Multiplane Facelift Following Facial Bone Contouring for Enhanced Mobilization and Rejuvenation.

INTRODUCTION: The aging process is inevitable in life, and the social demand for rejuvenation increases by year. The face acquires both soft tissue and skeletal changes through aging, and correcting only one side has limits in natural rejuvenation. Thus, the authors combined multiplane facelift with whole-facial bone contouring for maximal results. METHODS: From March 2017 to February 2019, a total of 22 patients received multiplane facelift following facial bone contouring in our institute. The authors retrospectively reviewed information on demographics, surgical procedure, complications, and satisfaction. Under general anesthesia, the patient received reduction malarplasty, genioplasty, and mandible anglectomy via intraoral incisions, and multiplane facelift through retrotragal and postauricular incisions. RESULTS: All patients were females with the mean age of 42.86 ±â€Š9.55. The mean operation time was 296.39 ±â€Š31.87 minutes and the mean follow-up period was 12.59 ±â€Š6.77 months. Few complications included hematoma and unfavorable scars. More than 95% of the patients were very satisfactory with the result. CONCLUSION: In this study, the authors present our novel procedure of combining whole-facial bone contouring and multiplane facelift. This technique can reestablish the facial skeletal foundation and effectively lift soft tissues in various vectors with longevity and safety.

Reconstruction of Ankle and Heel Defects with Peroneal Artery Perforator-Based Pedicled Flaps.

BACKGROUND: The reconstruction of ankle and heel defects remains a significant problem for plastic surgeons. The following options exist for reconstructing such defects: local random flaps, reverse flow island flaps, and free flaps. However, each of these methods has certain drawbacks. Peroneal artery perforators have many advantages; in particular, they are predictable and reliable for ankle and heel reconstructions. In this study, we report our clinical experience with peroneal artery perforator-based pedicled flaps in ankle and heel reconstructions. METHODS: From July 2005 to October 2012, 12 patients underwent the reconstruction of soft tissue defects in the ankle and heel using a peroneal artery perforator-based pedicled flap. These 12 cases were classified according to the anatomical area involved. The cause of the wound, comorbidities, flap size, operative results, and complications were analyzed through retrospective chart review. RESULTS: The mean age of the patients was 52.4 years. The size of the flaps ranged from 5×4 to 20×8 cm(2). The defects were classified into two groups based on whether they occurred in the Achilles tendon (n=9) or heel pad (n=3). In all 12 patients, complete flap survival was achieved without significant complications; however, two patients experienced minor wound dehiscence. Nevertheless, these wounds healed in response to subsequent debridement and conservative management. No patient had any functional deficits of the lower extremities. CONCLUSIONS: Peroneal artery perforator-based pedicled flaps were found to be a useful option for the reconstruction of soft tissue defects of the ankle and heel.