Nasolabial fold correction through cheek volume loss restoration versus thread lifting: a comparative study.

Nasolabial folds are caused by loss of deep fat and subsequent loss of muscle contour in the midface, leading to sagging which forms cosmetic issues in some cases when they are otherwise overly pronounced. Various treatment procedures have been developed to reduce their appearance. The objective of this study is to compare the efficacy of hyaluronic acid (HA) cheek fillers injection and thread lifting in improving the nasolabail folds. Twenty cases presenting with prominent nasolabial folds were randomly divided into two groups; group A underwent HA fillers for cheek lifting and group B underwent thread lifting for the cheek. Only one session was done for each case, and then they were followed up after 1 and 2 months. Statistical significant difference after treatment for both groups was detected using the wrinkle severity rating scale (WSRS) and the modified Fitzpatrick wrinkle scale (MFWS). The average global aesthetic improvement scale (GAIS) was 2.2 ± 0.79 for the fillers group and 3.2 ± 0.92 for the threads group, showing a statistical significant improvement with a p value less than 0.05 favoring the fillers group. 70% of fillers cases were satisfied and only 30% of threads cases. Fillers cheek injection is recommended for patients with sagged thin face to improve the nasolabial folds as well as giving volume and contour. Threads would do better for patients desiring an oval, less wide face shape. Combining threads with other cosmetic procedure would give a better holistic appearance.

Overcoming the failure of anesthesia in the mandibular teeth.

[No Abstract Available].

Analysis of morphological changes after facial massage by a novel approach using three-dimensional computed tomography.

BACKGROUND/PURPOSE: Photograph-based visual scoring has been used for evaluation of facial morphological changes. Here, we describe a three-dimensional computed tomography (3D-CT) method for objective analysis of facial and intra-facial (subcutaneous) changes. The effects of facial massage were examined using both methods. METHODS: Subjects were 12 healthy female volunteers without facial scars or deformation (age 30-54 years, mean 39.4 years). Photograph-based scoring of massage-induced morphological changes was done at the nasolabial folds, upper, lower and lateral cheeks and lower eyelids. For 3D-CT evaluation, the virtual center axis (VCA) was set as the cranio-caudal longitudinal line, and the VCA-skin surface distances (VSDs) were measured. Massage-induced changes of VSD were calculated (facial massage-induced change rate, FMCR). Intra-facial (subcutaneous) changes were also evaluated. RESULTS: Photograph-based scoring revealed marked morphological changes of the nasolabial folds after facial massage, and changes of the lower, upper and lateral cheeks and lower eyelid were also observed in more than half of the subjects. FMCR values were significantly changed in the paranasal area, nasolabial fold area and cranial part of the mandibular area. Photograph-based scores at the lower cheek and lower eyelid were well correlated with FMCR in the inferior part of the nasolabial fold and the mandibular area, respectively. Massage-induced changes of subcutaneous fat tissues and facial expression muscles were also apparent on CT images. CONCLUSION: 3D-CT imaging is useful for objective evaluation of the effects of facial massage, including anatomical changes in subcutaneous structures.