Facial Aesthetics Research Articles

Hair transplantation using long hair follicular unit excision technique in scarring alopecia of eyebrow: A case report

Hair transplantation remains a safe treatment option for patients who either desire to make the eyebrows appear fuller or the need to restore facial aesthetics in cases with scarring, as eyebrows constitute a prominent feature of the face. The increased aversion to undergoing head shaving due to occupational, social, and/or personal reasons in many patients, has led to the increased demand of non-shaven/long hair follicular unit excision (NSFUE) technique. With the advent of this technique, surgery is unnoticeable and a preview of upcoming results is achieved immediately after the procedure. With only a handful cases reported in world literature, we report the successful outcome of eyebrow transplantation using the NS-FUE technique in a 25-year-old female with post-traumatic scarring alopecia of eyebrow.

Removal of bacterial biofilm in patients undergoing fixed orthodontic treatment: a literature review

Orthodontic treatment is highly popular for restoring functional and facial esthetics in juveniles and adults. However, the prevalence of biofilm-related complications remains high. The objectives of this review are to 1) identify which of the two professional prophylaxis systems analyzed, rubber cup polishing (RCP) and air-powder polishing (APP), is the most effective in removing bacterial biofilm in patients undergoing fixed orthodontic treatment, and 2) the comfort expressed by the patient and any damage caused to the orthodontic device. The search yielded 23 scientific articles, 14 of which were excluded, and 6 met the inclusion criteria. From the studies analyzed, it is, therefore, possible to state that the APP technique is more effective than the RCP technique in removing dental plaque, and treatment is less time-consuming and safer concerning orthodontic devices, as none of the scientific articles examined did APP cause any damage to the orthodontic device or debonding of the brackets.

Customised cheek plumper for completely edentulous patient- A clinical report

Facial aesthetics is of utmost importance in person’s life. Aging is associated with loss of teeth, residual ridge resorption and reduced tonicity of the facial muscles, leading to an unesthetic appearance and sunken cheeks in some individuals. Aesthetics in such individuals seeking complete dentures can be improved with the help of cheek plumper by supporting and lifting the cheeks. This article describes an innovative, simple, cost-effective attachment system made by modifying the casted sprue as mode of attachment in completely edentulous patient requiring complete denture prostheses with detachable cheek plumper.

Use of Paramedian Forehead Flap in an Octogenarian:A Case Report.

Increase in life expectancy has led to increased number of octogenarian and nonagenarians population. These old people have increased chances of developing skin tumours like slow growing basal cell carcinoma on the sun exposed parts of body. Many a times surgeons all over the world are bit conservative in managing these elderly patients and compromise on cosmetic aspects due to very advanced age of these patients. This report is about an 87-year-old female with BCC of nasal dorsum who underwent a major surgical procedure to maintain facial aesthetics.

Rehabilitation of severe dentofacial deformity after early radiotherapy of retinoblastoma: a case report

BackgroundRetinoblastoma is an intraocular cancer of infancy and childhood, which has been treated with radiation therapy and chemotherapy. Radiation on growing patients can cause deterioration in maxillofacial growth and development that leads to severe skeletal discrepancies between the maxilla and mandible, and dental problems such as crossbite, openbite, and hypodontia.Case presentationWe present the case of a 19-year-old Korean man with chewing disability and dentofacial deformities. He had undergone enucleation of the right eye and radiation therapy of the left eye due to retinoblastoma 100 days after birth. Subsequently, he received cancer therapy for the secondary nasopharyngeal cancer at the age of 11 years. He was diagnosed with severe skeletal deformity including sagittal, transverse, and vertical growth deficiency of the maxilla and midface, and with class III malocclusion, severe anterior and posterior crossbite, posterior openbite, multiple missing upper incisors, right premolars, and second molars, and impaction of the lower right second molars. To restore impaired functions and esthetics of the jaw and dentition, the orthodontic treatment combined with two jaw surgery was performed. At the end of surgical orthodontics, dental implants were placed for prosthetic treatment of missing teeth. Additional plastic surgery for zygoma elevation was done with calvarial bone graft followed by fat graft. Facial esthetics and occlusal functions of patient were favorably enhanced with the improvement of skeletal discrepancy and the rehabilitation of maxillary dentition by prosthetic work. At the 2-year follow-up, the skeletal and dental relationships and implant prosthetics were well maintained.ConclusionIn an adult patient with dentofacial deformities caused by early cancer therapy in the head and neck area, interdisciplinary interventions including additional plastic surgery of zygoma depression and prosthetic work of missing teeth as well as surgical–orthodontic treatment could establish favorable facial esthetics and oral rehabilitation.

Working whilst studying: a survey of medically-qualified dental students

Medically-qualified junior trainees who are interested in oral and maxillofacial surgery (OMFS) are faced with the challenging decision to undertake the minimum three years required to obtain a Bachelor of Dental Surgery (BDS) with its associated expenses and loss of income from full-time employment, or to follow a different career path. Trainees have reported duration of training and financial factors, such as cost of attaining additional qualifications and loss of income, as common reasons for loss of interest in OMFS. This survey of students enrolled on King’s College London’s three-year BDS dentistry entry programme for medical graduates (DPMG)shows that most studentsundertake paid part-time work in various settings and specialties alongside their studies. The average number of hours worked by students whilst studying is reported to be 27.0/week. Students report a wide range of incomes from various sources including secondary-care shifts in the NHS and private sector, as well as non-secondary-care activities such as non-surgical facial aesthetics. Direct correlation is noted between the number of hours worked and earnings, with comparable potential income in OMFS and non-OMFS specialties. Participants working in OMFS report greater educational and training value compared with non-OMFS work.

Comparison of Mean Upper Lip Length in Individuals with Competent Lips, Lips Apart and Incompetent Lips

Background: The human lips are the essential structure for speech, facial expression and oral functions like eating, drinking and breathing. The orthodontic treatment is very crucial for the advancement of the facial expression Lip incompetence is a condition in which the lips fail to close adequately leading to negative effects on speech, facial esthetics and oral functions. Study design: It is a retrospective study conducted at WATIM Dental College Rawat, Rawalpindi and Altamash Institute of Dental Medicine, Karachi for the duration of six months from Jan 2022 to June 2022. Material and Methods: The patients were divided into three groups. The patients that did not follow the inclusion criteria were excluded from the study. Group I had patients with competent lips, group II had patients with their lips apart and group III had incompetent lips. There were 45 patients in each group. Results: The length of group I members was 19.8 mm for men and 18.7 mm for women, which was less than group III individuals with 20 mm and 18.9 mm average upper lip length for males and females. Group II patients had a length of 17.5mm for male patients and 16.4 mm for female patients. The P-value was calculated and the results were statistically significant. Conclusion: The length of group I members was 19.8 mm for men and 18.7 mm for women, which was less than group III individuals with 20 mm and 18.9 mm average upper lip length for males and females. Group II patients had a length of 17.5mm for male patients and 16.4 mm for female patients. Keywords: Lip incompetence and competent lips.

Association of Body Mass Index (BMI) with Lip Morphology Characteristics: A Cross-Sectional Study Based on Chinese Population

Lip morphology is essential in diagnosis and treatment of orthodontics and orthognathic surgery to ensure facial aesthetics. Body mass index (BMI) has proved to have influence on facial soft tissue thickness, but its relationship with lip morphology is unclear. This study aimed to evaluate the association between BMI and lip morphology characteristics (LMCs) and thus provide information for personalized treatment. A cross-sectional study consisted of 1185 patients from 1 January 2010 to 31 December 2020 was conducted. Confounders of demography, dental features, skeletal parameters and LMCs were adjusted by multivariable linear regression to identify the association between BMI and LMCs. Group differences were evaluated with two-samples t-test and one-way ANOVA test. Mediation analysis was used for indirect effects assessment. After adjusting for confounders, BMI is independently associated with upper lip length (0.039, [0.002-0.075]), soft pogonion thickness (0.120, [0.073-0.168]), inferior sulcus depth (0.040, [0.018-0.063]), lower lip length (0.208, [0.139-0.276]), and curve fitting revealed non-linearity to BMI in obese patients. Mediation analysis found BMI was associated with superior sulcus depth and basic upper lip thickness through upper lip length. BMI is positively associated with LMCs, except for nasolabial angle as negatively, while obese patients reverse or weaken these associations.

Prediction of the Postoperative Bone Regeneration Rate After Mandibular Reduction: From the Perspective of Preoperative Inflammatory and Immune Status.

Following mandibular reduction, bone regeneration in the angle region is a problem that can affect facial aesthetics and lead to revision surgery. The bone regeneration rate (BRR) varies between individuals and is difficult to predict. However, studies focusing on preoperative patient-related factors are lacking. As bone regeneration is closely related to the inflammatory and immune status of the organism, according to in vitro and in vivo evidence, preoperative inflammatory indicators were included in this study as potential predictors. Demographic and preoperative laboratory data were included as independent variables. The BRR calculated from computed tomography data was included as the dependent variable. Univariate analysis and multiple linear regression analysis were used to determine the key factors influencing the BRR. The ROC curves were used to analyse the corresponding predictive efficacy. 23 patients (46 mandibular angles) fulfilled the inclusion criteria. The mean bilateral BRR was 23.82 ± 9.90%. Preoperative monocyte count (M) was an independent positive factor for BRR, and age was a negative factor. Only M had a good predictive ability, and its optimal cut-off point to distinguish patients with BRR greater than 30% was 0.305 × 109/L. Other parameters were not significantly correlated with BRR. Patient age and preoperative M may influence BRR, with M having a positive effect and age having a negative effect. According to the preoperative blood routine tests that are readily available, using the diagnostic threshold (M [Formula: see text] 0.305 × 109/L) derived from this study, surgeons can better predict BRR and identify patients whose BRR is greater than the mean level. 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 .

Evidencia de la efectividad del uso de aparatología ortopédica prequirúrgica en pacientes con labio y paladar hendido: revisión sistemática.

This review article aimed to evaluate the evidence on the use of a presurgical orthopedic appliance (POP) in patients with cleft lip and palate. The search was conducted using Medline/PubMed, Scholar Google, Clinical Trails, ProQuest, Scopus, and Web of Science databases. During the search, 7,926 records were found, of which 105 full-text articles were analyzed, and 23 studies included analysis in patients with the use of POP, and their control groups without the use of POP prior to the same type of surgery. The devices most used for POP in the management of LPH were: the passive palate (Hotz palate), the nasolaveolar moulding (NAM), the McNeil device, and finally, the T-traction. The primary outcomes evaluated were: facial aesthetics and nasal appearance; the evaluation of cephalometric measurements, upper airways, nasal fissure width, as well as anatomical references such as inter-canine and inter-tuberosity distances. In addition, studies that evaluated occlusion and phonation were found. The evidence from this literature suggests that the use of active appliances had a better effect than passive appliances in terms of facial aesthetics and approximation of the maxillary seg-ments for the closure of the fissure. However, the heterogeneity, the risk of bias, and the low quality of the studies do not allow to state firm conclusions.

Embellishing Emotrics for a More Complete Emotion Analysis: Addition of the Nasolabial Fold.

Background: The nasolabial fold (NLF) greatly contributes to facial aesthetics; changes to NLF depth and vector are disfiguring in patients with facial paralysis (FP). NLF parameters are integral to clinician-graded outcomes, but automated programs currently lack NLF identification capabilities. Objective: To incorporate an automated NLF identification and quantification function into the facial landmark program, Emotrics, and to compare new Emotrics-derived NLF data to clinician-graded electronic facial paralysis assessment (eFACE) data for accuracy. Methods: Photographs of 135 patients with FP were marked bilaterally, using identification markers manually placed on each NLF. A machine learning model was trained to automatically localize the markers using these data. Once Emotrics accurately identified the NLF and its corresponding vector, photographs of 20 additional patients who underwent facial reanimation procedures were assessed by the algorithm. Results: The enhanced Emotrics algorithm successfully identified the NLF, and measured the vector from midline, in a series of patients with FP. NLF vector data closely matched corresponding eFACE parameters. Furthermore, changes in NLF presence and vector were detected following facial reanimation procedures. Conclusion: The Emotrics program now provides critical NLF data, providing objective parameters for clinicians interested in changing NLF dynamics after FP.

Satisfaction With Facial Aesthetic Appearance Following Maxillomandibular Advancement (MMA) for Obstructive Sleep Apnea (OSA): A Meta-Analysis.

A large cohort of patients diagnosed with obstructive sleep apnea (OSA) require surgical intervention, sometimes in the form of maxillomandibular advancement (MMA), to correct their functional disturbance. Such a surgical procedure typically results in a slight modification of the patients' facial appearance. The purpose of the current systematic review and meta-analysis was to examine the rate of satisfaction with facial aesthetics post-MMA intervention and to assess its dependability on and relationship with other patient or treatment factors. Based on the literature currently available, and to the best of our knowledge, this is the first paper to draw on the topic analytically. A search was conducted on four electronic literature databases (Pubmed, Ovid, Science Direct, and Scholar). Using referred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), our inclusion criterion covered any case with adequate reported data pertaining to the research question up to June 2021. Three evaluator groups were utilized. Satisfaction was defined as either an obvious reported increase in fondness for facial appearance or a state of indifference to the cosmetic results of the conducted changes. Dissatisfaction was defined as a clear discontent with the post-operative esthetic results. A multivariate analysis of the data was conducted, and Chi-square tests for independence were used to detect any significant associations. A meta-analysis of proportion was employed to permit for Freeman-Tukey double arcsine transformation and stabilize the variance of each study's proportion. Cochran's Q was computed, and the significance level was gauged as a function of P value. Meta-analyses of proportion conducted for assessment of aesthetic appraisal following surgical MMA for OSA elucidated a significantly higher predilection towards aesthetic satisfaction after surgical MMA for OSA for all evaluator groups in the encompassed studies. 94.2% of patients were satisfied with their facial esthetics postoperatively. The vast majority of patients that undergo MMA for the correction of OSA report satisfaction with post-surgical facial aesthetics. The subjective assessment of this parameter by physicians and laypeople portrays an equivalently significant skew towardpost-surgical appearance improvement. MMA is a generally safe procedure that substantially contributes to enhancement of both overall quality of life and perceived aesthetic appeal.

Treatment Plan and Discussions of Class I with Smilestream: A Case Report

The aim of the study was to present a Class I case and the treatment plan related to orthodontic diagnosis. The chief complaint of a patient and his parents are crowded teeth upper and lower and anterior crossbite. “@I’m looking like a crocodile” were the first words of the boy sitting on the dental chair. The main task was functional but also esthetics because it was from the first important to him. The treated malocclusion is characterized with a narrow maxillary width and prominence of the mandible. The maxilla was deficient in anteroposterior and transverse dimensions, causing a slightly concave and unpleasant profile, a crossbite relationship of lateral incisors and upper and lower anterior crowding. The use of mechanics was preferred and accepted as a better solution for the patient according to the idea to generate well directed growth. The patient was 12 year-old boy with Class I malocclusion and anterior crossbite. A molar and canine class 1 and correction of the malocclusion were obtained. The improvement of facial aesthetics and smile enlarging were also ensured.

Single-Step Full-Face Surgical Treatment of the Facial Profile.

The present study was performed to describe how much affordable, feasible, and straightforward is the approach the authors called "single-stage full-face surgical profileplasty," tailored to greatly improve the surgery of the facial profiling setting and achieve complete profile correction at the same time. From January 2010 to May 2019, 113 patients (95 females and 18 males; aged 19 - 63 years) were surgically treated for full-face profile amelioration. Profile correction was performed by using a combination of five procedures out of other various previously experienced: forehead fat grafting, rhinoplasty, lip fat grafting, genioplasty, and submental liposuction. All patients were assessed at 1, 3, 6, and 12 months following surgery for assessing the surgical profile treatment (SPT) outcome and any possible side effects of the combined treatment. Facial profile stability at 1 year was taken as the completion point of this treatment. Arnett et al's "Soft Tissue Cephalometric Analysis" (1999) was used to clinically evaluate the soft tissues before and after the SPT. Patients' satisfaction was measured with the Client Satisfaction Questionnaire-8" at 3 and 12 months after surgery. Statistics were used for Arnett et al's evaluation. Almost all the values were consistent and reached the normal ranges indicated by Arnett et al (p < 0.001), confirming that the desired results of the surgical profileplasty have been achieved. Single-stage full-face surgical profile treatment helps in correcting faults of the global facial deformity, in every single treated area, providing an overall improvement in facial aesthetics and harmony. Obtaining the simultaneous correction in the whole face has also the advantage of avoiding multiple surgical procedures, reducing postoperative discomfort, and the overall risks for the patient due to multiple surgical and anesthetic procedures.

A case report on palatally positioned single mesiodens: common supernumerary tooth

Mesiodens is one of the commonest dental anomalies in children. It may be present in primary or early mixed dentition. It can also be found in permanent dentition. It affects dental as well as facial aesthetics. The reported prevalence of mesiodens is about 0.15% to 1.9%. It is one of the etiologic factors causing malocclusion in children. Therefore, dentists can make the parents aware about the possibilities of malocclusion and convince for the treatment as soon as possible.

An Assessment of the Reduction of Submental Fullness With ATX-101 (Deoxycholic Acid Injection) in the Expanded Safe Zone.

Background and objective Facial aesthetics have a huge impact on how individuals view themselves and areviewed by society. The aesthetics of the face are tremendously influenced by the shape of the chin and neck. In this study, we aimed to observe the outcomes in individuals after the use of ATX-101(deoxycholic acid injection) in an expanded safe zone for submental fullness. To ensure optimal outcomes and reduce the risk of adverse events, appropriate patient selection is the key. ATX-101treatment may be administered in combination with hyaluronic acid fillers, botulinum toxins,cryolipolysis, and radiofrequency treatment. This is the first study of its kind to becarried out at the national level in Pakistan. Materials and methods This was a quasi-experimental study conducted at the Rawalian Burn and Reconstructive Surgery Unit, Holy Family Hospital, Rawalpindi, Pakistan for a period of nine months, from 10-1-2021 to 11-10-2021. A total of 62 patients who fulfilled the inclusion criteria were enrolled. We recordedif any complications had occurred or not. Moreover, the total number of treatment sessions, the volume of injectables used, and the interval between sessions were also documented. ATX-101 package was injected into the treatment area. Due care was taken to avoidthe region of the marginal mandibular nerve. After the procedure, outcomes and complications were observed. Results In this study, patient satisfaction was reported in 59 (95.2%) patients. After the fourth session,final improvement was observed in 59 (95.16%) patients. Tenderness was found in seven (11.3%) patients, bruising was noted in four (6.5%), edema was found in seven (11.3%), numbness was noted in one (1.6%), whereas paresis and alopecia were not found in any of the patients. Conclusion Our study concluded that ATX-101 is a very useful modality with fewer complication rates and is associated with significant improvement in the expanded safe zone for submental fullness.

Retentive ocular prosthesis restores post evisceration patients’ physical and psychological

Loss of eye does not only affect facial esthetics but also psychological health of the patient and leads to social disa-bility. A custom-made ocular prosthesis is a good alternative to promote physical, psychological and esthetically plea-sing appearance that can improve social acceptance of the patient. A 5-years-old female patient and 18-years old male patient were reported to Dental Hospital USU with the chief complaint of loss of an eye, making them often in-sulted by schoolmates, while the male patient lost confidence on socializing around. In these cases, ocular prosthe-ses with modification of custom tray was made by using a putty index obtained from wax pattern to produce a better fitting ocular prosthesis so it expected to be retentive as to produce comfort and increase patient confidence. Con-tact between ocular prosthesis and tissue bed is necessary to evenly distribute the pressure obtained with proper im-pression technique. This technique ensures a good fit of the custom tray thereby produce accurate adaptation to the tissue surface can increase the movement of the prosthesis and provide a good natural esthetic outcome. Post evi-sceration patients need psychological support to restore confidence and self-esteem in today's cosmetics challenging world. For these cases, patients’ self-confidence was restored and socializing as before without any embarrassment.

Wide alar base: Minimally invasive intraoral interalar suture for enhancing facial aesthetics

Wide alar base: Minimally invasive intraoral interalar suture for enhancing facial aesthetics

Perioral Anthropometric Indices: Its Relevance in Reconstructive Surgery

Background: The perioral region plays an important role in facial recognition, gender classification, esthetics, facial expression, speech and eating. Aim: To establish normative perioral data for South-East, Nigerian children Methods: A sample of 120 healthy subjects within the age range of 1 to 5 years were enrolled in this study. Two dimensional photographs of the face were captured non-invasively using a Nikon D 90 camera, ten perioral landmarks were identified and four indices deduced Results: It was observed that vertical mouth height index, upper lip thickness and lip index in the males showed higher values when compared to the females which indicates sexual dimorphism (P≤0.05). Most children in our cohort were classified as having a thick lip index, mouth of intermediate height in relation to the height of the face, thick upper and lower lip thickness index, narrow mouth in relation to the width of the eyes. The mean values of Vermillion height of Lower lip and Lower Lip Thickness Index was also observed to be consistently higher when compared to upper lip in both sexes. Conclusion: The study presents a primary data base for perioral anthropometric indices of children in South-East Nigerian which can aid ethnic specific postoperative evaluation of congenital or post-traumatic orofacial reconstructive surgeries.

Assessment of facial surface tension after CGF Harmony treatment – preliminary report

Introduction. The aim of the study was to evaluate the usefulness of the Clinical Direct Transmission System device and photographic medical documentation to assess the improvement in the skin of the face and hands before and after a one‑time CGF Harmony treatment.Material and methods. The study, after signing a voluntary informed consent, was attended by 3 patients of the Facial Aesthetics Clinic of the University Center of Dentistry and Specialist Medicine of the limited liability company. in Poznan. Once, in accordance with the procedure, a complex of stem cells and growth factors (CGF Harmony – in liquid and gel form) was administered to the area of the facial skin and the gel skin to the area of the dorsal surface of the hands. The observation period was 12 months, from the moment of the procedure, including control tests at several stages: before the procedure, immediately after administration, and approximately 6 and 12 months after the application.Results. The study showed no statistically significant differences in the surface tension of facial expressive muscles with a single application of CGF Harmony for most of the measurements.Conclusions. The analyzis of the photographic documentation and the subjective assessment of the patients, showed that the treatment turned out to be beneficial in terms of improving the quality of the facial skin and exceptionally beneficial in the area of the skin of the hands, which requires confirmation in further studies with a larger study group. There were no statistically significant changes in the facial expression muscles surface tension after the CGF Harmony procedure.