搜索结果：Facial plastic surgery : FPS

Bioactive peptides have become increasingly common ingredients in skincare products and procedural adjuncts in aesthetic practices. Modeled after naturally occurring matrikines, these short amino acid chains are designed to influence the extracellular matrix, cellular signaling, and skin repair. Peptides are commonly classified as signal peptides, carrier peptides, and neurotransmitter-inhibiting "botox-like" peptides based on their proposed mechanisms of action. While many of these compounds are marketed for wrinkle reduction, collagen stimulation, and improved skin quality, most supporting evidence is derived from in vitro and ex vivo studies rather than randomized clinical trials. These products are widely available with limited regulatory oversight and are increasingly incorporated into microneedling treatments, topical regimens, and postoperative skincare. As patient interest grows, facial plastic surgeons are more frequently asked about the role, safety, and efficacy of peptide-based products. This article presents current evidence and proposed mechanisms to help guide informed discussions and clinical decision-making in facial plastic surgery practice.

Rhinoplasty is one of the most frequently requested aesthetic procedures. However, a subset of patients presents with complex psychological profiles that can adversely impact surgical outcomes. Early psychological assessment is crucial to optimizing patient safety and satisfaction.This narrative review aims to explore the role of integrated psychological assessment within multidisciplinary facial plastic surgery services. It hypothesizes that early psychological input improves patient selection, manages expectations, and reduces revision rates.Narrative review.We conducted a structured narrative review of PubMed/MEDLINE, PsycINFO, Embase, and Scopus (from inception to June 2025), supplemented by clinical experience from a high-volume United Kingdom rhinoplasty center. Search terms included rhinoplasty, psychology, BDD, screening, and multidisciplinary care. Eligible sources comprised peer-reviewed studies, reviews, and guidelines on psychological assessment or outcomes in aesthetic rhinoplasty.Integrated psychological assessment can identify patients at risk of dissatisfaction, enhance patient selection, reduce revision surgeries, and improve overall outcomes.Multidisciplinary collaboration between surgeons and psychologists improves rhinoplasty outcomes, enhances patient safety, and supports the ethical principle of nonmaleficence.

Congenital craniofacial anomalies present complex reconstructive challenges impacting nasal function, facial symmetry, and psychosocial well-being. Effective restoration requires a multidisciplinary, patient-centered approach that integrates advances in imaging, surgical planning, and reconstructive techniques.This narrative review summarizes contemporary surgical strategies for nasal reconstruction in patients with cleft lip/palate and syndromic craniosynostosis.Relevant literature was reviewed alongside our own institutional experience. Focus was placed on preoperative assessment, multidisciplinary collaboration, operative timing, and technical innovations.Long-term outcomes demonstrate sustained improvements in nasal function, facial symmetry, and emotional well-being when care is provided by experienced multidisciplinary teams in dedicated units. Early psychological assessment and ongoing support are pivotal for optimizing patient outcomes.Multidisciplinary, long-term care integrating advances in imaging, reconstructive techniques, and psychosocial support improves functional, aesthetic, and emotional outcomes in nasal reconstruction in this complex group of patients.

Aesthetic medicine has expanded rapidly, yet the clinical infrastructure supporting the patient encounter has not kept pace with patient sophistication. Today's aesthetic patient is highly educated, visually literate, and accustomed to data-driven decision-making. A measurable gap exists between patient expectations and what the standard clinical encounter consistently delivers. This review examines emerging technologies in skin and facial analysis and presents the evidence-based case for their adoption across the full care continuum. Technologies are organized by clinical function: in-office multispectral skin analysis systems, three-dimensional (3D) volumetric imaging and simulation platforms, AI facial scoring and proportion analysis tools, and advanced tissue characterization modalities. A three-phase framework-preconsultation, consultation, and posttreatment-structures the case for adoption. Patient selection considerations, informed consent implications, and the appropriate boundaries of AI-assisted analysis versus clinical diagnostic judgment are addressed. Technology-augmented encounters produce better-informed patients, stronger clinical trust, and more defensible outcomes. Technology does not replace the surgeon-patient relationship-it amplifies it.

Internal nasal valve insufficiency is a major cause of nasal obstruction. Alar batten grafts (ABGs) are commonly used, but data on lateral crural tensioning (LCT) remain limited. To compare the efficacy of ABG and LCT techniques in improving nasal airflow. Primary outcomes were nasal obstruction symptom evaluation (NOSE) score and revision surgery rate; secondary outcome was complication rate. Retrospective cohort study (PICOS). The study included 22 patients undergoing rhinoplasty for nasal valve insufficiency (2017-2023): ABG (n = 8) and LCT (n = 14). NOSE scores were obtained via telephone survey. Data were collected from clinical records. Mean NOSE scores improved from 55 to 30.6 overall. ABG improved from 51.7 to 31.7, LCT from 56.7 to 30. One ABG patient required revision (12.5%), none in LCT group. Differences were not statistically significant between groups. LCT showed greater symptom improvement and no revisions. Further randomized trials are needed to confirm efficacy.

Hyperbaric oxygen therapy (HBOT) involves the administration of 100% oxygen at pressures greater than atmospheric pressure, leading to increased tissue oxygenation and enhanced wound healing. Its role in surgical practice has expanded due to its potential to improve tissue viability and manage a myriad of complications. To evaluate the clinical indications, therapeutic benefits, and treatment protocols of HBOT in facial plastic and aesthetic surgery. Literature review. A literature search of electronic databases including PubMed, the Cochrane Library, and Google Scholar was performed to identify studies evaluating HBOT in facial plastic surgery, including its use in rhytidectomy, rhinoplasty, vascular ischemia following dermal filler injections, and keloid management. HBOT serves as a valuable adjunct, improving tissue oxygenation, promoting wound healing, and potentially reducing complications. Early utilization may enhance surgical outcomes and recovery.

Understanding the environmental effects of surgery can help develop environmentally sound practices. Examine the environmental impact of performing septorhinoplasty. Case study. A primary septorhinoplasty was selected. Materials, medications, devices, and energy used were identified, and medical waste and torn plastics were characterized and measured. Global warming potential (GWP) and microplastics generated were calculated using published conversion rates. GWP of this septorhinoplasty was 192.3 kg CO2 equivalent (CO2e). The greatest contributor to GWP was the use of disposable supplies (160.95 kg CO2e), with smaller contributions from the sterilization of surgical equipment, anesthetic gases, environmental HVAC energy, surgical instrument manufacturing, and incineration of regulated medical waste. Microplastic production ranged between 97,637 and 530,638 microplastics. The environmental cost of septorhinoplasty was dominated by disposable items, contributing to GWP and microplastic production. Through awareness of the environmental impact of their choices, surgeons can develop mitigation strategies to minimize their effect.

Rhinoplasty outcomes are determined by the complex interplay of modifications to both the osseocartilaginous framework and the behavior of the overlying skin-soft tissue envelope (SSTE). Successful surgery demands attention to several soft tissue characteristics including skin thickness, elasticity, sebaceous content, and fibrous ligamentous attachments, which together influence tip definition, support, and long-term aesthetic outcomes. This review summarizes evidence-based principles and practical strategies for soft tissue management in primary rhinoplasty. By integrating anatomical knowledge, meticulous surgical technique, and attentive postoperative management, surgeons can enhance tip definition, minimize complications, and achieve durable, aesthetically satisfying results. Emphasizing both structural and soft tissue considerations provides a comprehensive framework for optimizing rhinoplasty outcomes through thoughtful SSTE management. This article thoroughly reviews the body of literature on skin and soft tissue management in primary rhinoplasty, providing a historical and contemporary account on this complex topic. The surgeon's understanding of nasal anatomy continues to evolve since the advent of facial plastic surgery. This review provides a detailed description of all the layers of the nose and how they relate to surgical considerations in rhinoplasty. This review provides both current and future insight into the management of skin and soft tissue management in rhinoplasty largely centered around strong understanding of nasal anatomy, soft tissue analysis and preservation, and refined grafting techniques. Contemporary rhinoplasty has shifted away from a "one-size-fits-all" approach and more toward a deliberate and methodical approach based on the biochemical, structural, and nuanced subtleties of the nasal SSTE that makes every nose a unique challenge. This review hopes to inform readers on the many complexities that must be taken into account in rhinoplasty with the goal of supplementing the modern surgeon's intellectual toolbox when approaching this challenging surgery.

To review the current state of ultrasound energy-based devices and their role in facial and neck rejuvenation. High-frequency ultrasound (HIFU) paved the way for the micro-focused and parallel beam ultrasound technology in aesthetics. Facial and cervical aging reflect multilayered structural changes, as well as reduced collagen production and increased collagen breakdown at the histologic level, resulting in rhytids and skin laxity. Micro-focused ultrasound with visualization (MFU-V) is adapted from HIFU, using significantly less ultrasound energy and visualization to precisely target the deep dermis and superficial musculoaponeurotic system (SMAS) at depths ranging from 1.5 to 4.5 mm; synchronous ultrasound parallel beam (SUPERB) technology uses parallel transducers to deliver energy at a precise depth of 1.5 mm to target the mid-dermis. Ultrasonic facial rejuvenation is ideal for those with mild to moderate skin laxity who desire incremental tightening and textural improvement without surgery. MFU-V can be performed at different tissue depths based on the transducer tip, with various combination protocols described; SUPERB technology delivers energy at a fixed depth. Self-limited erythema and edema, sun protection. The intersection of ultrasonic devices and regenerative medicine is promising. MFU-V and SUPERB are ideal noninvasive options for patients with mild to moderate skin laxity.

Patients with chin deficiency secondary to dentofacial deformity often present with aesthetic and functional complaints. Treatment of such deficiencies with conventional genioplasty may be limited when broader modification of the mandibular basilar contour is required. This retrospective case series reports the clinical and radiographic outcomes of 9 patients treated with wing (n = 8) or mini-wing (n = 1) genioplasty for anteroposterior and/or vertical chin deficiency, mandibular asymmetry, syndromic deformities, post-traumatic sequelae, or airway-related complaints. Wing osteotomy was indicated for the correction of the mandibular body and angle, whereas mini-wing osteotomy was reserved for deformities confined to the chin. Procedures were performed in combination with orthognathic surgery when indicated (n = 6). All patients demonstrated improved chin projection, mandibular contour, and lower facial harmony, with the additional benefits of transverse widening of the mandibular body, enhanced cervicomandibular angle definition, and improved symmetry. In one patient with obstructive sleep apnea, postoperative imaging showed enlargement of the pharyngeal airway space. Stable outcomes were maintained over the follow-up period (mean: 4.3 years; range: 1-9 years). Wing and mini-wing osteotomies represent reliable extensions of conventional genioplasty, allowing comprehensive modification of the mandibular basilar contour.

Facial and cervical aging is a multilayered process influenced by skeletal support, soft-tissue volume and position, ligamentous integrity, and skin quality. Ancestry-associated anatomic variation may affect clinical presentation, but surgical planning must remain anatomy-based rather than race-defined. This review outlines contemporary strategies for management of the heavy neck in ethnically diverse patients. In many ethnic patients, neck aging is driven predominantly by big structural changes rather than early cutaneous laxity. Thicker dermis, heavier soft tissues, relative chin retrusion, and preserved dermal elasticity predispose to progressive cervicomental obtuseness. Patients presenting with obtuse cervicomental contours related to deep cervical structures benefit most from anatomy-directed intervention rather than superficial fat reduction alone. Management frequently includes submental deep neck contouring with selective reduction of subplatysmal fat, anterior digastric bellies, and submandibular glands, combined with platysmaplasty, with or without conservative subcutaneous fat removal. Optimal outcomes often require integration with facial rejuvenation, incorporating extended facelift techniques that emphasize comprehensive retaining-ligament release rather than traditional superficial musculoaponeurotic system lift procedures. Surgical strategy should be guided by individual anatomy rather than ethnoracial categorization. Anatomy-based, patient-centered planning enables natural, balanced, and durable cervicofacial outcomes while preserving patient-specific aesthetic identity.

Septal deformities are highly prevalent in the population and septoplasties are one of the most common procedures performed by otolaryngologists and facial plastic surgeons. Caudal septal deformities represent a challenging component when managing septal deviations given the caudal septum's critical role as a tip supporting mechanism. As a result, they are a frequent cause for revision procedures. Caudal septal deformities can range from mild to severe and require careful assessment and strategic operative planning. Depending on the deformity, a variety of techniques can be employed for correction. These range from conservative approaches such as reshaping maneuvers and suture techniques to complete excision and reconstruction with grafting. Rhinoplasty surgeons must be prepared with a wide repertoire of interventions to address the caudal septum depending on the deformity present. This article provides a comprehensive review of septal anatomy, patient evaluation, and an updated algorithm for management of caudal septal deformities.

Injectable collagen stimulators have traditionally been linked to inflammatory foreign-body reactions (FBR) as a mechanism of action. However, the next-generation PLLA-LASYNPRO microspheres, contained in the CE-marked JULÄINE medical device, may represent a paradigm shift. Preclinical data suggest these microspheres can promote collagen and extracellular matrix (ECM) regeneration with minimal inflammatory response. This study aimed to evaluate the scientific soundness and clinical relevance of a non-inflammatory mechanism of action for PLLA-LASYNPRO. The central hypothesis was that design and manufacturing innovations could enable effective biostimulation while reducing inflammation and long-term tissue reactions. A structured expert board meeting was convened to assess the rationale and implications of this emerging mechanism. The process included a preliminary survey and an in-person consensus meeting involving multidisciplinary specialists in aesthetic and regenerative medicine. On January 24, 2025, 13 experts in aesthetic medicine, dermatology, and plastic surgery participated in a board meeting held in Milan, Italy. Scientific literature and preclinical data were reviewed in advance. Discussions were organized around biophysical characteristics, tissue integration, inflammatory profile, and safety considerations. The board considered the non-inflammatory mechanism of PLLA-LASYNPRO both biologically plausible and clinically promising. Key differentiating features included particle morphology, lack of excipients, and manufacturing purity. The panel highlighted the potential to reduce chronic inflammation, a known limitation of traditional collagen stimulators. Early clinical impressions supported this hypothesis, although prospective data are still forthcoming. This manuscript presents the consensus of a multidisciplinary board on the rationale for PLLA-LASYNPRO in aesthetic and regenerative medicine. It forms the first part of a two-paper series. The second manuscript will provide practical clinical guidance for the deep dermal administration of PLLA-LASYNPRO and real-world use of JULÄINE.

Minimally invasive cosmetic procedures consistently lead the aesthetic landscape year after year. Men are increasingly requesting aesthetic interventions with a focus on maintaining a youthful, powerful, and natural look. There are significant anatomical, physiological, and behavioral differences in the aging male face that warrant specific treatment considerations.Literature review of male gender-specific facial anatomy, aging patterns, treatment motivations/preferences. Description of the author's preferred injection techniques.Male and female faces are shaped by different aesthetic standards, impacting what is deemed attractive. Men are keenly aware of the sexual dimorphism in facial characteristics and often seek to preserve or enhance traits associated with traditional masculinity. Minimally invasive procedures can be customized to enhance or retain masculine features.Gaining a deeper understanding of factors affecting male rejuvenation patterns and learning specific injectable techniques will empower aesthetic providers to tailor cosmetic treatments for men, achieving success and encouraging continued growth of this burgeoning demographic.

Structural nasal obstruction is an important modifier of sleep-disordered breathing (SDB), but the specific impact of functional rhinoplasty on validated sleep-related outcomes has not been quantitatively synthesized. To systematically review and meta-analyze studies of adults with SDB undergoing functional rhinoplasty or septorhinoplasty, testing the hypothesis that surgery yields large improvements in nasal obstruction and modest improvements in sleep-related symptoms. PROSPERO-registered systematic review and random-effects meta-analysis conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. PubMed, Embase and Cochrane Library were searched to September 2025 for studies reporting validated symptom scores before and after functional rhinoplasty or septorhinoplasty in adults with SDB. Standardized mean differences (SMDs) with Hartung-Knapp-adjusted confidence intervals were pooled; risk of bias and publication bias were formally assessed. Eight studies (27 cohorts; n = 1,192) met inclusion criteria. Surgery was associated with large improvement in nasal obstruction (Nasal Obstruction Symptom Evaluation SMD: -4.99; 95% CI: -9.12 to -0.85), moderate reductions in daytime sleepiness (Epworth Sleepiness Scale SMD: -1.09; 95% CI: -2.33 to 0.15) and global sleep disturbance (Pittsburgh Sleep Quality Index SMD: -0.74; 95% CI: -1.21 to -0.26), and modest gains in functional status (Functional Outcomes of Sleep Questionnaire-10 SMD: 0.41; 95% CI: 0.16-0.65). Heterogeneity was substantial for most outcomes and small-study effects were detected. Functional rhinoplasty and septorhinoplasty appear to improve nasal obstruction and sleep-related patient-reported outcomes in adults with SDB, supporting their role as adjunctive procedures in selected patients. High heterogeneity and predominantly observational data highlight the need for larger, phenotype-driven studies to refine effect estimates and patient selection (PROSPERO registration number: CRD420251168358).

Nasal obstruction due to septal deviation and a crooked nose affects breathing and quality of life. Objective assessment of surgical outcomes remains essential. This study aimed to evaluate functional and aerodynamic improvements following surgery using subjective and objective tools. Primary outcomes included changes in the Turkish validated Standardized Cosmesis and Health Nasal Outcomes Survey (T-SCHNOS) scores, nasal resistance, and airflow patterns. A retrospective cohort study was conducted following the STROBE guidelines. Eight patients were assessed pre- and postoperatively using T-SCHNOS, 4-phase rhinomanometry (4-PR), and computational fluid dynamics (CFD). Five were tested under decongested and three were tested under nondecongested conditions. Four healthy individuals served as controls. CFD models were generated from DICOM data. Significant improvements were seen in T-SCHNOS, RMOS, Qdiff, and Vmax (p&#x2009;<&#x2009;0.05). Postoperative values approached control levels. Moderate correlation was observed between Qdiff and 4-PR (r&#x2009;=&#x2009;0.660), but other CFD-clinical parameter correlations were weak. Surgery significantly improves airflow metrics, although subjective-objective correlations vary.

Brow lift incorporates an assessment and correction of multiple factors which differ considerably between patients. Various options for brow lift exist, each with its limitations when correcting the full spectrum of age-related changes to the eyebrow. Objectives & Hypotheses: To describe a brow lift technique that addresses the limitations seen in other techniques. Case series Methods: The technique was performed from 2022 to 2023 for 70 patients aged 40 to 77 years. All patients were female. All patients underwent the technique with satisfactory results and no complications. No infection of the wound or asymmetry was observed, and no patients required a revision operation. No major complications such as facial paralysis or necrosis was observed. This technique is a versatile procedure with good aesthetic outcomes which preserves facial animation and can be combined with other procedures while effectively elevating the lateral third of the eyebrow.

Buccal fat pad reduction (BFPR) is increasingly used for lower facial contouring; however, long-term outcomes remain unclear. To evaluate aesthetic outcomes, patient satisfaction, complications, and long-term sequelae following BFPR. We hypothesized that the BFPR yields high satisfaction and favorable short-term outcomes with low complication rates, while long-term effects are underreported. Systematic review. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020-compliant review was conducted across MEDLINE, Embase, Web of Science, Scopus, and Cochrane CENTRAL through December 2025. Eligible studies reported aesthetic outcomes, satisfaction, or complications. PROSPERO registration: CRD420251274504. Ten studies (n&#x2009;=&#x2009;1,123) were analyzed. Objective assessments demonstrated a reduction in lower facial volume. Satisfaction was high. Among 921 procedures, 39 complications occurred (4.2%), mostly minor. Long-term outcomes were poorly assessed because follow-up was limited; one study reported a gaunt appearance (1.6%). BFPR appears safe with high satisfaction; however, evidence is limited by low-level studies and short follow-up.

Septoplasty and septorhinoplasty are key procedures in functional and aesthetic nasal surgery. Over the past decade, evidence on diagnostics, techniques, and outcomes has expanded significantly. To provide a structured summary of current evidence from systematic reviews and meta-analyses, focusing on diagnostics, surgical techniques, perioperative treatment, and patient-reported outcomes. Narrative review of 86 articles, reviews, and meta-analyses published within the past 10 years. Studies were screened for relevance to functional and aesthetic rhinoplasty. Extracted data covered diagnostic methods, surgical techniques, medications, PROMs, and functional outcomes. Four-phase rhinomanometry offers promise but lacks validation. Body dysmorphic disorder (BDD) screening is gaining relevance. Evidence supports perioperative corticosteroids and tranexamic acid; routine antibiotics appear unnecessary. PROMs (NOSE, ROE, SNOT-22) are widely used. Evidence for rhinoplasty is growing but heterogeneous. Standardized diagnostics, PROM-linked objective measures, and long-term data are needed to guide future patient-centered care.