RESUMO
Background: The rejuvenation and restoration of a well-defined jawline contour are crucial for enhancing facial aesthetics in both men and women. Within the jawline aesthetic unit (mandibular angle), the masseter muscle plays a significant role, as it is responsible for mandibular masticatory movements. We propose a new approach using ultrasound-guided intramuscular fat transfer to enhance the mandibular angle and jawline. Methods: The multicenter study included 20 patients from three countries (Peru, Brazil, and Mexico). After fat harvesting, the ultrasound-guided masseteric fat transfer was performed with a 1.5-mm Viaro cannula from an incision beneath the ear lobule. The fat was then injected intramuscularly into the masseter at each side of the mandibular angle. Results: Masseter ultrasound-guided fat transfer was performed on 10 men and 10 women between 2021 and 2022. The patients had a mean age of 34.4â ±â 6.39 years and a mean body mass index of 22.39â ±â 2.59 kg per m2. The mean injected volume was 5.83 mL and 5.58 mL on the right and left sides, respectively. Muscle thickness increased in patients immediately postsurgery, but decreased after 1 month. The muscle remained significantly thicker on each side than the presurgery measurements in patients regardless of gender (both P < 0.0001). Conclusions: Ultrasound-guided intramuscular fat transfer is a safe and reproducible technique for enhancing the jawline contour at the mandibular angle. We believe that it could be a more durable solution than other procedures, although further evaluation of long-term results is necessary.
RESUMO
Background: Rib remodeling is a surgical technique for waist shaping in women and men. However, one of the main patient complaints is the scar. We aimed to describe a scarless, ultrasound-guided rib remodeling (RibXcar) technique that assessed the degree of angular variation of the fracture by ultrasound and the variation in waist measurement and patient satisfaction through a survey. Methods: The RibXcar technique was performed in 30 women aged 18-35 years in Peru, Colombia, and Mexico between October and December 2022 by three board-certified plastic surgeons trained in ultrasound and in this technique. The plastic surgeons measured costal angles before and immediately, 1 month, and 3 months after the surgery by ultrasound, as well as the waist in the same site and at these time points. Similarly, patient satisfaction was surveyed 3 months after the surgery, in which questions were asked about body aesthetics and the puncture site. Results: Ultrasound angular measurements before and immediately, 1 month, and 3 months after the surgical procedure were 168.00, 158.00, 160.00, and 160.43 degrees in the 10th rib, 170.50, 160.50, 152.50, and 163.50 degrees in the 11th rib, and 172.00, 162.00, 154.00, and 165.00 degrees in the 12th rib, respectively. The satisfaction survey showed that patients were satisfied with the aesthetic results of both the shape of the waist and the puncture site. Conclusions: RibXcar surgery maintains the angular variation over time. Similarly, waist measurements show a sustained reduction. Three months postoperatively, the patients were satisfied with the aesthetic results of the waist and the puncture site.
RESUMO
Introducción y Objetivo. Las técnicas de liposucción han sufrido diversas variaciones en el transcurrir del tiempo; sin embargo, observamos que los resultados estéticos en cuanto a naturalidad en el abdomen en ocasiones no son los mejores a pesar del apoyo tecnológico y de las nuevas técnicas quirúrgicas, pues el abdomen, al ser un área con características específicas en sus diferentes áreas, requiere un tratamiento especial por zonas. Nos proponemos demostrar, mediante el estudio de imágenes, el diferente grosor del tejido celular subcutáneo en el abdomen así como proponer, de acuerdo a los hallazgos, subunidades estéticas del mismo como base al planeamiento prequirúrgico de la liposucción abdominal. Material y método. Evaluamos 14 pacientes mediante ecografía abdominal de partes blandas para medir el grosor del tejido celular subcutáneo en 3 puntos de la zona lateral y 3 puntos de la zona medial del abdomen previamente establecidos, a fin de demostrar si existen diferencias estadísticamente significativas entre ellos. Resultados. El análisis estadístico demostró que existen diferencias estadísticamente significativas respecto al grosor del tejido celular subcutáneo entre la zona medial del abdomen (puntos 4, 5 y 6) con respecto a la zona lateral (puntos 1, 2 y 3) encontrando una relación 2:1; así como diferencias de grosor entre los puntos 1 y 2 en comparación con los puntos 4 y 5; de los puntos 1 y 2 con el punto 3; de los puntos 4 y 5 con el punto 6; y del punto 3 con el punto 6. En base a esas diferencias proponemos dividir el abdomen en una zona medial y otra lateral con subunidades estéticas de acuerdo a sus características morfológicas (grosor del tejido celular subcutáneo). También obtuvimos, de acuerdo a la correlación de Pearson, que dicha diferencia entre la zona medial y lateral del abdomen no está en relación al peso ni a la edad del paciente, pues siempre existe diferencia de grosor del tejido adiposo entre la zona lateral y la medial del abdomen. Conclusiones. Existe diferente grosor del tejido celular subcutáneo abdominal en las diferentes zonas señaladas, por lo que decidimos usar este parámetro para agrupar subunidades estéticas en el abdomen. Inferimos que esto podría ayudar a un planteamiento prequirúrgico para la liposucción abdominal, a fin de conseguir resultados estéticos favorables y conservar los relieves naturales del abdomen
Background and Objective. Liposuction techniques have undergone several variations in the passage of time; however we note that the aesthetic results in terms of naturalness in the abdomen sometimes are not the best despite technological support and new surgical techniques, because the abdomen, being an area that presents specific characteristics in its different areas, requires special treatment by zones. Our aim is to demonstrate by imaging the different thickness of the subcutaneous cellular tissue in the abdomen, as well as to propose new aesthetic subunits of the abdomen according to the findings, as it bases on the preoperative planning of abdominal liposuction. Methods.A series of 14 patients were evaluated using soft tissue abdominal ultrasonography to measure the thickness of the subcutaneous cellular tissue in 3 points of the lateral area and 3 points of the medial zone previously established, in order to demonstrate if there are statistically significant differences between them. Results. Statistical analysis showed that there are statistically significant differences regarding the thickness of the subcutaneous tissue between the medial abdomen (points 4,5 y 6) compared to lateral area (points 1,2 y 3) with a ratio of 2:1, as well as between the points 1 and 2 compared to points 4 and 5; 1 and 2 compared to point 3; 4 and 5 compared to point 6; and point 3 compared to point 6. For these differences it is proposed to divide the abdomen into medial and lateral areas with their aesthetic subunits according to their morphological characteristics (thickness of the subcutaneous cellular tissue). Thus, according to Pearson's correlation, this difference between the medial and lateral areas of the abdomen is not correlated with the patient's weight or age, since there is always a difference in the thickness of adipose tissue between the lateral and medial areas of the abdomen. Conclusions. There is a different thickness of subcutaneous abdominal cell tissue in the different areas indicated, so we decided to group it into aesthetic subunits according to the different morphological characteristic studied (thickness). We infer that this could help a pre-surgical planning for abdominal liposuction and achieve favorable aesthetic results while retaining the natural relief of the abdomen
