Forehead Reduction Surgery with Hairline Advancement.

Hairline reduction surgery, also known as aesthetic forehead reduction, is a surgical procedure that aims to reduce the upper facial third and improve facial harmony. This article describes the anatomy of hairline advancement surgery and the surgical technique used by the author. The study included 21 patients from 2019 to 2023, and the forehead reduction length was on average 22.48 ± 2.64 mm. The most common complaint was hypoesthesia of the scalp, present in 100% of patients, resolving in all cases by 2 months after surgery. Forehead reduction surgery is among the procedures that provide more satisfaction to patients due to the great changes that it can achieve.

Artificial Intelligence in Facial Plastic and Reconstructive Surgery: A Systematic Review.

Artificial intelligence (AI) is a technology that is evolving rapidly and is changing the world and medicine as we know it. After reviewing the PROSPERO database of systematic reviews, there is no article related to this topic in facial plastic and reconstructive surgery. The objective of this article was to review the literature regarding AI applications in facial plastic and reconstructive surgery.A systematic review of the literature about AI in facial plastic and reconstructive surgery using the following keywords: Artificial Intelligence, robotics, plastic surgery procedures, and surgery plastic and the following databases: PubMed, SCOPUS, Embase, BVS, and LILACS. The inclusion criteria were articles about AI in facial plastic and reconstructive surgery. Articles written in a language other than English and Spanish were excluded. In total, 17 articles about AI in facial plastic met the inclusion criteria; after eliminating the duplicated papers and applying the exclusion criteria, these articles were reviewed thoroughly. The leading type of AI used in these articles was computer vision, explicitly using models of convolutional neural networks to objectively compare the preoperative with the postoperative state in multiple interventions such as facial lifting and facial transgender surgery.In conclusion, AI is a rapidly evolving technology, and it could significantly impact the treatment of patients in facial plastic and reconstructive surgery. Legislation and regulations are developing slower than this technology. It is imperative to learn about this topic as soon as possible and that all stakeholders proactively promote discussions about ethical and regulatory dilemmas.

Use of Polydioxanone Threads as an Alternative in Nonsurgical Procedures in Facial Rejuvenation.

Minimally invasive cosmetic procedures are in increasing demand worldwide. Patients are constantly searching for office-based techniques that can help improve the signs of aging but without the morbidity of a surgical procedure. Thread lifting with polydioxanone (PDO) sutures is a cosmetic procedure where lax tissue is lifted and repositioned trying to create a more youthful looking facial contour. The threads are absorbable and come in different shapes and lengths. The rate of complications and the downtime of the procedure are low, which are something patients are looking for. Ideally, these procedures should be performed by trained specialists who have complete knowledge of the facial anatomy, thus enhancing and improving results. Thread lifting with PDO absorbable threads has become an excellent option for minimally invasive facial rejuvenation procedures with a high satisfaction among patients and very few complications. It is a new tool that can be introduced in the armamentarium of specialists who work in the field of facial plastic surgery and who can offer this option to their patients with improved outcomes.

Ethnic Rhinoplasty.

Ethnic rhinoplasty traditionally has been used to define this surgical procedure performed on non-Caucasian patients. Because of globalization, massive migrations, and interracial mixing, ethnic patients today are considered mixed race patients. Surgical techniques should be based not on what ethnic group they belong to but on anatomical findings and patients' needs and wishes. Preservation techniques are presented and structural approaches are discussed using sutures and grafts. The final objectives of rhinoplasty are better definition, more refined appearance, and compliance with patients' aesthetic ideals while preserving function.

Integrated Management of the Thick-Skinned Rhinoplasty Patient.

Patients with thick skin are a challenge in facial plastic surgery. Rhinoplasty is still the most frequently performed facial plastic procedure worldwide and it becomes very difficult to obtain optimal consistent results in these patients. A systematic presurgical skin evaluation is performed dividing skin into type I-III depending on the elasticity, oiliness, presence of skin alterations, size of skin pores, and laxity. Depending on the skin type, presurgical, surgical, and postsurgical management of the epidermis and dermis is defined. Preconditioning and treating thick skin can improve postsurgical results and reduce postsurgical unwanted results.

Isotretinoin Use in Thick-Skinned Rhinoplasty Patients.

One of the characteristics of mestizo patients can be the thick sebaceous skin associated with a poor osteocartilaginous underlying nasal structure. In spite of using a proper structural approach where grafts and sutures are used to define the nasal tip, frequently the results are suboptimal. Surgical techniques have been described to reduce the thickness of the skin-soft tissue envelope, but these frequently give unreliable results. The monitored use of isotretinoin given orally as a complement after performing a rhinoplasty can adequately control the production of the sebaceous glands and thin the skin-subcutaneous tissue envelope in a uniform fashion without compromising the underlying bony and cartilaginous structures of the nose. Patients ideally should be treated jointly with a dermatologist and be followed closely to monitor hepatic function. Follow-up after 2 years with pre- and postoperative pictures shows improved definition of the nasal tip and dramatic improvement on sebaceous gland production.

Management of Thick Skin in Rhinoplasty.

Rhinoplasty in thick skin patients is challenging because the skin soft tissue envelope (S-STE) is more inelastic, and has a tendency for prolonged postsurgical edema, increased dead space formation, and underlying scar tissue formation. Changes in the S-STE will have an impact on how the final rhinoplasty result will look. When performing surgery, approaches should be targeted to the underlying bony-cartilaginous framework and the S-STE to obtain consistent, improved long term results. In this article, 3 experts will be discussing up to date medical, topical, and surgical management key points, as well as diagnostic options and post-operative treatments.

Septal Extension Graft Versus Columellar Strut.

Stabilizing the nasal base is important before working on the nasal tip lobule. This will help define the nasolabial angle, the alar columellar relationship and nasal tip projection and rotation. Columellar struts and septal extension grafts are techniques that balance the nasal base and create a stable structure to modify the nasal tip. The type of graft used, and its design will depend on the patient's needs, cartilage availability and surgical techniques used. An endonasal or open approach can be used. In this chapter, authors will share their experience using columellar struts and the different types of septal extension grafts.

Trends in facial plastic surgery in Latin America.

In an effort to try to define the tendencies in the practice of facial plastic surgery in the different countries of Latin America, a survey was conducted from June 2012 to August 2012. Questionnaires were sent to specialists in otolaryngology and facial plastic surgery in the countries of Colombia, Brazil, Venezuela, Ecuador, Chile, Peru, and Mexico. Results are shown and discussed. Comparisons are made with existing surveys performed by the American Academy of Facial Plastic and Reconstructive Surgery.

Structural rhinoplasty in Latin American patients.

Patients coming from Latin America are also known as mestizos or Hispanics. They are a combination of different ethnic groups where predominant facial features will vary depending on where the patient is coming from. A structural approach to the nose will be presented showing how techniques using sutures and grafts are used to reinforce and reconstruct existing structures achieving cosmetic long-term results. The surgical goal is to achieve a more defined looking nose that does not look overdone, is attractive, and retains ethnic characteristics.

Rhinoplasty across Latin America: case discussions.

A presentation of four different rhinoplasty cases performed by four different surgeons in Latin America is presented. For each case, presurgical photographs and discussion of the patient are presented. Intrasurgical photographs and description of surgical techniques employed as well as postsurgical pictures are included for each case. This will give readers the opportunity of seeing how different surgical techniques can be used effectively in treating patients of mixed races with good cosmetic long-term results.

Nuances with the mestizo tip.

Mestizo nasal tips are a challenge. A gradual approach is presented, emphasizing minimal tissue resection, reinforcement of support structures of the nasal tip, and use of sutures and grafts in a judicious manner. The final result should be tips with improved definition, rotation, and projection.

Non-Caucasian Rhinoplasty.

Today non-Caucasian patients comprise an important group of patients seeking rhinoplasty. The term non-Caucasian is used interchangeably to speak about patients of ethnic origin. It becomes important to understand the interplay of culture, race, and ethnicity when evaluating patients and defining what their aesthetic ideals are and what will be needed for surgery. An integrated approach and management of the non-Caucasian patient is presented in which medical and surgical options are explored. The final goal when treating non-Caucasian patients should be trying to help patients achieve their aesthetic ideal in the best possible fashion.

Global Practice Patterns of Dorsal Preservation Rhinoplasty.

Background: Dorsal preservation rhinoplasty (DPR) has recently received significant academic attention in part due to theoretical benefits over excisional surgical methods. The purpose of this study was to assess the global practice patterns regarding this technique. Materials and Methods: An 11-item questionnaire was electronically distributed to regional academies/societies representing rhinoplasty surgeons worldwide. Respondent exposure to and use of DPR were assessed based on geographic location. Results: Eight hundred thirty-six responses were received. Despite early publications on DPR originating largely from Western Europe and the United States, Turkey and Mexico have the greatest use of DPR techniques currently. The familiarity across many regions with preservation techniques appear to be secondary to courses and conferences rather than incorporation into training. Mexico demonstrates the greatest exposure to DPR during training. One hundred twenty-five respondents had previously used but abandoned dorsal preservation techniques. Poor results, less predictability, and complications (largely hump recurrence) are cited as common reasons for this. Conclusion: There is variability in the global practice of DPR across regions and this will likely continue to evolve.

Ethnic considerations of the crooked nose.

Ethnic features must be taken into account when planning surgery of a patient with a crooked nose. A systematic approach is presented with emphasis on reinforcing structural support, correcting functional and cosmetic abnormalities, aligning structures, and using camouflage techniques to improve appearance and function.

Aesthetic surgery for the Mestizo/Hispanic patient: special considerations.

Mestizo patients, also known as Hispanic or Latino patients, are a growing ethnic group worldwide. Cosmetic procedures have become more accessible, and more patients are looking for procedures that will not only improve their facial features but also make them have a more youthful appearance. Mestizo facial characteristics are reviewed, and a stepwise approach to the aging Mestizo face is presented where nonsurgical and surgical options are discussed including midface-lifting techniques and short scar face-lifting procedures.

Management of the Mestizo Nose.

Mestizo noses have mesorrhine nasal characteristics. They have a modest osteocartilaginous framework, nasal tips that tend to be bulbous with poor projection and rotation, and skins that tend to be thick and acne prone. A structural rhinoplasty approach is performed, focusing on anatomic findings. Conservative tissue excision with preservation or reinforcement of support structures of the nose is done. Structural grafting and suturing techniques are used to remodel cartilage and create better definition and support. The skin and soft tissue envelope is managed medically and surgically. The objective is to create balanced-looking noses that bring patients closer to their own aesthetic ideal.

Understanding and Getting Involved in the International Facial Plastic Surgery Community.

This article is intended to engage international facial plastic and reconstructive surgeons so they can maximally benefit from the increased connectivity fostered by the Internet. Facial plastic surgeons are encouraged to participate in the educational programs being developed by the International Federation of Facial Plastic Surgery Societies. Many international surgeons grapple with the issues surrounding the development or expansion of their own facial plastic and reconstructive surgery practices. The Strategy Circle and suggestions on how to acquire knowledge and surgical skills are discussed. Practical recommendations to assist in transitioning a practice to facial plastic and reconstructive surgery are provided.