Rhytidectomy Research Articles

Re: Pilot study on efficacy and patient satisfaction with 1,450-nm laser boosting treatment after a thread lift procedure

Re: Pilot study on efficacy and patient satisfaction with 1,450-nm laser boosting treatment after a thread lift procedure

Corrigendum: Pilot study on efficacy and patient satisfaction with 1,450-nm laser boosting treatment after a thread lift procedure

Corrigendum: Pilot study on efficacy and patient satisfaction with 1,450-nm laser boosting treatment after a thread lift procedure

The Ponytail Lift: 22 Years of Experience in 600 Cases of Endoscopic Deep Plane Facial Rejuvenation.

During aging, the face loses volume with progressive sagging of the soft tissues, while the neck demonstrates skin laxity and muscle banding. The treatment of facial and neck aging usually involves a traditional facelift, which can cause noticeable scarring and distortion of anatomy. Modern facelift surgery must avoid such shortcomings and still address aging in all layers of the face. To achieve this goal a novel surgical technique was developed and coined the "ponytail lift" (PTL). When global facial rejuvenation is indicated, this procedure is combined with neck skin excision and referred to as the "ponytail facelift" (PTFL). A retrospective analysis of 600 consecutive cases over 22 years (2000-2022) of facial rejuvenation employing the endoscopic techniques of PTL and PTFL was performed. Patients were followed for at least 12 months postoperatively. Demographics, surgical data, and complications were recorded and analyzed. Additionally, technical details of the PTL and PTFL are discussed. There were no instances of postoperative skin flap necrosis, and no permanent nerve injuries were recorded. An additional surgical touch-up procedure to address unsatisfied aesthetic needs was performed in 20 cases. The ponytail procedures offer a stepwise approach matched to the extent of the problem and are intended to refresh or transform the face with minimal incisions. The procedures represent a deep plane facelift without the scar burden, with incisions that are hidden in the temple, postauricular, and posterior scalp. The described techniques are safe and effective while providing reliable and satisfying results.

ASSOCIATION OF SCULPTRA WITH MICROFOCUSED ULTRASOUND FOR FACIAL REJUVENATION

With the increasing demand for an improvement in the appearance of the skin, technologies have advanced more and more each day, providing excellent visible and lasting aesthetic results in facial rejuvenation. A procedure that is currently in great demand and has proven to be effective is poly-L-lactic acid - Sculptra, an injectable collagen bio-stimulator that offers a non-surgical alternative with minimally invasive techniques that promises to improve and consequently delay skin aging. Another device that offers non-invasive therapy, indicated for facial lifting, sagging treatment and reduction of localized adipose tissue is the Microfocused Ultrasound – Ultraformer III. The work briefly addressed skin aging for a better explanation and aims to evaluate the effectiveness of the association of poly-L-lactic acid – Sculptra with Microfocused Ultrasound – Ultraformer III in a case study with two applications over a period of 60 days. Each of these biostimulators mentioned has certain attributes, providing an improvement in the appearance and characteristics of aging. In view of this, the sum of the two techniques demonstrates positive results according to stereographic analysis with the 3D Vectra H2 software and appropriate according to the anamnesis and problems presented by the patient.

Top 50 Highly Cited Publications in Facelift Surgery: A 50-Year Bibliometric Analysis Review.

Facelift surgery, also known as rhytidectomy, is a commonly performed procedure to address aging-related changes in the face and neck. Over the years, its techniques and methodologies have evolved. This study aimed to provide a bibliometric analysis of the top 50 most cited publications related to facelift surgery over a fifty-year period (1973-2023). The authors obtained data from the Web of Science Core Collection on July 15, 2023. Using a predefined search strategy, the most cited articles from 1973 to 2023 on facelift surgery were identified. The publications were analyzed for their type of study, journal of publication, geographic origin, and primary outcomes. Furthermore, the authorship gender distribution was assessed. The majority of the publications (34 out of 50) were published in the "Plastic and Reconstructive Surgery" journal. The USA contributed to 72% of the research, followed by the UK, Mexico, Australia, and Germany. The primary outcomes varied from surgical techniques, anatomical studies, risk factors, patient-specific outcomes, and facial rejuvenation techniques, to comparative and historical progression of techniques. Notably, male authors dominated the field with 47 out of 50 papers having both a first and senior male author. Facelift surgery has seen substantial research development over the past fifty years. The USA has been at the forefront of this research, with a predominant focus on surgical techniques and anatomical studies. Male dominance in authorship indicates potential scope for increased gender diversity in this specialty. Annual updates are recommended for continued insights. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Free Dermal Fat Grafting: A Novel Technique for the Correction of Nasolabial Folds During Facelift Surgery.

Traditional facelift surgery does not behave well in the correction of nasolabial folds, which is a common clinical problem and needed to be improved. To investigate the effect of free dermal fat grafting during facelift surgery for the treatment of nasolabial folds. This prospective cohort study involved 80 patients with moderate to severe nasolabial folds and facial skin dermatolysis. Fifty of them underwent facelift surgery combined with free dermal fat grafting, and 30 of them underwent traditional facelift surgery. These patients were followed up 2 months, 6 months, and 1 year after the surgery to evaluate the effect. The difference in Wrinkle Severity Rating Scale (WSRS) scores, assessed at each follow-up, between the patients who underwent and did not undergo free dermal fat grafting during facelift surgery, was statistically significant. For patients who underwent free dermal fat grafting during facelift surgery, the WSRS scores assessed at 2 months, 6 months, and 1 year after the surgery were significantly different from those before the surgery. The analytic results of FACE-Q indicated a high level of overall satisfaction rate. No major complications were recorded. Free dermal fat as a filler for nasolabial folds can achieve excellent therapeutic effect. The combination of facelift surgery with free dermal fat grafting for the treatment of nasolabial folds can provide very good long-term results and a high patient satisfaction rate for patients with symptoms of facial aging such as facial dermatolysis, obvious wrinkles, and deep nasolabial folds.

Cosmetic facial surgery: a bird's eye view

Surgical procedures that rejuvenate and/or harmonize the face are known for their long-lasting and clinically relevant positive effects on the psychological well-being and quality of life of the client. Despite the popularity of cosmetic injectables, facelift surgery remains the most powerful and durable treatment for restoring aging symptoms, especially in the female face. Skin correction of the upper eyelids is the most commonly performed aesthetic facial surgery. This article provides an overview of the most important cosmetic surgical procedures for the face, focusing on the facelift, neck lift, forehead lift, upper and lower eyelid correction, subnasal lip lift and rhinoplasty. The indications, contraindications, treatment techniques, advantages and disadvantages are explained. Due to the increasing demand for cosmetic treatments, it is important that dentists and oral and maxillofacial surgeons have knowledge of these procedures in order to provide optimal information, referral or treatment when desired.

Ultrasound‐guided thread lifting for the prevention of parotid gland and diagnosing parotid duct complications

AbstractBackgroundThread lifting is a common minimally invasive plastic surgery procedure. Parotid gland injury caused by thread lifting is a known complication; however, visual evidence of this complication is lacking.ObjectivesThis study aimed to present cases of parotid gland injury by thread lifting shown using ultrasound and to discuss the importance of ultrasound detection of the location of the parotid gland before thread insertion.MethodsThis study included eight patients diagnosed with parotid gland perforation and one with parotid duct injury due to threads from November 2020 to October 2022.ResultsSix patients showed tenderness and swelling, three were asymptomatic, and one with duct injury showed severe swelling and pain. Although the severity and duration of symptoms have differed, we confirmed the progress of improvement with conservative treatment and confirmed ultrasound findings progressed.ConclusionsUsing ultrasound to detect the parotid gland's location before thread lifting might reduce the chance of parotid duct injury. Identifying immediate parotid duct or gland injury with ultrasound can help to act quickly for delayed pain or swelling and reduce the likelihood of additional complications.

Facial Contouring after Permanent Filler Removal with Combined Facelift and Fat Grafting: A Case Series

Background: Aesthetic procedures for addressing aging range from simple injection of dermal fillers to facelift surgery. The last few decades have witnessed the development of diverse techniques to minimize facial wrinkles, volumize the face, and restore a youthful appearance. For example, fillers are a group of compounds used for cosmetic and reconstructive purposes, especially related to the face. Therefore, this study aimed to demonstrate specific cases where problematic dermal fillers were evacuated in combination with facelift procedures and fat grafting. It therefore demonstrates means to manage and treat permanent filler complications with a multidisciplinary evidence-based approach to achieve functional and cosmetic outcomes. Methods: Between January 2020 and August 2022, 50 patients were subjected to drainage of permanent dermal filler followed by facelift and fat grafting with a minimum 6-month follow-up recorded. Results: A total of 50 female patients between 30 and 56 years of age underwent permanent dermal filler removal in conjunction with facelift and fat grafting. The surgery was successful in all cases, but four cases of seroma and four cases of facial mandibular nerve neuropraxia, five cases of scar hypertrophy, two cases of wound infection and one case of pixie ear deformity were encountered during the follow-up. Conclusion: In this study, we present the characteristics of combining facelift and fat grafting procedures after surgical drainage of permanent dermal fillers to achieve aesthetically favorable results.

Post-Face Lift Facial Paralysis: A 20-Year Experience.

Facial nerve (FN) injury during a face lift is a relatively rare but potentially devastating complication. Despite extensive literature discussing FN anatomy and danger zones, few studies describe detailed management, FN exploration intraoperative findings, and outcome after post-face lift facial paralysis (PFFP). The authors reviewed a 20-year experience in managing iatrogenic PFFP. Patients with PFFP were retrospectively identified between 2002 and 2022. Demographic data, operative details from the face lift procedure, facial function after face lift, medical and surgical management, intraoperative findings, and long-term outcomes were analyzed. A total of 25 patients who experienced PFFP were referred for evaluation over the past 20 years. Eight patients required FN exploration, 6 of whom underwent nerve repair; all recovered to some degree, with 50% achieving essentially normal facial function. Fourteen patients underwent nonsurgical management, including physical therapy, chemodenervation, and filler therapy. Of these nonsurgical patients who were not lost to follow-up, 50% achieved normal facial function and 42% achieved nearly normal facial function. The single patient who had no spontaneous improvement presented outside the reinnervation window and was not an operative candidate. PFFP outcome depends on injury type and location, accurate assessment, and appropriate treatment; however, the overall prognosis is favorable. FN exploration is warranted when nerve transection is suspected. Observation is suitable for patients demonstrating early signs of recovery. Patients presenting beyond a reasonable reinnervation window will need other facial reanimation techniques. When FN exploration is required, outcomes may be superior in a facial nerve center setting. Adjunctive interventions for symmetry improvement while awaiting recovery are available. Therapeutic, IV.

RETRACTION.

Sahan A, Karaosmanoglu N, Ozdemir P. Is it possible to obtain long-lasting results with thread lift in the brow region? Introduction of a new suspension technique and evaluation of 50 patients. J Cosmet Dermatol. 2023; vol 22, iss 6:1863-1869. https://onlinelibrary.wiley.com/doi/full/10.1111/jocd.15658 The above article, published online on February 10, 2023, in Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the authors, the journal's Editor-in-Chief, Michael H Gold, and Wiley Periodicals, LLC. After publication, the authors informed the editorial office that they had been unable to obtain ethics committee approval for the study although initially stating that the approval was already at submission.

Long-Term Improvement of Crow's Feet Wrinkles in Combination With Cervicofacial and Temporal Lifting: Review of the Literature.

The lateral orbital crow's feet area is one for which rejuvenation is most frequently requested by patients. Moreover, lateral canthal wrinkles are a common source of dissatisfaction after rhytidoplasty. Botulinum toxin injection has emerged as a most popular, easy, and effective solution; nevertheless, repeated injections are required periodically for long-term effect. Other nonsurgical options have also been described to have some demonstrable advantages. Orbicularis oculi surgical manipulations have been described as well. A systematic PubMed literature search was conducted to identify clinical cohort studies including more than 10 patients describing surgical approaches for improvement of crows' feet wrinkles in combination with face and/or temporal lifts. The search was complemented by Embase, Medline, and Cochrane searches in addition to screening of reference lists of selected studies and simple term searches about surgical treatment of crow's feet. Fourteen studies satisfied the inclusion criteria and were included in this review describing various muscle excision techniques including vertical strip excision, lateral partial resection, wedge resection, muscle resection in "C" pattern, and enlarged myectomy of about one-third of the whole orbital extension in addition to muscle manipulation modalities, including muscle splaying, muscle division, muscle division and splaying, muscle undermining with partial denervation, and muscle suspension. Interposition of fascia between orbicularis muscle and overlying skin was also reported. View the few studies retrieved and the wide spectrum of reported techniques, it is not possible to determine from this review the most effective modality. Nevertheless, it seems that subcutaneous undermining of the lateral canthal area combined with splaying and traction of the orbicularis oculi muscle and fixation to the temporalis fascia with or without muscle division would yield the best long-term results. This review indicates also that surgical correction of crow's feet during rhytidectomy or temporal lift could be a positive complement to improve aesthetic outcome. Unfortunately, if not underreported, it is definitely neglected. We believe that this review may be an eye-opener for surgeons.

Recent Fluctuations in Public Searches for Cosmetic Procedures as Shown by Google Trends.

The goal of this study is to understand the dynamic trends of 20 cosmetic procedures in the United States using Google Trends. This was a descriptive cross-sectional study using Google Trends to measure changes in search volumes for 20 cosmetic procedures from a 5-year period (2018 to 2023) in the United States. Outcome measures included total and weekly changes in relative search volumes and variance levels for the following 20 search terms related to cosmetic surgeries: blepharoplasty, botox, breast augmentation, breast lift, brow lift, buccal fat removal, chemical peel, dermal filler, face lift, hair removal, hair transplant, lip filler, liposuction, masseter botox, microneedling, otoplasty, photofacial, rhinoplasty, tear trough filler, and tummy tuck. Search terms were divided into 3 categories, a) those with a change of public interest over a single week of 25% or less, b) 26%-50%, and c) greater than 50%. There was an overall 5-year increase of public interest in all but 5 search terms: breast augmentation, breast lift, liposuction, photofacial, and tummy tuck. Within a single week, lip filler, masseter botox, buccal fat removal, and tear trough filler exhibited greater than 50% change in public interest, while public interest in microneedling, hair removal, rhinoplasty, tummy tuck, liposuction, breast lift, and augmentation were more stable with less than 26% change. While certain procedures may experience rapid accelerations in public interest, not all procedures will consistently increase in popularity. Physicians must recognize the shifting popularity of cosmetic procedures to provide informed cosmetic care to patients.

Augmented and Virtual Reality Applications in Facial Plastic Surgery: A Scoping Review.

Augmented reality (AR) and virtual reality (VR) are emerging technologies with wide potential applications in health care. We performed a scoping review of the current literature on the application of augmented and VR in the field of facial plastic and reconstructive surgery (FPRS). PubMed and Web of Science. According to PRISMA guidelines, PubMed and Web of Science were used to perform a scoping review of literature regarding the utilization of AR and/or VR relevant to FPRS. Fifty-eight articles spanning 1997-2023 met the criteria for review. Five overarching categories of AR and/or VR applications were identified across the articles: preoperative, intraoperative, training/education, feasibility, and technical. The following clinical areas were identified: burn, craniomaxillofacial surgery (CMF), face transplant, face lift, facial analysis, facial palsy, free flaps, head and neck surgery, injectables, locoregional flaps, mandible reconstruction, mandibuloplasty, microtia, skin cancer, oculoplastic surgery, rhinology, rhinoplasty, and trauma. AR and VR have broad applications in FPRS. AR for surgical navigation may have the most emerging potential in CMF surgery and free flap harvest. VR is useful as distraction analgesia for patients and as an immersive training tool for surgeons. More data on these technologies' direct impact on objective clinical outcomes are still needed. N/A Laryngoscope, 134:2568-2577, 2024.

Is Bipolar Radiofrequency-Assisted Liposuction Equivalent to Open Anterior Platysmaplasty in Facelift Surgery?

BackgroundDuring facelift surgery, anterior platysmaplasty (AP) has been used for decades, but it limits lateral advancement and can induce contour irregularities. Radiofrequency-assisted-liposuction (RF) in the anterior neck can avoid these disadvantages by tightening skin without open surgery. PurposeThe purpose of the study was to compare the esthetic outcomes in facelift surgery with AP and RF. Study designA five-year retrospective cohort study was performed on facelift patients treated by a single surgeon. Exclusions were single-side surgery, previous facelift, chin/lip augmentation/reduction, and inadequate data. Primary predictor variableThe predictor variable was neck management technique (AP vs RF). Outcome variablesThe primary outcome variable was the change in cervicomental-angle (CMA) following surgery as measured on facial photographs. Secondary outcomes included distance changes from the central CMA point in vertical and horizontal planes to repeatable reference planes. CovariatesCovariates were age, BMI, ASA classification, smoking, and simultaneous procedures. AnalysesThe statistical analysis was performed using Wilcoxon sum-rank, Fisher exact, Kruskal-Wallis tests, Pearson’s correlation, and linear regressions. The level of statistical significance was P<.05. ResultsThere were 132 patients included in the study; 67 received AP and 65 received RF. AP trended toward better performance in CMA change in the unadjusted analysis (-18.7° ± 13.8° versus -22.3° ± 13.7°, respectively, P=.08). AP and RF performed similarly in the adjusted analysis (P=.29). Techniques were similar in horizontal distance change to the CMA (P=.31). RF was associated with less change in the vertical distance to the CMA in the unadjusted analysis (-11.9mm ± 11.0mm versus -6.7mm ± 8.7mm, respectively, P=.01) and adjusted analysis (β=4.3mm, 95% CI .8 to 7.9mm, P=.02). ConclusionUtilization of the RF technique for management of the anterior neck in facelift surgery is associated with similar outcomes to the AP technique in horizontal distance to the CMA but, AP performed better in CMA change and vertical distance to the CMA.

Thread lifting as a modern method of non-radical face rejuvenation

Purpose of the study: The purpose of this review of scientific literature is to collect, systematize and update modern ideas about the types, methods and principles of thread lifting, taking into account the basic requirements for efficiency and safety.In this paper, we reviewed publications presented in scientific databases: Web of Science, Scopus, PubMed, Cochran library, Medline, and PubMed Central. The keywords for searching for materials were: thread lift, thread lift history, thread lift sutures, face thread lift, polylactic threads, polydioxanone threads.The earliest approach to the effective use of thread rejuvenation techniques was the use of non-absorbable threads based on polypropylene, which are still successfully used along with modern threads, among which a special place is occupied by absorbable threads and new modifications of non-absorbable ones, complemented by various fixing design features (notches, cones).A large selection of threads, techniques and principles of correction allows specialists to create an individual management plan for each patient, and continuity and synergy between the sequential use of different modifications of threads allows one to prolong the results obtained and delay or refuse more radical anti-aging surgeries on the face.At the same time, as a result of the review of the scientific literature, no published studies were found on the comparative analysis of thread and surgical methods of rejuvenation, which requires further study.

Menopause in Plastic Surgery Patients: An Underrecognized and Undertreated Comorbidity.

Nearly half of all patients undergoing plastic surgery are middle-aged cisgender women, all of whom will experience menopause. Plastic surgeons do not treat menopause directly, but it can be a concern-and even a motivating factor-for patients seeking plastic surgery. In addition, the changes associated with menopause underlie problems that many plastic surgeons seek to address, including with face lifts, breast surgery, and vaginal rejuvenation. Hormone replacement therapy has the potential to improve quality of life by treating bothersome symptoms and delaying the physical changes brought on by loss of estrogen. However, recent reports in the media highlight that women face significant barriers to accessing menopause care due to a lack of trained providers willing to manage hormone replacement therapy, as well as historical concerns regarding increased cancer risk, which recent evidence suggests were overestimated. Plastic surgeons may be the first, or only, providers with whom women discuss how their bodies change with age. As a result, plastic surgeons should consider menopause as an underlying risk factor or comorbidity for any woman presenting with aging-related complaints, and to ensure that these patients have access to appropriate menopause care in their communities. This is especially important for surgeons offering vaginal rejuvenation therapies, given that locally acting topical estrogen is a safe and highly effective treatment. The authors present guidance and recommendations for how plastic surgeons should take menopause into account when evaluating and advising patients. In addition, the authors present a treatment algorithm for safe prescribing of locally acting hormone replacement therapy for vaginal rejuvenation.

ELift, Helium Plasma Radiofrequency (Renuvion) Subdermal Treatment and Minimal Access Face and Neck Lift, is an Effective Facial Rejuvenation Technique with Minimal Downtime

eLift, Helium Plasma Radiofrequency (Renuvion) Subdermal Treatment and Minimal Access Face and Neck Lift, is an Effective Facial Rejuvenation Technique with Minimal Downtime

The Understanding and Stability of Insertion Layers in Thread Lift

The Understanding and Stability of Insertion Layers in Thread Lift

Advancements in Facelift Surgery Instrumentation: Modifications to Trepsat Spatula-Tipped Facelift Scissors—A Letter to the Editor

Advancements in Facelift Surgery Instrumentation: Modifications to Trepsat Spatula-Tipped Facelift Scissors—A Letter to the Editor