Facial Contour Research Articles

Effect of Facial Acupuncture Stimulation: Magnetic Resonance Imaging-Based Masseter Muscle Volume Analysis and Questionnaire Evaluation

Abstract Background Cosmetic acupuncture may improve wrinkles, swelling, sagging, and facial asymmetry and may lift facial contours. Objectives To investigate the impact of cosmetic acupuncture on masseter muscle volume and its implications for facial aesthetics Methods We included 10 apparently healthy adult women (average age, 50.3 ± 6.45 years) and performed acupuncture once a week for 8 weeks. Magnetic resonance imaging was conducted before acupuncture stimulation and 3 days after the treatment. The collected image data were analyzed using ZioCube software (ZioSoft Co., Ltd., Tokyo). Before and after the intervention, two evaluators measured the masseter muscle volume thrice each and calculated the average value. Results The average total volume of the left and right masseter muscles decreased from 40.73 ± 8.2 cm3 to 37.81 ± 8.57 cm3 after cosmetic acupuncture, a significant reduction of 2.92 ± 2.48 cm3 (7.37%, p < 0.05). All 10 subjective evaluation items showed significant decreases, particularly in facial sagging, contour, and asymmetry, confirming aesthetic improvements and psychological satisfaction among participants. Cosmetic acupuncture reduced masseter muscle volume, leading to noticeable aesthetic benefits. Conclusions Acupuncture stimulation at acupoints around the masseter muscle can reduce the muscle volume due to muscle relaxation. The improvement in subjective evaluation and changes and decreases in masseter muscle shape enable the attainment of facial contour aesthetics, contributing to the evidence in support of cosmetic acupuncture.

Zygomatic Implant Perforated Flap vs Fibula Osseous Flap Maxillary Reconstruction

This cohort study assesses the potential differences in facial contour and patient-reported outcomes in zygomatic implant perforated flap compared to fibula free flap maxillary reconstruction.

Clinical Outcomes and Safety Profile of a Dextranomer-Hyaluronic Acid Hybrid Filler: A Case Series Analysis.

The demand for aesthetic treatments targeting the middle and lower face is on the rise, especially because of changes in appearance associated with aging. This study aimed to assess the use of a hybrid filler for sculpting and contouring of the chin, jaw, and malar region. A retrospective analysis was performed on patients who underwent jaw and chin contouring and cheek augmentation using a hybrid filler (hyaluronic acid and dextranomer). The evaluation focused on the naturalness of appearance, enhancement in volume, and the durability of the results, employing a 5-point scale. Both patient satisfaction and physician evaluations were measured using the Likert scale and the Global Aesthetic Improvement Scale (GAIS), respectively. Follow-up with patients extended up to 6 months after treatment, during which any treatment-related adverse events (AEs) were meticulously recorded and analyzed. Nineteen patients participated in the study, receiving an average injection volume of 2.4 ± 0.9 mL to attain the desired outcomes. The evaluation of natural appearance, volumizing effects, and durability at the analyzed time point consistently scored above 4. All 19 patients' aesthetic improvement was evaluated as "very much improved" and "much improved", at the GAIS score. All patients report improvement in their appearance, with 89.5% rating it as "very much improved" or "much improved" on the Likert scale. Only expected AEs such as mild pain and lower swelling were registered. The hybrid filler proved effective and safe for facial contouring, with significant patient satisfaction and minimal adverse effects.

Clinical Validation of Face-Fit Surface-Lighting Micro Light-Emitting Diode Mask for Skin Anti-Aging Treatment.

Photobiomodulation therapy based on micro light-emitting diodes (µLEDs) holds remarkable potential for the beauty industry. Here, a cosmetically effective face-fit surface-lighting µLED mask for skin anti-aging is introduced. The face-conformable mask enables deep tissue treatment through proximal light irradiation, with a 3D origami structure capable of adapting to complex facial contours with closed adherence. A blister-assisted laser transfer achieves rapid and accurate µLEDs transfer at a high throughput of 50 chips per second, facilitating a mass-producible and large-area process. Finally, clinical trials demonstrate significant improvements in elasticity, sagging, and wrinkles across six facial areas, with a maximum enhancement of 340% in deep skin elasticity of the perioral area compared to the conventional LED mask group.

Ultrasonographic study and anatomical guidelines for botulinum neurotoxin injection into the parotid gland.

Benign enlargement of the parotid gland hypertrophy results in a bulky lateral facial contour and esthetic appearance. This study aimed to determine the depth from the skin surface to the parotid fascia, which encompasses the parotid gland. The anatomical properties of the parotid glands were evaluated in 40 patients using ultrasonography. An up-to-date understanding of the localization of botulinum neurotoxin (BoNT) injection based on anatomy could lead to better localization of the injection into the parotid gland through morphological measurements using data previously published from cadaveric studies. Measurement using the otobasion inferius as a landmark revealed parotideomasseteric fascia thickness averaging 4-6 mm from the skin surface, with the parotid gland extending approximately 15 mm anteriorly. Analysis showed a 3-7 mm thickness range, indicating an optimal injection depth for safety and efficacy in BoNT procedures. Utilizing the otobasion inferius as an anatomical landmark offers a practical approach for measuring parotideomasseteric fascia thickness, addressing cadaveric study limitations. These guidelines aim to maximize the effects of BoNT therapy, which can be useful in clinical settings, by minimizing its deleterious effects.

Long-term Follow-up of Secondary Reconstruction of Facial Paralysis and Depressive Deformities After Subtotal Temporal Bone Resection.

Subtotal temporal bone resection (STBR) frequently results in facial paralysis and depression, making reconstruction challenging due to significant tissue loss. This study aimed to evaluate the effectiveness of a procedure designed for simultaneous smile and soft tissue reconstruction after STBR. The authors included 3 patients who underwent latissimus dorsi (LD) neuromuscular flap combined with adipose flap transfer after STBR at the Tokyo Medical and Dental University Hospital between 2010 and 2016. Among these patients, 2 had facial vessels unsuitable for anastomosis due to prior neck dissection, and their masseteric nerves were unavailable for neurorrhaphy due to STBR. The thoracodorsal nerve was coaptated to the contralateral facial nerve in all patients and to the ipsilateral masseter nerve in one patient. Follow-up periods ranged from 7 to 13 years, with all patients achieving spontaneous smiles within 12 months post-surgery. Although depressive deformities improved, long-term follow-up revealed buccal muscle bulging due to unstable LD muscle fixation from a zygomatic arch defect caused by STBR. Revision surgeries, including muscle refixation with a tensor fasciae lata graft, muscle reduction, eyebrow lifting, blepharoplasty, and adipose tissue repositioning, were performed as needed. Ultimately, all patients achieved satisfactory facial contours and spontaneous smiles. This study demonstrates that free LD muscle with adipose flap transfer is effective for post-STBR reconstruction. However, detailed surgical planning and multistage reconstruction are often necessary due to the complexities involved.

Quantification of facial symmetry in orthognathic surgery: A novel approach integrating 3D contour maps and hyper-dimensional computing

This study aimed to enhance the evaluation of facial symmetry crucial for planning and assessing outcomes of orthognathic surgery (OGS). An innovative approach combining three-dimensional (3D) facial contour lines with hyperdimensional (HD) computing was developed for this purpose. Data were collected using 3D cone beam computed tomography (CBCT) at Chang Gung Memorial Hospital from 2016 to 2021. A comprehensive dataset was compiled, including images from 150 normal individuals and 2500 patients, totaling 5150 preoperative and postoperative facial images. A machine learning model was trained to analyze these images, and 3D contour data were used to create a facial symmetry quantification system with HD computing. Additionally, 3D CBCT data from 200 patients before and after OGS were retrospectively reviewed for clinical application. The developed facial symmetry algorithm demonstrated an overall accuracy of 84.1 %. Postoperative facial symmetry scores improved significantly, with a mean score increase of 53 %, from 2.40 to 3.63. The study culminated in the creation of a web-based system that leverages HD computing and 3D contour mapping to automate facial symmetry assessment. This system offers a user-friendly interface for rapid and accurate evaluations, facilitating better communication between clinicians and patients.

Parotid Gland Suspension Combined with Rhytidectomy to Recontour the Lower Face and Neck Enlargement Caused by Benign Parotid Hypertrophy.

Lower face and neck aging and facial shape changes are usually caused by soft tissue descent. During lower face and neck enlargement, parotid hypertrophy is an important influence factor of morphologic changes in the periauricular regions. Most plastic surgery techniques greatly improve the shape of the lower face and neck, but ignore the manipulation of the parotid gland. We aimed to resolve the lower face and neck enlargement caused by parotid hypertrophy. Thus, we performed parotid gland suspension combined with rhytidectomy to improve the lower face and neck contour. This retrospective study recruited 22 patients who underwent parotid gland suspension combined with rhytidectomy from 2012 to 2020. The evaluation of patient outcomes was performed by selecting items from the FACE-Q scale. Surgical procedures involved parotid gland exposure and parotid fascia suspension. Patient-perceived age appraisal indicated a younger appearance with follow-ups for approximately 3-10year after the surgery (mean ± standard deviation - 5.53 ± 3.67). Patients had a high satisfaction level for facial appearance (67.15 ± 16.84), lower face (74.69 ± 21.22), and contour of the parotid gland areas of the neck (65.76 ± 23.62). The lower face and neck contours were narrowed and tightened. The parotid gland area showed a remarkable improvement after surgery. Parotid gland suspension combined with rhytidectomy obtained an outstanding improvement. This method can achieve a better lower face and neck contour, especially in patients with benign parotid hypertrophy or lower face and neck enlargement in periauricular regions. 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 .

A Unified Approach to Facial Contours and Volume Correction: The Role of the Cheek and the Chin.

Facial proportions and contours influence perceptions of beauty and youthfulness. In particular, the shape and definition of the midface and lower face impact the overall appearance of the face. This review provides anatomical evidence to support a holistic approach to facial analysis and rejuvenation that starts with assessment and treatment of the midface and lower face to create an aesthetically desirable facial balance. The cheek and chin can be considered "anchors" or starting points within full-face treatment because of the noticeable impact of their treatment on the definition and contour of the entire face. Age-related changes in the cheek and chin affect overall facial appearance and can produce unintended facial emotional attributes such as looking tired, angry, or sad. Patients seek facial aesthetic treatment typically for a global improvement such as revitalization or genderization of facial features. Best practices in aesthetics have evolved from treatment of individual areas to a holistic paradigm that uses multimodal therapy to improve overall facial emotional attributes. Hyaluronic acid fillers are useful for volume replacement and smoothing abrupt transitions that develop with age throughout the midface, chin, and jaw. A combination of hyaluronic acid filler for volume restoration and sodium deoxycholate and/or onabotulinumtoxinA for volume reduction where appropriate may optimize lower facial contour. This review highlights the importance of facial angles and contours as well as the significance of panfacial assessments and treatment, focusing on the relationships within areas of the face, specifically the midface and lower face, to optimize results.

Dynamic three-dimensional facial topography in pediatric facial palsy: Understanding asymmetrical facial contours

BackgroundObjective assessment of facial movements remains pivotal for diagnosis, treatment, and long-term monitoring of patients with facial palsy (FP). This study aims to utilize curvature analysis in pediatric patients with and without FP to define facial contours and to quantify three-dimensional (3D) excursion during smile. MethodsPediatric patients with and without FP had 3D motion capture acquired from rest to maximum smile positions. 3D curvature analysis was performed with a custom MATLAB algorithm. A 40-vertex “smile curve” along the nasolabial fold-cheek-orbit contour was extracted from each patient-specific 3D mesh hemiface. This allowed quantification of excursion and asymmetry for affected vs. unaffected sides in FP patients, and comparison with controls. ResultsTwelve FP (mean 12.5yr., range 5-18) and 12 control (mean 12.1yr., range 5-18) patients were analyzed. Differences in facial contour are intensified during animation, especially in the nasolabial fold, cheek, and periorbital regions of interest and the smile curve which links them. Mean excursion differed significantly between the FP and control groups in all regions of interest (p < 0.0001). ConclusionsCurvature analysis provides insight into the unexplored relationship of the 3D morphological dynamics of the concavity and convexity of the face, to add to the understanding of this complex condition. The magnitude of asymmetry between a FP patient’s affected vs. unaffected smile curve excursion, and comparison to the control group, could allow surgical treatment to be tailored to an individual patient’s dynamic anatomy by identifying and quantifying facial region-specific asymmetry.

A Novel Approach for Improving Midface Aesthetics: A Pilot Study.

Asian individuals often seek solutions to address midface depression and enhance nasal alar base morphology to achieve Western facial aesthetics. Current treatment options, including injections and invasive procedures, have limited efficacy and safety. To address these challenges, we introduced the "modified A-10 surgery," which integrates the Point A-Koji method, titanium plates, and artificial dermis insertion. The efficacy of the modified A-10 surgery was illustrated using a case study of a 22-year-old woman. Surgical planning was based on dental cone-beam computed tomography data, with lateral cephalometric radiographs used to determine the titanium plate dimensions. The surgery involved customized plate alignment, fixation, and artificial dermis insertion. The modified A-10 surgery substantially improved facial aesthetics and structural parameters. Facial convexity increased from 15.5 degrees to 23.2 degrees, enhancing the 3-dimensionality. The nasolabial angle shifted from 91.9 degrees to 110.2 degrees, achieving the desired mouth projection. Other measurements, such as the E-line to the lower lip and the distance from point A to the subnasal point, contributed to refined aesthetics. The nasal alar base thickness increased by 2.2 mm (19.5%), correcting the depression. The modified A-10 surgery represents a minimally invasive and comprehensive solution for midface depression and nasal alar base enhancement. By combining the Point A-Koji method, titanium plates, and artificial dermis insertion, this surgery successfully achieved improved facial aesthetics and contours. The results validate its potential as a long-term solution, with implications for antiaging interventions and promising avenues for future research.

Three-dimensional Analysis of Lifting Effects after High-intensity Focused Ultrasound (Ultraformer-MPT) across Seven Facial Aesthetic Units Considering SonoAnatomy.

This investigation delves deep into the lifting degree for each area of noninvasive facial rejuvenation through high-intensity focused ultrasound (HIFU). The study meticulously examines the lifting effects of HIFU treatment across seven distinct facial aesthetic-units, using advanced three-dimensional scanner analysis. The study examined a cohort of 50 patients treated with HIFU. Pre- and immediate posttreatment evaluations were conducted using three-dimensional scanner analysis, allowing for precise quantification of lifting effects across seven aesthetic units. Treatment protocols were tailored to leverage five cartridges with micropulsed mode options, optimizing outcomes based on sonographic anatomy. The forehead was lifted by 1.24 mm; crow's feet, 2.25; malar region, 2.46; posterior cheek, 3.40; jowl, 2.90; mandible, 3.09; and neck, 3.53. The forehead showed a lift of 1.24 mm, attributed to the thin tissue requiring a cautious approach to avoid discomfort. A lift of 2.25 mm in the crow's feet area demonstrated the efficacy of HIFU in addressing fine lines and wrinkles. Significant lift of 2.47 mm in the malar region highlights HIFU's effectiveness in addressing mid-face laxity and restoring volume to the cheeks. The most substantial lift of 3.38 mm in the posterior cheek underscores targeted energy application for enhanced lifting and contouring. Notable lifting effect of 2.90 mm in the jowl area benefits sagging along the jawline, refining facial contour. Lift of 3.10 mm in the mandible shows improvement of lower facial laxity, defining the jawline. The highest lift of 3.55 mm in the neck region addresses laxity and sagging for a defined neck profile.

Enhanced Transconjunctival Lower Blepharoplasty: A Novel Method for Intraorbital Fat Transposition and Stabilization.

The evolution of lower blepharoplasty has shifted from simply removing of orbital septum fat to smoothing of the lid-cheek junction through fat repositioning. This paper adopts a novel technique to transpose and stabilize intraorbital fat during transconjunctival lower blepharoplasty. The tear trough and nasal alar base were filled to correct the pouch while ensuring the blood supply of the fat flap. Between September 2019 and June 2022, 104 patients aged between 22 and 49 who underwent bilateral fat flap transposition-nasal alar base filling lower blepharoplasty were selected. The surgical results were assessed by non-operative plastic surgeons according to the Hirmand grading system. Moreover, a self-satisfaction survey was conducted and patients were followed up for at least 6months to evaluate any complications and surgical outcomes. A high-frequency ultrasound imaging system was used to assess the degree of filling of the tear trough and nasal alar base. All 104 patients were followed up for at least 6months. The postoperative Hirmand grade was 0 for 96 out of 104 (92.3%) patients. In terms of self-satisfaction assessment, there were 92 out of 104 (88.5%) patients reported satisfaction. Dermatologic ultrasound showed no obvious gaps 6months after surgery. Transconjunctival fat flap transposition combined with nasal alar base filling during lower blepharoplasty has been shown to have a positive postoperative effect and high patient satisfaction. This procedure can preserve the blood supply of the fat flap, reduce the rates of fat absorption and denaturation, and improve facial contour, resulting in a satisfactory repairing effect. 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 .

A full-face contouring using micro-autologous fat transplantation (MAFT)-gun technique in Vietnamese population

IntroductionMicro-autologous fat transplantation (MAFT)-gun technique is applied to accurately deliver small fat parcels to multiple fat layers in varied facial sites. Our study presented surgical and clinical outcomes of the MAFT-gun technique for full face contouring. MethodsFrom 01/2021 to 06/2023, 31 healthy participants undergoing fat grafting by MAFT-gun technique for volumization of their full face at our hospital were included. Data on fat volume grafted in different facial sites, complications, and satisfaction rate (%) were collected and analyzed. ResultsThe fat volumes grafted over the left and right cheek were 10.3 ± 0.31ml and 10.2 ± 0.30ml. The forehead and temples demanded lower fat volume by 9.8 ± 0.23ml and 4.5 ± 0.21ml. A small fat volume was required for the nasolabial fold, the tear trough, and the infraorbital areas, by 2.2 ± 0.11ml, 1.9 ± 0.10ml, and 1.4 ± 0.11ml. The fat volumes for the nasolabial fold and the tear trough were significantly different between young and old people. No complications including infection, necrosis, or vascular injury were noted. At the end of the follow-up, 26 patients (83.9%) expressed their satisfaction after the procedure. ConclusionThe MAFT-gun technique is safe and effective for full-face autologous fat grafting. Commercial closed-system processors could be an effective alternative to centrifugation for fat processing. The procedure contributed to the improvement of facial hollowness and brought a more attractive and satisfied appearance to people even after 12 months postoperatively.

Semaglutide “Ozempic” Face and Implications in Cosmetic Dermatology

ABSTRACTBackgroundSemaglutide, a glucagon‐like peptide‐1 receptor agonist, has been utilized for the treatment of type 2 diabetes. Recently, it has gained popularity for its ability to aid in weight loss. However, rapid weight loss induced by semaglutide has been shown to lead to noticeable facial volume loss and the appearance of a prematurely aged face referred to as “Ozempic face.” As this term gains more popularity and increasingly more nondiabetic patients seek rapid weight loss options, there is growing concern among patients and healthcare providers regarding using semaglutide for weight loss as it may have a negative impact on facial esthetics.ObjectiveThe purpose of this paper is to investigate the semaglutide face phenomenon associated with GLP‐1 agonist use for the treatment of obesity.MethodsA comprehensive search on PubMed was conducted to identify the available information related to semaglutide regarding Ozempic face. The search was conducted using a combination of keywords, including “semaglutide,” “semaglutide face,” and “Ozempic face.”Results“Semaglutide face” is recognized as having similar characteristics to a naturally occurring aging face. However, the characteristics of an Ozempic face occur in people much younger than what is seen with the natural aging process. While some believe that this phenomenon is attributed to acute weight loss at a faster rate than normal, many physicians argue that the semaglutide face phenomenon is more likely to occur with the amount of weight lost overall rather than whether that individual used a semaglutide medication to achieve the weight reduction or not. Overall, the semaglutide face phenomenon is characterized by elastin and collagen loss, fat and muscle volume loss, and excessive sagging skin.ConclusionsThe semaglutide face phenomenon highlights the esthetic implications of using semaglutide for the promotion of accelerated weight loss. While this term is not medically recognized, the hollow or sunken look following rapid weight loss sheds light on the effect of semaglutide in facial fat redistribution and volume loss. The metabolic changes induced by GLP‐1 agonists can impact adipose and muscle tissue, which can lead to changes in facial contour and overall appearance. While semaglutide‐induced facial changes may resemble signs of premature aging, they are distinct in their rapid onset and association with significant weight loss. Individuals experiencing semaglutide face have treatment options available depending on their own treatment goals.

A Fast Face Changing Method Adaptable to Various Postures

Image face-changing technology is influenced by skin color and posture. After changing faces, the contour information or skin color information of the user's face will be lost, resulting in low similarity between the changed image and the user's face in the source image. This paper introduces a rapid face-changing method that can adapt to various poses. Regardless of whether the facial poses in the source image and template image differ significantly, this method can retain the facial contours and skin tone in the user's source image without deformation, resulting in a high similarity between the transformed image and the face in the source image. Additionally, it offers low computational complexity, quick processing speed, and a small amount of computational effort.

Effects of Tool Shape on Facial Contour Reduction in Middle-aged Women in Their 50s and 60s

Purpose: This study aimed to evaluate the effect of tool-based facial care on face size reduction in middle-aged women and to analyze the differences in effectiveness by tool form.Methods: The study was conducted with 14 middle-aged women in their 50s and 60s who volunteered to participate at a P aesthetic shop in Gangnam-gu, Seoul. The participants were divided into three groups: Group A (11 participants) received treatment with a meridian-scraping-shaped tool, Group B (4 participants) received treatment with a plain tool, and Group C (3 participants) was untreated. Group A underwent treatment twice a week for a total of six sessions with the meridian-scraping-shaped tool. After a year, some participants from Group A were reassigned to Group B for further care with the plain tool. Face sizes were compared over time by measuring 14 variables, including length, width, and jawline length. Data were analyzed using Kruskal–Wallis and Friedman tests.Results: In Group A, there was a significant reduction in most facial areas, particularly in face width and jaw width (p&lt;0.001). In contrast, Group B showed significant reductions in only some areas, while no changes were observed in the control group. This study found that the meridian-scraping-shaped tool was more effective in reducing facial contours than the plain tool.Conclusion: This study demonstrated that the meridian-scraping-shaped tool, which applies the leverage principle, was more effective in reducing facial contours in middle-aged women compared to the plain tool. The shape of the tool has a critical impact on treatment outcomes.

Utilization of facial fat grafting augmented reality guidance system in facial soft tissue defect reconstruction

BackgroundSuccessfully restoring facial contours continues to pose a significant challenge for surgeons. This study aims to utilize head-mounted display-based augmented reality (AR) navigation technology for facial soft tissue defect reconstruction and to evaluate its accuracy and effectiveness, exploring its feasibility in craniofacial surgery.MethodsHololens 2 was utilized to construct the AR guidance system for facial fat grafting. Twenty artificial cases with facial soft tissue defects were randomly assigned to Group A and Group B, undergoing filling surgeries with the AR guidance system and conventional methods, respectively. All postoperative three-dimensional models were superimposed onto virtual plans to evaluate the accuracy of the system versus conventional filling methods. Additionally, procedure completion time was recorded to assess system efficiency relative to conventional methods.ResultsThe error in facial soft tissue defect reconstruction assisted by the system in Group A was 2.09 ± 0.56 mm, significantly lower than the 3.23 ± 1.15 mm observed with conventional methods in Group B (p < 0.05). Additionally, the time required for facial defect filling reconstruction using the system in Group A was 25.45 ± 2.58 min, markedly shorter than the 37.05 ± 3.34 min needed with conventional methods in Group B (p < 0.05).ConclusionThe visual navigation offered by the fat grafting AR guidance system presents obvious advantages in facial soft tissue defect reconstruction, facilitating enhanced precision and efficiency in these filling procedures.

A clinical prospective study on the surgical management of zygomatico-maxillary complex fractures using two-point fixation

The ZMC fractures are one of the most frequently occurring maxillofacial injuries due to its prominence and facial contour. The ZMC forms a principle buttress of face and helps transmit occlusal forces to skull base. Fracture of zygomatic bone leads aesthetic and functional deformity. Restoration to premorbid condition is most predictable by ORIF. In this study was to evaluate efficacy of two-point internal fixation using conventional miniplates and screws for ZMC fractures. 35 patients with established unilateral isolated ZMC fractures were operated using two-point fixation method i.e. the maxillary buttress and the fronto-zygomatic suture, followed up for 3 months. Patients were assessed clinically and radiographically at different follow up intervals. Charts of patients were reviewed for age, gender, etiology, malar height analysis and vertical dystopia. 35 patients in this study, underwent ORIF under GA with two-point fixation. Preoperatively, mean malar height of the patients recorded was 66.55 ± 3.02. There was a significant increase in malar height postoperatively (P &amp;#60; 0.0001). 70.24 ± 2.05, at 1st week, and 69.87 ± 1.98. in 3rd and 6th weeks. Preoperatively, mean vertical dystopia of patients was 2.24 ± 0.71. Postoperative resolution of vertical dystopia was statistically significant (P&amp;#60;0.0001), with value of 0.52 ± 0.52.Integrity of ZMC is important in maintenance of normal facial width and prominence of cheek. Two‑point fixation shows satisfactory results functionally, esthetically and also provides additional advantage by eliminating another surgical site. Thus we conclude that our study provides a basis for further research.

The Biocompatibility and the Effect of Titanium and PEKK on the Osseointegration of Customized Facial Implants.

The purpose of this study was to investigate the optimization of computer-aided design/computer-aided manufacturing (CAD/CAM) patient-specific implants for mandibular facial bone defects and compare the biocompatibility and osseointegration of machined titanium (Ma), Sandblasted/Large-grit/Acid-etched (SLA) titanium, and polyetherketoneketone (PEKK) facial implants. We hypothesized that the facial implants made of SLA titanium had superior osseointegration when applied to the gonial angle defect and prevented the senile atrophy of the bone. Histologic findings of the soft-tissue reaction, hard-tissue reaction, and bone-implant contact (BIC (%) of 24 Ma, SLA, and PEKK facial implants at 8 and 12 weeks were investigated. There was no statistical difference in the soft tissue reaction. Bone was formed below the periosteum in all facial implants at 12 weeks and the BIC values were significantly different at both 8 and 12 weeks (p < 0.05). Ma, SLA, and PEKK facial implants are biocompatible with osseointegration properties. SLA can enhance osseointegration and provoke minimal soft tissue reactions, making them the most suitable choice. They provide an excellent environment for bone regeneration and, over the long term, may prevent atrophy caused by an aging mandible. The bone formation between the lateral surface of the facial implant and periosteum may assist in osseointegration and stabilization.