Elastic thread modified minimal access cranial suspension lift for lower and middle third facial rejuvenation

Thread lift boasts the advantage of minimal invasion for facial rejuvenation and has been increasingly used nowadays. The purpose of this study was to evaluate the outcomes and safety of elastic thread when it was used in the modified minimal access cranial suspension (MACS) lift for rejuvenation of the lower and middle third of the face.Forty-six patients with sagging and laxity of the lower face treated by the elastic thread modified MACS lift from December 2015 and December 2017 were enrolled in this study. A retrospective chart review was conducted. The degree of Wrinkle Severity Rating Scale (WSRS) score and satisfaction score were evaluated immediately, 6 months and 12 months after procedure. Complications during the study were also recorded.All the patients were female, with a mean age of 50.7 ± 6.4 years and a mean follow-up period of 15.4 ± 2.1 months. The mean operation time was 114 ± 13 minutes. For the left face, the mean WSRS score was 4.0 ± 0.8 preoperatively and 3.1 ± 0.8 on the 1-year follow-up; and 4.1 ± 0.9 and 3.1 ± 0.7 on the right face (P < .01). Thirty-nine (84.8%) patients considered the long-term results satisfactory. There were no major complications during the follow-up period.The elastic thread modified MACS lift is a minimally invasive, effective and safe method to improve lagging middle and lower third of the face without significant postoperative morbidity or complications.

Parotid ductal stenosis after facial cosmetic surgery (2 case reports)

RATIONALE

Facial cosmetic surgery sometimes causes complications involving surrounding tissues. In particular, parotid damage may cause fibrous tissue formation, ductal stenosis, and obstruct salivary flow. Affected patients usually complain of symptoms such as pain and swelling.

PATIENT CONCERNS

The authors report 2 cases of obstructive parotitis, arising as a complication of facial cosmetic surgery that were treated successfully using sialendoscopic procedures.

DIAGNOSIS

A diagnosis of parotid ductal stenosis was made based on medical history, clinical manifestations, imaging studies, and sialendoscopic findings for the 2 patients.

INTERVENTIONS

The successful sialendoscopic procedures was given to the 2 patients.

OUTCOMES

The 2 patients have shown no recurrent symptoms during follow-up.

LESSONS

Surgeons that perform facial cosmetic procedures should attain a thorough knowledge of the surgical anatomy of the parotid region and sialendoscopic procedure may be helpful for the management of obstructive parotitis due to complication of cosmetic surgery.

Improvements in the perception of facial attractiveness following surgical aesthetic treatment; study based on online before and after photos

Background

Aesthetic surgery procedures such as lip augmentation, eyelid correction, face‐lifting, or Botox treatment for lines and wrinkles are an important part of cosmetic surgery.

Objectives

The aim of the study was to estimate improvement in appearance following plastic surgery using modern collective intelligence methods of validation.

Methods

A total of 108 photographs showing 54 patients prior to and following cosmetic surgery were downloaded from Internet web presentations of several unnamed plastic surgeons. The same number of photographs depicted each of the four investigated areas of treatment—26 lip enhancement, 26 blepharoplasty, 26 face‐lift, 26 botulinum toxin injection. Attractiveness of depicted individuals was assessed by 167 observers. Each photograph was judged separately.

Results

Blepharoplasty produced the most remarkable improvement in attractiveness amounting to 32.79 (SD ± 26.35). Improvement following Botox treatment stood at 30.29 (SD ± 24.55), whereas face‐lifting produces improvement of 28.70 (SD ± 22.76). Improvement following lip augmentation was estimated at 12.70 (SD ± 29.8). Highest Spearman's rank correlation coefficient was obtained for face‐lift and Botox (0.24 and 0.22, respectively).

Conclusions

Blepharoplasty, face‐lifting, and Botox deliver a significant improvement in facial attractiveness. Additionally, face‐lifting and Botox are distinguished by a high level of reproducibility. Our results indicate that lip augmentation is a treatment with a statistically significant, but less marked improvement in attractiveness.

Emergent Bilateral Face-lift Hematoma: A Case Report

The face-lift, or rhytidectomy, is a common surgical procedure in the United States. Facial hematoma is the most frequent complication after face-lift. Sometimes an emergent expanding hematoma may require general anesthesia and can present difficulty in securing the airway. This article reviews the frequency and causes of an expanding hematoma and how it affects anesthesia care. The case summary describes an emergent bilateral hematoma after a face-lift in a 50-year-old woman, the emergency treatment, and her subsequent recovery. Details of the procedure are provided. The purpose of examining this case is to inform and educate anesthesia providers about the possibility of a common face-lift complication and how to prepare for securing the difficult airway in this situation.

The Danger Zone in the Anterior Neck: Anatomical Landmarks to Avoid Injury to Anterior Jugular Vein During Face-Lift and Neck-Lift

Background: An estimated 125,711 face-lifts and 54,281 neck-lifts were performed in 2015. Regardless of the technique employed, facial and neck flap elevation carries with it anatomical risk of which any surgeon performing these procedures should be aware of. Statistics related to anterior jugular vein injury during these procedures have not been published. Objective: To define a "danger zone" that will contain both of the anterior jugular veins on the basis of anatomical landmarks to aid surgeons with planning their surgical approach during rhytidectomy in the anterior neck region. Methods: Ten fresh tissue heminecks were dissected. All specimens were dissected under loupe magnification in a 45° (face-lift) position in which a midline incision was used for exposure. Measurements from the anterior jugular vein to the hyoid, thyroid cartilage, and cricoid cartilage bilaterally were taken. The transverse distance between the anterior jugular veins at the level of the hyoid, thyroid cartilage, and cricoid cartilage was also measured. Results: The anterior jugular veins remain in an anatomical danger zone while they travel in the anterior neck. Regardless of anatomical variation of the vessels between bodies, they generally reside in this danger zone from their inferior emergence behind the sternocleidomastoid muscle until they branch in the suprahyoid region. Conclusions: Knowledge of the anatomy, course, and location of the anterior jugular veins through the anterior neck based on anatomical landmarks and distance ratios can facilitate a safer dissection during rhytidectomy procedures.

Unfavourable results in facial rejuvenation surgery: How to avoid them

Unfavourable results are the bane of most of the surgeons. Every surgeon tries hard to prevent them, but only proper foreknowledge of where things could go wrong will help in preventing them. For this article, a careful retrospective review of past facial rejuvenation cases passing through our clinic were done. Various common aesthetic unfavourable results, complications and steps to avoid them have been described.

Prediction of face-lift outcomes using the preoperative supine test

BACKGROUND

Patients considering a facelift (facial rhytidectomy)need some means of predicting their surgical outcomes. This will help them decide whether to proceed with the operation.

METHODS

A total of 50 consecutive patients were asked to examine themselves with a hand-held mirror while lying supine on an examining table to give them a reasonable approximation of their postoperative result.

RESULTS

The tissues of the face redrape in a very when lying completely supine. The appearance that the patient sees of himself or herself during the "supinetest" correlated very well with the actual postop result after rhytidectomy consisting of subcutaneous undermining,SMAS plication, and platysmaplasty.

CONCLUSION

This supine test may be useful in helping patients preoperatively predict their facelift outcomes and may serve as a good adjunct to imaging.