Genioplasty Research Articles

The Effect of Selfies on Cosmetic Surgery

Objective: Objectives: The present study aimed to evalu-ate how selfies (self-photographs) are related to cosmetic surgery. Methods: This is a prospective, observational study per-formed using a self-administered survey. An online ques-tionnaire was distributed through social media to a ran-dom sample of 653 individuals from Saudi Arabia aged 18 to 65 years (mean 29.4±10.9 years). 25.1% of respondents were male (164 men), 74.9% were female (489 women). Results: The majority of respondents were satisfied by their appearance in the selfie. 5.8% of respondents stated they had had a cosmetic procedure as a result of self-pho-tography. The procedures involved were: lip fillers, botox, rhinoplasty, cheek fillers, chin implant, scar revision and face-lift. A further 37.8% of respondents expressed a wish to undergo a cosmetic procedure (rhinoplasty, lip fillers, chin implant, scar revision, cheek fillers, botox or face-lift) due to selfies. 134 respondents expressed dissatisfac-tion with their appearance in selfies, 47 of whom (35.1%) expressed an interest in a cosmetic procedure. 46% of those who believed selfies reveal their deformities also wished to have a corrective procedure. Concerning their preferred type of procedure, women chose rhinoplasty, lip fillers, cheek fillers, anti-aging botox, face-lifts and chin implants more often than men. Conclusion: Improvements to body-image through cosmetic surgery outcomes should improve body image and thereby promote self-esteem and socialization. The selfie may underlie the increase in demand for cosmetic procedures and the number of such procedures subsequently undertaken.

Chin augmentation with the use of cannula from a single, midline entry point: Evaluation of 50 patients.

A chin that is of right size, shape, and contour plays a crucial role in overall facial balance and esthetically harmonious appearance. Dermal fillers have been widely used for correcting mild to moderate chin retrusion and resorption. The aim of this study was to share our preferential technique for chin augmentation and to evaluate our results in 50 patients. A total of 50 patients consisting of females who received hyaluronic acid injection for chin augmentation and rejuvenation were enrolled in the study. We have described chin augmentation technique with the use of cannula from a single, midline entry point. The study included 50 female patients, and the mean age was 37.56±8.84years. The median injected filler volume for augmentation of the mental area was 2.25mL (minimum=1, maximum=4mL). Four (8%) patients had ecchymosis related to the procedure. Chin has a profound effect on the perception of attractiveness and is an area of concern for rejuvenation of the lower third of the face. Our preferential technique allows the practitioners to increase the likelihood of a satisfactory esthetic outcomes and minimize the risks of the procedure.

Lamellar Arrangement in Facelift Procedures

Introduction: The aging process of the face involves: Skinelastosis, lipodystrophy, gravitational effect and atrophy. Fordecades while planning facelift procedures, the face wasdivided into regions (upper, middle, lower face). Reflectingon the etiology of aging it seems logic to plan facelift proceduresin horizontal fashion rather than traditional verticalplanning. In this study we are addressing the face in 3 lamellas:Skin, subcutaneous fat and SMAS where we are combiningthe advantages of both techniques: Traditional supra-SMASand deep composite facelift.Material and Methods: Retrospective study from 2014to 2017 included 52 cases. Procedures were done using sedationand local anesthesia. Incisions followed by skin undermining(1st lamella) and ligament release from superficial fat compartmentsand SMAS. Thus, allowing repositioning of superficialfat compartments (2nd lamella, e.g. malar pad of fat)and SMAS plication in upward vector; in which compositefacelift lacks. Followed by sub-SMAS and sub-platysmadissection (3rd lamella) giving advantage of platysma redrapingover the neck, enabling good pull and mobilizationof SMAS (re-enhancing our previous fat repositioning andplication) and allowing SMAS excision (preventing lateralcheek bulge). Plication, excision and SMAS anchoring. Skinand SMAS pull in upward and lateral vector. Ancillary proceduresas chin augmentation and fat injection were used whenneeded.Results: Follow-up from 6 months to 2 years. 84.6%complied to follow-up, 90.9% were satisfied, chin implant in9%, lipo-injection in 22.7%. Complications 13.6%, early:6.8% had tenderness and redness managed by antibioticointment, 2.2% had hematoma collection which was surgicallyevacuated and coagulation of bleeding vessels, 2.2% hadmandibular neuropraxia for 3 weeks; late: 6.8% hypertrophicscarring.Conclusion: Restoring the harmonious facial anatomyduring facelift procedure is crucial step. Lamellar faceliftensures addressing all facial components as a safe, reliableprocedure that ensures long term desired aesthetic outcome

Auxiliary usage of botulinum toxin A in plastic surgery in China.

Currently, botulinum toxin A (BTA) is mainly used in the treatment of muscle spasms and in cosmetic procedures, and its cosmetic indications are expanding rapidly. There have been sporadic reports focused on the preoperative usage of BTA complementing plastic surgery. We briefly summarize the current experience of BTA complementing plastic surgery in China based on clinical experience. We reported a brief review of the preoperative use of BTA as an accessory to plastic surgery (blepharoplasty, chin augmentation, mandibular angle ostectomy, rhinoplasty, hyaluronic acid fillers injection for wrinkle reduction) based on previous studies and our experience. Preoperative treatment with BTA in plastic surgery helps surgeons operate and results in better cosmetic results. Preoperative BTA treatment can reduce the occurrence of surgical complications as well as improve the surgical results in some plastic surgeries. The procedure is suitable for clinical application and worth promoting.

Chin Augmentation and Reshaping: Using Calcium Hydroxylapatite With Lidocaine (CaHA+) Filler

Adequate chin projection is associated with strength in the male jawline, youth in a female face, and a harmonious balance with the nose. Calcium hydroxylapatite plus integral lidocaine (CaHA+; Merz North America, Inc.) is a filler that has demonstrated immediate volume improvement for midface augmentation and for filling facial folds. There is a paucity of reports of the use of CaHA+ in the chin. The objective of this study was to assess the use of moldable CaHA+ injections to improve the chin profile. Twelve patients with microgenia were treated with CaHA+ chin injections for improvement of the chin profile. Deep, pre-periosteal, serial injections of CaHA+ were performed on the chin. Efficacy was assessed by the treating physician using sagittal profile views at 1-week, 1-month and 6-month follow-ups. Patients were monitored for complications. In total, 5 male and 7 female patients were treated to optimal enhancement of their chin profile. Average age was 47 years (range of 22-64 years). Patients received a mean total volume of 4.8 mL CaHA+. All patients were satisfied, and results persisted at the 6-month assessment. No complications were noted. CaHA+ can be used to augment the chin to enhance a recessed chin profile. This procedure is quick and effective, providing immediate results. Patients seeking a less-invasive alternative to surgery without the associated downtime may be ideal candidates for CaHA+ injections into the chin.

Implication of Location of the Ascending Mental Artery at the Chin Injection Point.

Facial proportions can be improved by means of chin augmentation in patients with a receding chin. The ascending mental artery is the main arterial supply to the top of the chin, and arterial occlusion of this artery can result in soft-tissue infarction. This study aims to measure the topographic anatomy of the ascending mental artery at the chin injection area, using a three-dimensional camera. Thirty-one embalmed cadaveric faces were dissected at the chin. The midline of the inferior margin of the mandibular protuberance was marked with a pin. A variation in size between the two opposite ascending mental arteries was noticed. The depth of the artery from the skin surface and distance from the midline were measured using a three-dimensional camera. There were 19 dominant ascending mental arteries on the right and 12 on the left. The dominant ascending mental arteries enter the chin paracentrally, approximately 6 mm (mean ± SD, 5.64 ± 4.34 mm) from the midline, within the muscular plane, and at a depth of 4.15 ± 1.95 mm from the skin. Furthermore, the artery formed an anastomosis with the sublingual artery, within the floor of the mouth. Every aesthetic physician should recognize the course of the ascending mental artery and use the appropriate techniques to avoid vascular injury during chin augmentation using filler injections.

Chin augmentation with cervical flaps associated with rhytidoplasty

Chin augmentation with cervical flaps associated with rhytidoplasty

Comprehensive Application of Autologous Costal Cartilage Grafts in Rhino- and Mentoplasty

Underdevelopment of nose and chin in East Asians is quite common. Rhinoplasty and mentoplasty are effective procedures to solve the above-depicted defects and can achieve remarkable cosmetic effects. An autologous costal cartilage graft has become an ideal material for rhinoplasty, especially for revision surgery. However, many problems in the clinical application of costal cartilage remain unresolved. This study is to investigate application strategies of autologous costal cartilage grafts in rhino- and mentoplasty. The methods involved are as follows: application of an integrated cartilage scaffold; comprehensive application of diced cartilage; and chin augmentation of an autologous costal cartilage graft. In this study, satisfactory facial contour appearance was immediately achieved in 28 patients after surgery; 21 patients had satisfactory appearance of the nose and chin during the 6- to 18-month follow-up. Cartilage resorption was not observed. Two patients had nasal tip skin redness and were cured after treatment. This procedure can be used to effectively solve: curvature of the costal cartilage segment itself; warping of the carved costal cartilage; and effective use of the costal cartilage segment. The procedure has achieved satisfactory outcomes, and its application is worth extending to clinical practice.

Chin Reshaping in Profileplasty: Augmentative and Reductive Strategies.

After studying this article, the reader should be able to understand how various implants, osteotomies, and reductive tissue techniques affect the aesthetic outcomes of chin reshaping surgery. The roles of standard versus custom chin implants, the operative steps and indications for a bony genioplasty and the techniques for chin reduction are described with emphasis on proper patient selection and avoiding their common complications.

Evaluation of Personality Perception in Men Before and After Facial Cosmetic Surgery.

Facial cosmetic surgery has previously focused on improvements in perceived physical attractiveness and youthfulness. However, human beings are judged throughout life based on many other characteristics and personal qualities that are conveyed by their faces. To examine the association of facial cosmetic surgery in men with perceptions of attractiveness, masculinity, and personality traits. Cohort study with retrospective evaluation by blinded raters of preoperative and postoperative photographs of 24 male patients who underwent facial cosmetic surgery between January 1, 2009, and January 31, 2016. A total of 6 surveys were constructed with 8 sets of photographs each (4 preoperative and 4 postoperative). Each of these surveys was then sent to at least 36 lay people via the web-based survey tool Survey Monkey. Additional invites were sent for individual surveys until a minimum of 24 responses were received for each survey. Preoperative and postoperative photographs of the same patient were not placed in the same survey to avoid recall bias. Anonymous raters used a 7-point Likert scale to rate their perception of each patient's personality traits (aggressiveness, extroversion, likeability, risk seeking, sociability, and trustworthiness), attractiveness, and masculinity based on photographs in their assigned survey. Raters were blinded to study intent. Data analysis was performed between August 2018 and March 2019. Ratings of personality, attractiveness, and masculinity. This survey study included photographs of 24 men who underwent facial cosmetic surgery; the mean (SD) age of the patients was 49.3 (16.4) years. A total of 145 participants completed the survey; the majority of respondents were men (n = 81; 56%) between the ages of 25 and 34 years (n = 116; 80%). Score increases were significant for perceived attractiveness (0.29; 95% CI, 0.13-0.46), likeability (0.41; 95% CI, 0.24-0.57), social skills (0.25; 95% CI, 0.08-0.40), and trustworthiness (0.27, 95% CI, 0.11-0.44) when evaluating all facial cosmetic procedures together (upper blepharoplasty, lower blepharoplasty, face-lift, brow-lift, neck-lift, rhinoplasty, and/or chin implant). Upper blepharoplasty was associated with positive changes in perceived likeability (0.72; 95% CI, 0.06-1.50) and trustworthiness (0.74; 95% CI, 0.22-1.25). Lower blepharoplasty was associated with decreased perception of risk seeking (-0.78; 95% CI, -1.45 to -0.10). Face-lift was associated with increased perception of likeability (0.69; 95% CI, 0.08-1.30) and trustworthiness (0.66; 95% CI, 0.05-1.27). Neck-lift was associated with increased perception of extroversion (0.60; 95% CI, 0.10-1.09) and masculinity (0.70; 95% CI, 0.21-1.19). Patients who underwent rhinoplasty had improvements in perceived attractiveness (0.51; 95% CI, 0.03-1.00) and likeability (0.40; 95% CI, 0.03-1.00). Chin augmentation did not show any significant improvements. The results of this study suggest that men undergoing facial cosmetic surgery may experience changes in perceived attractiveness, masculinity, and a variety of personality traits. These findings complement those from a previous study on female patients, which together broaden the understanding of the association of cosmetic surgery with societal perceptions of persona. NA.

Mentoplasty with Customized Guides and Plates Using 3D Technology: a More Precise and Safer Technique.

SUMMARY:Mentoplasty or genioplasty is a common operation to enhance function and appearance of the chin, which has major impact on character impressions and facial beauty. With the advent of new 3D technologies, the technique can be performed using customized guides and plates (with 3D planning and printing), addressing the drawbacks of the procedure, making it minimally invasive, safe, very accurate, and predictable. In this article, we describe a surgical technique using customized surgical guides and plates and performed under local anesthesia and oral sedation, with a surgical time of approximately 45 minutes. The video includes a 3D animation of customized mentoplasty and a recording of real procedures for chin augmentation using customized guides and plates, with use of a minimally invasive approach.

Analysing chin prominence in relation to the lower lip: The lower lip-chin prominence angle

The purpose of this investigation is to describe a potentially useful analysis in assessing the required extent of sagittal chin augmentation or set-back, by relating chin prominence to lower lip position using the ‘lower lip-chin prominence angle’. The secondary aim was to quantitatively evaluate the influence of this angle on perceived attractiveness and desire for surgery. Having described this angular analysis, a quantitative evaluation was undertaken by incrementally altering the angle on an idealised profile image to create a range of images that were rated on a 7-point Likert scale by a pre-selected group of pre-treatment orthognathic patients, clinicians and laypeople. In treatment planning alterations in chin prominence, an ‘ideal’ sagittal position with soft tissue pogonion on or just behind a true vertical line through the most prominent point of the lower lip may be used. Chin retrusion or prominence up to an angle of 15° retrusion to −5° prominence is deemed acceptable. Surgery is desired from chin prominence of greater than −15° and retrusions greater than 25°. The greater the retrusion or prominence of the chin from an angle of 0°, the less the perceived attractiveness and the greater the desire for surgical correction.

Role of Ancillary Procedures in Facial Rejuvenation.

Face-lift techniques have evolved beyond the concept of lifting and now include incorporating superficial and deep filling of facial fat compartments to address volume deflation and aging. In addition to traditional face-lift methods involving the excision and tightening of skin and the underlying soft tissues, the following ancillary procedures have become paramount in achieving an optimal result: blending the lid-cheek junction; chin augmentation; lobule augmentation; hand rejuvenation; perioral rejuvenation; chemical peels; and laser resurfacing. We presented a summary of these integral techniques.

A “surgical guide” for genioplasty

A “surgical guide” for genioplasty

Mentalis muscle resuspension. The foundation for chin surgery

Background: The Mentalis Muscle is one of the main supporting anatomical entities of the soft tissues of the lower lip and chin. A Mentalis muscle dysfunction can result in lower lip ptosis, eversion of the lower lip, lip incompetence, and esthetic disharmony with unnatural exposure of the lower incisors. The most common etiological factor we have seen is previous genioplasty procedures where there was a failure to resuspend the mentalis muscle at the time of the initial surgery. Traditional muscle suspension techniques will fail to obtain acceptable outcomes in these cases.

Chin Augmentation Using Silastic Implants.

An aesthetically pleasing face is centered on strength, symmetry, and balance. A defined, well-projected chin and jawline are crucial to this harmony and recontouring the lower third of the face plays a significant role in plastic surgery. Chin augmentation can be performed with injectables, implantation, or osseous genioplasty. The selection of the best procedure is based on the type and extent of deformity. This article reviews chin augmentation with emphasis on alloplast implantation. The relevant anatomy, patient evaluation, implant indications and limitations, alloplast selection, and surgical techniques in implantation are presented.

Investigation of the presence and variation of the ascending mental artery: Conventional dissections and ultrasonographic study.

Tongue and mouth floor infarction following filler injections for chin augmentation is a rare complication that has the increase in incidence been reported. This study investigated the arterial anastomosis between the submental and sublingual arteries that can lead to the emboli and subsequent tongue infarction during chin augmentation. Forty-two formaldehyde-embalmed cadavers and four soft-embalmed cadavers were dissected to verify the incidence and source of the ascending mental artery. Ultrasonographic study of the artery was performed in 10 healthy volunteers. Attention was paid to discriminate whether the ascending mental artery arose from the submental artery or the sublingual artery using the arch of the mylohyoid muscle as the discriminating landmark. Incidence of ascending mental artery from the sublingual artery was 7.1% in the studied population. All ascending mental arteries were 0.7±0.2mm in diameter at the mental protuberance and were branches of the submental artery that arose from the facial artery, except for two arteries that arose from the sublingual artery. Ultrasonographic study revealed that one left and one right sublingual artery from the lingual arteries penetrated the mylohyoid muscle near the midline to become the ascending mental artery in two volunteers. The ascending mental artery from the other side continued from the submental artery. Findings from the cadaveric dissections and ultrasonographic study revealed that the ascending mental artery may be a branch that continues from the lingual artery, or communicates with the sublingual artery through the mouth floor.

Anterior open bite correction with hybrid FLOWJAC® system devices, patient with previous Chin bone resorption. Case report.

The orthodontic minitubes system (FLOWJAC ® System, Bogotá, Colombia) is an innovating system that blend the selfligating philosophy techniques and a lowprofile appliance. The FLOWJAC® System works with low orthodontic forces, same as selfligation devices. The system uses heat-treated wires with better physical properties such as hysteresis when is compare with traditional wires. However, the FLOWJAC® technique doesn´t use a wire sequence to get a “working wire”, just a 0,014 Copper NiTi. The clinician in each appointment must modify the minitube location to the clinical desire teeth position. The present report blend FLOWJAC® devices in the upper arch and clear selfligation in the lower arch. The patient treated has mandibular bone resorption due a alloplastic chin augmentation. The root apex from first right premolar to the first left premolar seen to be near to the resorption area using Cone Beam Computer Tomography. That´s the reason why we use a pre-adjust devices in the lower arch, to avoid pulpar and periodontal counter effects. This case was finished with proper functional and aesthetics objectives; such as molar and canine class I, anterior open bite closure with 20% of overbite, coincidence of dental smile arch with lower lip, and without root and pulpar counter effects. The porpoise of this report is to present an orthodontic case with bone resorption on right premolar and incisors area of the mandible. The case was treated with selfligation orthodontics system; FLOWJAC® System in the upper arch and Empower Clear® (American Orthodontics Shebboyiang, USA) in the lower arch and could be done with a precise diagnosis and adequate treatment planning.

Vascular and Nerve Relations of the Marginal Mandibular Nerve of the Face: Anatomy and Clinical Relevance.

The marginal mandibular nerve of the facial nerve is frequently injured during corrective and cosmetic surgery. Recent or emerging techniques such as the injection of filler materials, botulinum toxin, allotransplantation of composite tissues of the face, placement of chin implants, and submental cryolipolysis require in-depth knowledge of this nerve. The studies to date are not in agreement regarding the number of branches of the marginal mandibular nerve and its relationship with the vasculature and other nerves. This study involved 62 half-heads from cadavers. In 22.6 percent of the cases, the marginal mandibular nerve of the facial nerve was a single branched entity and lateral to the pedicle, with respect to the facial artery and the facial vein. In 16 cases (29 percent), the marginal mandibular nerve had two branches. In 12.9 percent of the cases, the marginal mandibular nerve gave rise to three branches. In 17 cases (35.48 percent), the marginal mandibular nerve gave rise to between four and more than 10 branches, thereby forming a plexus at its end. Analysis of this collection of cases revealed that the marginal mandibular nerve was more consistently lateral to the facial vein than to the facial artery. The marginal mandibular nerve exhibited connections with other branches of the facial nerve and branches of the trigeminal nerve. The facial vein had a more consistent relationship with the marginal mandibular nerve than the facial artery. This study provides the anatomical bases of substitution, proprioception, and clinical variations in injuries of the marginal mandibular nerve and in their prognosis.

Which nostril should be used for nasotracheal intubation with Airtraq NT®: the right or left? A randomized clinical trial

Background/aim Nasotracheal Airtraq is specifically designed to improve the glottis view and ease the nasotracheal intubation process in normal and difficult cases. Materials and methodsAfter Ethics committee approval, we decided to enroll 40 patients with an ASA physical status of I or II, between 18 and 70 years of age undergoing elective maxillofascial, oral, and double chin surgery to determine which nostril is more suitable for nasotracheal intubation with nasotracheal Airtraq. Patients were randomized into the right and left nostril groups. Results Demographic and airway characteristics were similar among the groups. Nasotracheal intubation through the right nostril was shorter than that of the left nostril during nasotracheal intubation with the Airtraq NT (P < 0.001). 90° counterclockwise rotation of the tip of the tube was needed for directing the tube into the vocal cords in both right and left nostril groups (72% vs 88%). External laryngeal pressure and head flexion maneuvers can ease the intubation from the left nostril (P < 0.001 vs P = 0.03). Cuff inflation maneuver also can be helpful in some cases. We did not need any operator change or Magill forceps for any of the patients. Conclusion Nasotracheal intubation via the right nostril can be safely and quickly performed with the Airtraq NT without the need of Magill forceps. We recommend the use of the 90° counterclockwise rotation, external laryngeal pressure, and head flexion maneuvers to direct the tube into the vocal cords first. On the other hand, cuff inflation maneuver must also be kept in mind.