Effects of Midcheek Lift According to Dissection Plane and Range: An Anatomical Study.

BACKGROUND: Midcheek lift has been performed for cosmetic or reconstructive surgery of the lower eyelid. For midcheek lift through the subciliary incision, preperiosteal and subperiosteal dissections are the most often implemented, with good clinical outcomes. However, a comparative assessment of the effects of these 2 methods had not been conducted. OBJECTIVES: In this study we compared the effects of midcheek lift according to preperiosteal or subperiosteal plane and range of midfacial dissection. METHODS: Forty hemifaces of 20 fresh cadavers were dissected. One side of the hemiface underwent preperiosteal dissection, and the other side underwent subperiosteal dissection. After dissections of 5, 10, 15, 20, and 30 mm and all of the midcheek area from the inferior orbital rim, the length of the elevated lid-cheek junction was measured by placing upward traction on the lateral portion of the lower lid. RESULTS: In both methods, the length of the midcheek lift increased as the dissection progressed, and the length of the lift on the lateral side was greater than that on the medial side. The length of the pulled skin in the preperiosteal group was the greatest in most cases. However, in the full dissection cases, the midcheek lift length was not statistically different between the 2 surgical methods, especially on the lateral side. CONCLUSIONS: Flap elevation in lower blepharoplasty surgery can be predicted based on the surgical method and dissection range. Implementing a surgical plan that takes this into account can enhance both reconstruction and aesthetic surgery outcomes in the midcheek area.

Mandible Angle Resection with the Retroauricular Approach.

Square-shaped and large moon-shaped faces are commonly observed in Asians, and the contour of the mandible is associated with the shape of the lower part of the face. Mandible contouring surgery is performed to create a softer impression for East Asians. Currently, most surgeries are performed using an intraoral approach. External approaches have not been cosmetically attempted because of possible damage to the facial nerve and visible scarring and have been limited to mandible bone fracture reduction. This study included 42 patients who underwent mandibular angle reduction via classical intraoral incision and retroauricular incision between April 2019 and October 2021. Clinical outcomes were assessed using the Global Aesthetic Improvement Scale and Visual Analog Scale. Surgery was successful in all cases, with no significant complications. An appropriate mandibular contour was achieved postoperatively. All patients were satisfied with the outcome. Some patients experienced short-term complications, such as hematoma and wound disruption of the skin above the incision line. However, these improved within 3 weeks, and no serious long-term complications were observed. Mandible angle resection with the retroauricular approach is a promising alternative for patients, allowing speedy recovery and the resumption of routine daily life.

Alar crease as a donor site for the extension limb of modified nasolabial V-Y advancement flap.

BACKGROUND: The traditional nasolabial V-Y advancement flap is widely used for midface reconstruction, particularly for the lower third of the nose and upper lip, as its color and texture are similar to these areas. However, it provides insufficient tissue to cover large defects and cannot restore the nasal convexity, nasal ala, and adjacent tissues. The purpose of this study is to investigate the modified nasolabial V-Y advancement flap with extension limbs the along alar crease for the reconstruction of complex midface defects. METHODS: A retrospective analysis of 18 patients, who underwent reconstruction with the modified nasolabial V-Y advancement flap, was performed between September 2014 and December 2022. An extension limb was added along the alar crease, adjacent to the defect area, and was hinged down as a transposition flap at the end of the advancement flap. RESULTS: The extension limb along the alar crease successfully covered large and complicated defects, including those of the ala, the alar rim, the alar base, the nostrils, and the upper lip, with minor complications. CONCLUSION: The alar crease is a good donor site for the reconstruction of large and complex nasal and upper lip defects.

Immunomagnetic separation and size-based detection of Escherichia coli O157 at the meniscus of a membrane strip.

We developed a facile method for the detection of pathogenic bacteria using gold-coated magnetic nanoparticle clusters (Au@MNCs) and porous nitrocellulose strips. Au@MNCs were synthesized and functionalized with half-fragments of Escherichia coli O157 antibodies. After the nanoparticles were used to capture E. coli O157 in milk and dispersed in a buffer solution, one end of a test strip was dipped into the solution. Due to the size difference between the E. coli-Au@MNC complexes (approximately 1 µm) and free Au@MNCs (approximately 180 nm), only E. coli-Au@MNC complexes accumulated at the meniscus of the test strip and induced a color change. The color intensity of the meniscus was proportional to the E. coli concentration, and the detection limit for E. coli in milk was 103 CFU mL-1 by the naked eye. The presence of E. coli-Au@MNC complexes at the meniscus was confirmed using a real-time PCR assay. The developed method was highly selective for E. coli when compared with Salmonella typhimurium, Listeria monocytogenes, and Staphylococcus aureus.