiana Germano
- Department of Maxillofacial Surgery, AOU 'Federico II', Naples, Italy
| | - Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, University Hospital of Sassari, Sassari, Italy
| | - Francesco Giovacchini
- Maxillofacial Surgery Unit, Santa Maria Della Misericordia Hospital, San Sisto, Perugia, Italy
| | - Rosanna Cataldo
- Department of Social Science, Federico II University of Naples, Italy
| | | | - Luigi Califano
- Department of Maxillofacial Surgery, AOU 'Federico II', Naples, Italy
| | - Pasquale Piombino
- Department of Maxillofacial Surgery, AOU 'Federico II', Naples, Italy
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Kitagawa N, Iwanaga J, Tubbs R, Kim H, Moon YS, Hur MS. Variant muscle fibers connecting the orbicularis oculi to the orbicularis oris: case report. Anat Cell Biol 2022; 55:497-500. [PMID: 36044997 PMCID: PMC9747335 DOI: 10.5115/acb.22.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 06/16/2022] [Indexed: 01/02/2023] Open
Abstract
The orbicularis oculi (OOc) is a sphincteric muscle of the eyelids, whereas contraction of the orbicularis oris (OOr), another sphincteric muscle, causes narrowing of the lips. Facial muscle fibers normally blend with adjacent muscles. However, muscle fibers connecting the various facial muscles that have different actions and that are located at distant sites, such as the OOc and the OOr have been rarely reported. Herein, we report a rare case of connecting fibers between the inferior margin of the OOc and the OOr. These connecting fibers were blended with the OOr between the inserting fibers of the levator labii superioris and levator anguli oris. Contraction of such variant muscles might affect typical facial expressions.
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Affiliation(s)
- Norio Kitagawa
- Oral Medicine Research Center, Fukuoka Gakuen, Fukuoka, Japan,Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Joe Iwanaga
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan,Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA,Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan,Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - R.Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA,Department of Anatomical Sciences, St. George’s University, St. George’s, Grenada, West Indies,Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA,Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA
| | - Hongtae Kim
- Department of Anatomy, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Yong-Suk Moon
- Department of Anatomy, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Mi-Sun Hur
- Department of Anatomy, Daegu Catholic University School of Medicine, Daegu, Korea,Corresponding author: Mi-Sun Hur, Department of Anatomy, Daegu Catholic University School of Medicine, Daegu, Korea, E-mail:
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High-Frequency Ultrasound of Facial Filler Materials in the Nasolabial Groove. Aesthetic Plast Surg 2022; 46:2972-2978. [PMID: 35699759 DOI: 10.1007/s00266-022-02967-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/19/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Various dermal fillers are often used for nasolabial groove filling. High-frequency ultrasonography might be a valuable tool for assessing facial filler materials. METHODS The facial ultrasound images of plastic surgery hospital of the Chinese Academy of Medical Sciences from November 2014 to November 2021 were analyzed and judged. RESULTS A total of 94 patients who underwent high-frequency ultrasound with a nasolabial groove filler were included in the study. Hyaluronic acid was detected in 35 cases, polyacrylamide in 34 cases, lipofilling in 10 cases, silicon oil in seven cases, calcium hydroxyapatite in six cases, and silicone implant in two cases. The ultrasonic performance of hyaluronic acid was divided into four types: aggregation, diffusion, mixed pattern, and associated infection; of polyacrylamide was divided into five types: aggregation and inclusion, aggregation and non-inclusion, diffusion, mixed pattern, and associated infection; and of lipofilling was divided into four types: aggregation, diffusion, fat liquefaction necrosis, and cystic change. Echo intensity, echo characteristics, boundary clarity, fluidity, and blood flow signals can be used as the basis for identifying filler materials. CONCLUSION High-frequency ultrasound has an identification significance for the filling materials in the area of nasolabial groove. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Sadr-Eshkevari P, Flint RL, Alpert B. An Overview of Maxillofacial Approaches to Smile Design. Dent Clin North Am 2022; 66:343-360. [PMID: 35738731 DOI: 10.1016/j.cden.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The oral and maxillofacial surgeon (OMS) has the knowledge and skills to make drastic skeletal changes in favor of a more cosmetic smile. OMS can alter intraoral and extraoral soft tissues to make subtle or significant changes in facial cosmesis. This article provides an overview of the scope of the OMS in smile design. The authors provide a cursory review of pertinent gross and surgical facial anatomy, discuss the role of orthognathic surgery and rhinoplasty in smile cosmesis, and describe the fundamentals of common cosmetic procedures ranging from gingivoplasty to lip lift and lip augmentation and the use of neurotoxins.
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Affiliation(s)
- Pooyan Sadr-Eshkevari
- Oral and Maxillofacial Surgery Department, University of Louisville, Louisville, KY, USA.
| | - Robert L Flint
- Oral and Maxillofacial Surgery Department, University of Louisville, Louisville, KY, USA
| | - Brian Alpert
- Oral and Maxillofacial Surgery Department, University of Louisville, Louisville, KY, USA
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Usages of thread lifts on nasolabial folds for facial rejuvenating effects. EUROPEAN JOURNAL OF PLASTIC SURGERY 2022. [DOI: 10.1007/s00238-022-01961-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Lazzarotto A, Robiony M, Cambiaso-Daniel J, Nocini R, Gualdi A. Social Profiloplasty:A Practical Assessment and Injection Guide. Facial Plast Surg 2022; 38:135-142. [PMID: 35253136 DOI: 10.1055/a-1789-4621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
The trend of aesthetic medical procedures continues growing every year since decades all over the globe, especially considering minimal invasive treatments since the results are immediate and the downtime minimal. Hence, treatments with hyaluronic acid fillers have become extremely popular and routinely used in common practice. However, numerous areas of treatment were identified and described in the last years clinical training and consciousness of possibly complication remain still under represented. In the following article, we present four key treatment areas for optimal overall facial rejuvenation of what the authors define the social profile. Of each area an assessment, anatomical considerations, danger zones and the preferred personal technique of the authors are described.
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Affiliation(s)
| | | | - Janos Cambiaso-Daniel
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Graz University of Technology, Graz, Austria
| | - Riccardo Nocini
- 3Department of Otolaryngology, Verona City Council, Verona, Italy
| | - Alessandro Gualdi
- Division of Plastic, Aesthetic and Reconstructive Surgery, San Raffaele Hospital, Milano, Italy
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Hyaluronic Acid Filler Injection Technique in Multiple Layers of the Nasolabial Fold. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e3318. [PMID: 33425622 PMCID: PMC7787292 DOI: 10.1097/gox.0000000000003318] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 10/27/2020] [Indexed: 11/26/2022]
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Cohn JE, Greco TM. Advanced Techniques for the Use of Neurotoxins in Non-Surgical Facial Rejuvenation. Aesthetic Plast Surg 2020; 44:1788-1799. [PMID: 32239250 DOI: 10.1007/s00266-020-01691-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 03/16/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Neurotoxins initially were used to treat hyperfunctional rhytids of the face, but now have been expanded to improve facial shaping, correct facial asymmetry and even improve skin texture and tone. METHODS The clinical approach to non-surgical facial rejuvenation is approached into four anatomical regions: the upper face, midface, lower face and neck. RESULTS The key muscles of the upper face include frontalis, orbicularis oculi, corrugator supercilii, procerus, depressor supercilii and temporalis. The muscles in the midface to be discussed include the levator labii superioris, levator labii superioris alaeque nasi, depressor anguli oris, depressor septi nasi and nasalis. Treatment of the lower face focuses on the orbicularis oris, mentalis, depressor anguli oris and masseter muscles. Finally, treatment of the neck region will be reviewed with emphasis on platysmal bands and necklace lines as well as the Nefertiti lift. CONCLUSIONS Non-surgical facial rejuvenation using neurotoxins should be performed safely and effectively in order to avoid and treat complications. LEVEL OF EVIDENCE V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Jason E Cohn
- Department of Otolaryngology-Head and Neck Surgery, Division of Facial Plastic Reconstructive Surgery, Philadelphia College of Osteopathic Medicine, 4190 City Line Avenue, Philadelphia, PA, 19131, USA.
| | - Timothy M Greco
- Center of Excellence in Facial Cosmetic Surgery, 2 Bala Plaza, PL-15, Bala Cynwyd, PA, 19004, USA
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Hur M, O. J, Yang H, Kwon H, Lee S, Lim HS, Lim SY, Oh C. Heights and spatial relationships of the facial muscles acting on the nasolabial fold by dissection and three-dimensional microcomputed tomography. PLoS One 2020; 15:e0237043. [PMID: 32750081 PMCID: PMC7402499 DOI: 10.1371/journal.pone.0237043] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 07/17/2020] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to clarify the heights and spatial relationships of the facial muscles acting on the nasolabial fold (NLF) by dissection and three-dimensional microcomputed tomography for use in aesthetic treatments. This study used 56 specimens from 34 embalmed adult Korean. A reference line (RF) was set to imitate the NLF after removing the skin, from the superior point of the alar facial crease to the lateral point of the orbicularis oris muscle at the level of the corner of the mouth. The heights and spatial relationships of the facial muscles along the RF could be categorized into five main patterns. The dominant pattern was that the levator labii superioris alaeque nasi muscle (LLSAN), levator labii superioris muscle (LLS), zygomaticus minor muscle (Zmi), and zygomaticus major muscle (Zmj) were on the medial third, medial half, middle third, and lateral third of the RF, respectively. In micro-CT imaging, beneath the skin of the medial half of the NLF, the LLSAN and Zmi fibers inserted into the dermis of the NLF and adjacent to the NLF. Beneath the skin of the middle third of the NLF, the Zmi fibers were found before the muscle inserted into the dermis of the NLF and adjacent to the NLF. Beneath the skin of the lateral third of the NLF, the lateral margin of the orbicularis oris muscle and some Zmj fibers were found at the location of the NLF. The present study utilized dissections and micro-CT to reveal the general pattern and variations of heights and spatial relationships of the facial muscles passing beneath the NLF. These findings will be useful for understanding which muscles affect specific parts of NLFs with various contours, for reducing the NLF in aesthetic treatments, and for reconstructing the NLF in cases of facial paralysis.
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Affiliation(s)
- Mi‐Sun Hur
- Department of Anatomy, Catholic Kwandong University College of Medicine, Gangneung, Korea
| | - Jehoon O.
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Korea
| | - Hun‐Mu Yang
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Korea
| | - Hyun‐Jin Kwon
- Department of Anatomy, Yonsei University College of Medicine, Seoul, Korea
| | - Seunggyu Lee
- Department of Mathematics and Research Institute of Natural Science, Gyeongsang National University, Jinju, Korea
| | - Ha Seong Lim
- Areumdaunnara Dermatology Clinic, Seongnam, Korea
| | - So Young Lim
- Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chang‐Seok Oh
- Department of Anatomy and Cell Biology, Sungkyunkwan University School of Medicine, Suwon, Korea
- * E-mail:
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Chen GC, Sun M, Yin NB. New Insights into the Three-Dimensional Anatomy of the Facial Mimetic Muscles Related to the Nasolabial Fold: An Iodine Staining Technique Based on Nano-computed Tomography. Aesthetic Plast Surg 2020; 44:80-86. [PMID: 31535170 DOI: 10.1007/s00266-019-01495-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 08/31/2019] [Indexed: 11/24/2022]
Abstract
PURPOSE This study aimed to introduce a novel approach to study the facial mimetic muscles (FMMs) in relation to the nasolabial fold (NLF) and realize the visualization of complex three-dimensional (3D) structures and spatial relationships of the FMMs. MATERIALS AND METHODS Nano-computed tomography (nano-CT) and iodine staining techniques were used to obtain the two-dimensional (2D) radiographs of the FMMs. Materialise Mimics software was then used to reconstruct the 3D model of the FMMs. RESULTS The zygomaticus major muscle (ZMM) was divided into trunk fibers and branch fibers. The trunk fibers of the ZMM were subdivided into branch fibers layer-by-layer. Adipose tissue in the cheek was not a mass of unorganized fat. It was separated and fixed by branch fibers. Moreover, the trunk fibers of the ZMM were directly connected to the levator anguli oris (LAO), not the skin. On the contrary, the ZMM was connected to the skin by its subdivided branch fibers indirectly. The muscle fibers in the modiolus were organized, rather than disorganized. In other words, the terminal of the trunk fibers of the ZMM was located in the LAO. Moreover, the terminal of the trunk fibers of the LAO was located at the terminal of the trunk fibers of the musculus depressor anguli oris at the corner of the mouth. Furthermore, the levator labii superioris alaeque nasi was not directly connected to the orbicularis oris muscle. It was connected to the combination of the LLS and the rhinaeus. CONCLUSIONS Although nano-CT has many disadvantages, it enabled the 3D anatomical study of the FMMs in relation to the NLF when combined with iodine staining. We imported the 2D images obtained by nano-CT scanning into the Mimics software, successfully reconstructed the FMMs, and finally obtained images of complex 3D structures of the FMMs. The shapes, positions, and 3D spatial relationships of the FMMs were clearly visualized. The novel insights into the 3D anatomy of the FMMs may help understand the formation of the NLF. Finally, the results of this study may help improve the rejuvenation surgery of the NLF soon. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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Affiliation(s)
- Guo C Chen
- Department of Plastic and Aesthetic Surgery, The First Affiliated Hospital/School of Clinical Medicine of Guangdong Pharmaceutical University, Guangzhou, 510080, Guangdong, China
| | - Min Sun
- Department of Cleft Lip and Palate Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-da-chu, Beijing, 100144, China
| | - Ning B Yin
- Department of Cleft Lip and Palate Center, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Ba-da-chu, Beijing, 100144, China.
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Finite-Element Biomechanical-Simulated Analysis of the Nasolabial Fold. J Craniofac Surg 2019; 31:492-496. [PMID: 31842067 DOI: 10.1097/scs.0000000000006063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Nasolabial fold (NLF) is an important anatomic sign of facial aging. However, the dynamic biomechanical relationships between the facial mimetic muscles (FMMs) and the NLF remain unclear. OBJECTIVE This study aimed to investigate the dynamic biomechanical relationships between the FMM and various NLF by finite-element analysis (FEA). METHODS The 3-dimentional computer-aided design (3D CAD) model of the skin-muscle-maxillofacial bone in the NLF was established by using the engineering design module of the Computer-Aided 3-dimensional Interactive Application (CATIA) software. This CAD model was then imported into the Hypermesh software to set element type, mesh, and material properties. Finally, the 3D FEA model of the skin-muscle-maxillofacial bone in the NLF was generated, and then exported and uploaded into the Abaqus software with HM format for mechanical force loading and biomechanical analysis. RESULTS A 3D FEA model of the skin-muscle-maxillofacial bone in the NLF was successfully established by using the Mimics, Geomagic Studio, CATIA, Hypermesh, and Abaqus softwares. This FEA model had a good geometrical resemblance and good biomechanical properties. This provided an ideal biomechanical model for the study of deformation and the biomechanics of soft tissues, such as the NLF. The FEA was applied to the biomechanical simulation of the NLF. We established five effective FEA models to study the dynamic biomechanical relationships between the NLF and the FMM. The dynamic biomechanical relationships between the NLF and the FMM were preliminarily determined by computer simulating different types of mechanical force loadings. CONCLUSION The FEA is an effective method to simulate the dynamic biomechanical relationships between the NLF and the FMM. Through the FEA simulation described in this study, we could preliminarily conclude that the formation of different types of NLF is mainly due to the coordinated contraction of various FMM. Moreover, not all FMM are involved in all types of NLF. According to the results of the FEA simulations in this study, it is worthwhile considering investigating the role of botulinum toxin in improving the morphology of the NLF in the near future.
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Askeroglu U, Pilanci O. A New Perspective to the Periorbital Aesthetics: Bella Eyes. Aesthetic Plast Surg 2019; 43:1564-1569. [PMID: 31576417 DOI: 10.1007/s00266-019-01497-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 09/02/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The term beautiful eyes can be defined as youthful, brilliant, vivid, and attractive eyes. The anthropometric findings about beautiful eyes may differ according to gender or race. In order to form such a beautiful eye, a variety of surgical, nonsurgical, or combination methods for periorbital region rejuvenation have been proposed. The surgical methods include coronal/peritrichial, endoscopic, upper and lower eyelid, or transconjunctival incisional procedures. Neuromodulators, fillers, and laser treatments are some of the nonsurgical approaches. Regardless of the method, while treating this particular area, the aesthetic unit concept should always be taken into consideration. METHODS We attempted to combine an endoscopic dynamic canthopexy procedure with endoscopic temporal and brow lift, which we call "bella eyes" to achieve a more attractive look, especially in young people who desire a slanted eyelid. We aim to share our clinical experience from 35 patients and the technical details of the bella eyes procedure. RESULTS Patient satisfaction was high, and the endoscopic technique eliminated all of the minor deformities and provided excellent harmony through each subunit of the periocular area with minimal discomfort and well-hidden scars. CONCLUSION We believe that this procedure is a good way to achieve a beautiful eye in young women. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
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New Insights Into 3-Dimensional Anatomy of the Facial Mimetic Muscles Related to the Nasolabial Fold: An Iodine Staining Technique Based on Micro-Computed Tomography. Ann Plast Surg 2019; 84:322-327. [PMID: 31688114 DOI: 10.1097/sap.0000000000002050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study aimed to introduce a novel approach to study the facial mimetic muscles (FMMs) related to the nasolabial fold (NLF) and realize the visualization of complex 3-dimensional (3D) structures of the FMM. METHODS Micro-computed tomography (micro-CT) and iodine staining technique were used to obtain the 2-dimensional radiographs of the FMM. Materialise Mimics software was then used to reconstruct the 3D model of the FMM. RESULTS The zygomaticus major muscle was not directly connected to the orbicularis oris muscle (OOM). The terminal fibers of the zygomaticus major muscle were located in the levator anguli oris. The surface of the FMM was covered with some unknown muscle fibers in the NLF. The terminal fibers of the zygolabialis ended in the middle of the ipsilateral OOM rather than the edge of the OOM. At the same anatomical level, the FMM fibers were so closely connected to each other that they were not separated by adipose tissue. A detailed 3D sequence of the muscle fibers in the modiolus at the corner of the mouth was determined. The muscle fibers in the modiolus were organized rather than disorganized. The terminal fibers of the levator anguli oris were located at the terminal fibers of the musculus depressor anguli oris at the corner of mouth. CONCLUSIONS Although the micro-CT had many disadvantages, the micro-CT combined with iodine staining technique enabled the 3D anatomical study of the FMM related to NLF. We imported the 2-dimensional images obtained by micro-CT scanning into Mimics software, successfully reconstructed the FMM related to the NLF, and finally obtained images of complex 3D structures of the FMM related to the NLF. The shapes, positions, and 3D spatial relationships between the FMM related to the NLF were clearly visualized. The novel insights into the 3D anatomy of the FMM related to NLF may help understand the formation of the NLF. Finally, the results of this study may help improve rejuvenation surgery of the NLF in the near future.
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Kattimani V, Tiwari RVC, Gufran K, Wasan B, Shilpa PH, Khader AA. Botulinum Toxin Application in Facial Esthetics and Recent Treatment Indications (2013-2018). J Int Soc Prev Community Dent 2019; 9:99-105. [PMID: 31058058 PMCID: PMC6489509 DOI: 10.4103/jispcd.jispcd_430_18] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 01/08/2019] [Indexed: 01/10/2023] Open
Abstract
Background Ever-changing perception of beauty from childhood to old age is changing with the revolution in cosmeceuticals science. Esthetics is an individual's perception since time immemorial. Standards of beauty have changed through centuries with increased awareness about esthetics. The face remains main source of information for identification and discrimination. It constitutes a structural ground for many nonverbal messages including the emotional state of a person, so the proverb "Face is an index of mind" holds good. The wrinkles and laxity are considered to be one of the factors for aging. Hence, escalating demand for cosmetic treatment to reduce facial wrinkles and laxity has stimulated us to search for published literature for nonsurgical techniques for enhancement of facial beauty. The review analyzed the published data to provide narrative basic review in a concise way to the beginners, clinicians, and students. Materials and Methods We have adopted search criteria using keywords: Botox, Botulinum toxin, incobotulinumtoxinA, esthetics, face, uses of Botox, with various Boolean operators and or in title, and abstract using PubMed search engine. The database search limited to PubMed only from January 2013 to June 2018. Results Various search results have been appended as annexures at the end of the article for further reference for the readers. Finally, 17 references were selected to write narrative review to meet our objectives. Conclusion The advancing front in the use of toxins is an emerging science for the beautification of a face. Botox exploded in to market because of efficacy, tolerability, and minimally invasive nature. The present review gives brief about the history of Botulinum toxin, types, mechanism of action, clinical indications, preparations, storage, and technique for various uses with a brief note on patient selection, contraindications, and complications.
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Affiliation(s)
- Vivekanand Kattimani
- Department of Oral and Maxillofacial Surgery, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - Rahul Vinay Chandra Tiwari
- Department of Oral and Maxillofacial Surgery and Dentistry, Jubilee Mission Medical College Hospital and Research Center, Thrissur, India
| | - Khalid Gufran
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin Abdul Aziz University, Alkharj, Riyadh, Kingdom of Saudi Arabia
| | - Bharti Wasan
- Department of Oral and Maxillofacial Surgery, Guru Nanak Dev Dental College and Research Institute, Sunam, Punjab, India
| | - P H Shilpa
- Department of Pediatric Dentistry, Faculty of Dentistry, AIMST University, Bedong, Malaysia
| | - Anas Abdul Khader
- Department of Periodontics, Azeezia Dental College, Kollam, Kerala, India
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