Facial Plast Surg [JOURNAL]
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200 papers
Angulated Cephalic Strip Flap in Lateral Crura Reduction: A Scroll Area Preservation Technique in Rhinoplasty.
Generalow A, Kovacevic M, Stigger T … +1 more , Kofler B
Facial Plast Surg · 2026 Feb · PMID 39965762 · Publisher ↗
In nasal tip surgery, achieving both functional and aesthetic results is crucial. Several complications, such as alar retraction or weakening of the internal nasal valve (INV), are associated with the "classical" cephali...
In nasal tip surgery, achieving both functional and aesthetic results is crucial. Several complications, such as alar retraction or weakening of the internal nasal valve (INV), are associated with the "classical" cephalic trim. To prevent complications in nasal tip surgery a horizontal reduction of the lateral crus (LC) using a cephalic hinged flap while preserving the scroll area is described. In 138 patients with bulbous tips, a modification of the hinged flap, the angulated cephalic strip flap (ACSF), was performed during open septorhinoplasty. The cephalic portion of the lower lateral cartilage was superficially incised without separation, preserving the scroll area. The anterior-cephalic triangle of the cephalic portion was resected to facilitate tip sutures and avoid cartilage duplication in the new dome area and hereby creation of additional, undesired volume. The cephalic part was folded inferiorly and anchored with a single fixation suture. Additionally, a fixation with a suture in the scroll area should be performed to strengthen the cranial border of the LC to prevent flap displacement and warping of lower lateral cartilage, particularly in thin-skin patients where the healing forces are significantly stronger. In all 138 patients, a satisfactory postoperative result was achieved, with improved aesthetic and functional outcomes for the nasal tip. The ACSF facilitated tip suturing in all patients after resection of the anterior-cephalic triangle. No revision related to this technique was required, and no narrowing of the INV was observed.
5-Fluorouracil in Facial Plastic Surgery: Indications, Efficacy, and Safety - A Systematic Review and Narrative Synthesis.
Bogari A, Jomah M, Alshehri N … +6 more , Alrabiah HF, Binghaith A, AlOsaimi K, Aldhwaihy L, Baghazal A, Bogari H
Facial Plast Surg · 2026 Feb · PMID 39965761 · Publisher ↗
5-Fluorouracil (5-FU) is an antimetabolite that inhibits fibroblast proliferation and collagen synthesis, making it valuable in facial plastic surgery for scar modulation and other conditions. This systematic review exam...
5-Fluorouracil (5-FU) is an antimetabolite that inhibits fibroblast proliferation and collagen synthesis, making it valuable in facial plastic surgery for scar modulation and other conditions. This systematic review examines the indications, outcomes, and safety of 5-FU in facial plastic surgery. Due to methodological heterogeneity across studies, a narrative synthesis was performed. A comprehensive search of MEDLINE, Cochrane, SCOPUS, EMBASE, PubMed, and Web of Science identified 32 eligible studies (1,456 patients) from 4,772 screened articles. Indications included keloids, hypertrophic scars, contractures, periocular scars, granulomas from filler complications, nasal skin thickening, infections following thread lifts, resistant facial warts, and hypochromic lesions. Most studies reported reductions in scar size, erythema, and recurrence rates, with combination therapies enhancing outcomes. Adverse effects were mild and transient. However, variability in dosing, administration frequency, and follow-up underscores the need for standardized treatment guidelines and long-term studies.
Edema, Ecchymosis, and Pain: Classic versus Electric Micro-Saw Osteotomy.
Bayrakci E, Aricigil M, Eryilmaz MA … +2 more , Eravci FC, Arbağ H
Facial Plast Surg · 2026 Feb · PMID 39965760 · Publisher ↗
To compare postoperative edema, ecchymosis, and pain after rhinoplasty using conventional (classical) osteotomy versus powered (electric) micro-saw osteotomy techniques. Between December 2021 and May 2023, 90 patients ag...
To compare postoperative edema, ecchymosis, and pain after rhinoplasty using conventional (classical) osteotomy versus powered (electric) micro-saw osteotomy techniques. Between December 2021 and May 2023, 90 patients aged 18 to 45 underwent rhinoplasty at our clinic. Of these, 45 patients underwent lateral and transverse osteotomy with powered saw instruments, whereas 45 underwent conventional osteotomy. A resident examined edema, ecchymosis, and pain on the first, third, and seventh postoperative days. The specialist was blinded to the osteotomy method (single-blind). Edema and ecchymosis were categorized using the Yücel modification of the Kara and Gokalan classification, and the pain was evaluated using the visual analog scale. The patients who underwent osteotomy with an electric micro-saw (group 1) had less edema on the first and third days than with conventional osteotomy (group 2). However, on the seventh day, although group 1 had slightly less edema than group 2, there were no significant differences. On the other hand, group 2 had significantly more ecchymosis on the first and third postoperative days compared with group 1, but there were no significant differences on the seventh day. On the first postoperative days, patients in group 2 reported significantly more pain on average compared with group 1. There were no significant differences in pain levels between the two groups on the third and seventh days following the surgery. After rhinoplasty, patients commonly suffer from edema, ecchymosis, and pain. Our research suggests that using a powered micro-saw effectively reduces early-stage ecchymosis and pain compared with the conventional low-to-low osteotomy technique. However, there were no notable differences between the two methods regarding edema, ecchymosis, and pain on the seventh day after surgery. The electric micro-saw appears to be a feasible alternative in the osteotomy step, showing effectiveness comparable to that of the conventional method.
The Challenges and Considerations with Autologous Rib Microtia Reconstruction.
Liu YC, Mukerji S, Truong MT
Facial Plast Surg · 2025 Apr · PMID 39947640 · Publisher ↗
Microtia encompasses a spectrum of congenital pinna malformation. Autologous rib reconstruction is a widely utilized surgical reconstruction technique for microtia. The surgery presents various challenges that can impact...
Microtia encompasses a spectrum of congenital pinna malformation. Autologous rib reconstruction is a widely utilized surgical reconstruction technique for microtia. The surgery presents various challenges that can impact surgical outcomes and patient satisfaction. Sculpting and shaping the cartilage into a detailed auricular framework poses is a technically difficult surgery due to the complexity of the ear's anatomy. Postoperative complications such as scar formation, infection, and framework resorption may lead to poor aesthetic outcomes like asymmetry of the reconstructed ear and inadequate projection. Patient-related factors, such as age, rib cartilage quality and quantity, and psychological expectations, also play critical roles in determining success. Additionally, the surgeon's experience and expertise heavily influence the reconstruction's quality.This paper explores the challenges microtia surgeons face during the reconstruction process, emphasizing technical, patient-specific, and postoperative challenges. It underscores the importance of comprehensive preoperative planning, advanced surgical training, and ongoing research to mitigate these challenges and optimize outcomes in autologous rib microtia reconstruction.
The Effectiveness of Functional Septorhinoplasty in Improving COVID-19-related Olfactory Dysfunction.
Pendolino AL, Scarpa B, Andrews PJ
Facial Plast Surg · 2026 Feb · PMID 39929248 · Full text
Long-Term COVID-19-related olfactory dysfunction (C19OD) remains a significant challenge with no established treatment providing meaningful improvement. This study aimed to assess the efficacy of functional septorhinopla...
Long-Term COVID-19-related olfactory dysfunction (C19OD) remains a significant challenge with no established treatment providing meaningful improvement. This study aimed to assess the efficacy of functional septorhinoplasty (fSRP) in improving olfactory dysfunction in patients with persistent C19OD compared to a control group undergoing olfactory training (OT). In this prospective study patients with persistent C19OD undergoing fSRP were enrolled while those declining surgery continued with OT as the control group. Patients were followed for six months with olfactory function assessed using Sniffin' Sticks (S'S) and nasal airflow evaluated through peak nasal inspiratory flow (PNIF) and acoustic rhinometry (AR). Among the participants 12 underwent fSRP while 13 were in the control group. Significant improvements (p < 0.05) in all S'S scores were observed in the fSRP group but not in the control group. TDI scores improved above the minimal clinically important difference only in the fSRP group. Strong correlations were found between olfactory scores and nasal measurements. Comparison of olfactory threshold gains between groups revealed a statistically significant benefit in the fSRP group. These findings suggest that fSRP can significantly improve persistent C19OD providing a notable olfactory threshold gain compared to OT.
Improving Postsurgical Management of Rhinoplasty: A Comprehensive Review of Existing Literature.
Villarroel PP, Langdon C, Arancibia-Tagle D
Facial Plast Surg · 2025 Dec · PMID 39909395 · Publisher ↗
Rhinoseptoplasty addresses both nasal deformities and functional issues. Effective postoperative care is essential for optimal recovery, as complications such as swelling, bruising, and pain can adversely affect healing...
Rhinoseptoplasty addresses both nasal deformities and functional issues. Effective postoperative care is essential for optimal recovery, as complications such as swelling, bruising, and pain can adversely affect healing and patient satisfaction. Proper postoperative care emphasizes the significance of comprehensive management strategies.A systematic literature review was performed utilizing the PubMed and Cochrane databases to identify articles published between 2014 and 2024 that specifically addressed postoperative care following rhinoplasty. Of 191 articles, 22 met the preestablished inclusion criteria. We assessed the quality of evidence according to the Oxford Centre for Evidence-Based Medicine's Levels of Evidence.Seven key studies were analyzed, exploring a range of postoperative care interventions, including administering corticosteroids, elevating the head during and after the procedure, using alternative therapeutic approaches, and applying cooling techniques.Postsurgical recovery after rhinoplasty involves managing pain, swelling, and bruising, among other complications. Educating patients about expected outcomes and the healing process helps alleviate their anxiety and uncertainty. Corticosteroids have proven effective in controlling swelling and bruising. Antibiotics are generally not recommended. Silicone septal splints provide support, particularly when stabilization of an injured mucous membrane or septal cartilage is required; however, nasal packing is not recommended. Adhesive strips can help reduce edema in the dorsal and supratip areas. Positioning patients in a 20° reverse Trendelenburg position during surgery, followed by maintaining the head elevated at a 90° angle postoperatively, has significantly reduced edema and ecchymosis. Using a cannula for drainage and cooling techniques has been shown to reduce postoperative morbidity effectively.Rhinoplasty is a common facial plastic surgery, yet there is no consensus on optimal postoperative care. Key strategies include silicone splints, subperiosteal drainage, nasal taping, cooling, corticosteroids, and intra- and postoperative head elevation. However, further systematic trials are necessary to refine these strategies and improve patient outcomes.
Exosomes in Facial Plastic Surgery.
Abraham MT, Wilson J
Facial Plast Surg · 2025 Apr · PMID 39832778 · Publisher ↗
Exosomes have emerged as a promising therapeutic frontier in facial plastic surgery. Preclinical studies have demonstrated their ability to modulate wound healing, skin rejuvenation, hair growth, and nerve regeneration....
Exosomes have emerged as a promising therapeutic frontier in facial plastic surgery. Preclinical studies have demonstrated their ability to modulate wound healing, skin rejuvenation, hair growth, and nerve regeneration. Early clinical evidence suggests potential benefits in enhancing recovery after laser resurfacing, treating acne scars, and promoting hair growth. Despite their potential, there are currently no exosome products that are FDA-approved for medical use, and they should be considered experimental until receiving regulatory approval and robust clinical validation. As research advances, exosomes may offer valuable tools for facial plastic surgeons to improve patient outcomes and expand regenerative medicine applications in facial aesthetics and reconstruction.
Irradiated Homologous Costal Cartilage Grafts in Complex Functional Septorhinoplasty.
Jama GM, Bhanwala S, Pericleous A … +4 more , Acharya V, Unadkat SN, Randhawa PS, Andrews PJ
Facial Plast Surg · 2025 Dec · PMID 39824508 · Publisher ↗
Optimal results in complex nasal reconstruction, particularly in the context of post-traumatic and revision septorhinoplasty, often require the use of cartilage grafts to provide additional structural support to the nose...
Optimal results in complex nasal reconstruction, particularly in the context of post-traumatic and revision septorhinoplasty, often require the use of cartilage grafts to provide additional structural support to the nose. While autologous costal cartilage (ACC) has been traditionally used, this can be limited by donor site morbidity, increased operative time, and in some cases, lack of suitable cartilage for grafting. There has been a trend towards using irradiated homologous costal cartilage (IHCC) as an alternative source of graft material. We review our departmental experience of using IHCC in functional septorhinoplasty surgery. We performed a retrospective review of electronic medical records of all patients who underwent septorhinoplasty using IHCC at a tertiary referral center between May 1, 2022, and April 30, 2024. Demographic data, surgical details, and postoperative outcomes, including rates of infection, resorption, warping, and revision were recorded and analyzed. Fifty-seven patients (34 males, 23 females) with a mean age of 41.0 years (range: 18-65 years) were included. Forty-one were revision septorhinoplasty operations, while 16 were primary cases. Almost all were performed via an open approach (98.2%). Three patients developed postoperative infection (5.3%) while one developed columellar dehiscence needing further revision surgery (1.8%). Functional and aesthetic results were otherwise satisfactory in all patients. We observed no cases of warping, resorption, or extrusion. The median length of follow-up was 279 days (interquartile range: 171-527 days). We present the largest United Kingdom series to date on the use of IHCC in septorhinoplasty surgery. Our findings support its use as a safe and effective graft material and a viable alternative to autologous sources, offering the benefits of a robust reconstructive material and shortened operative time, without the risk of donor site complications. A longer follow-up period is ideally required to evaluate its long-term structural stability.
A Long-term Evaluation: Deep Plane versus High SMAS Face Lift.
Mariani M, Fabbri M, Serra PL … +4 more , Murone V, Scucchi B, Botti C, Botti G
Facial Plast Surg · 2025 Oct · PMID 39820938 · Publisher ↗
In the last few years, the Deep Plane Face Lift (DPFL) has gained great popularity among plastic surgeons, even if its origins are traced back to the 1970s. Certainly, it could have some advantages but based on our exper...
In the last few years, the Deep Plane Face Lift (DPFL) has gained great popularity among plastic surgeons, even if its origins are traced back to the 1970s. Certainly, it could have some advantages but based on our experience, it can reveal some unpleasant features in the long term. For this reason, the senior authors have adopted the high superficial musculoaponeurotic system (SMAS) Face Lift for many years in their surgical practice.The goal of our study is to analyze the DPFL critical aspects in the long term and show how the High SMAS Face Lift (HSFL) technique can help to improve them.
The Surgical Management of the Eye in Facial Palsy.
Malik M, Wilcsek G, Shamil E
Facial Plast Surg · 2026 Feb · PMID 39719146 · Publisher ↗
The surgical management of the periocular region in facial palsy is a critical aspect of addressing the ocular morbidity associated with facial paralysis. The reconstruction around the eye in facial palsy should take int...
The surgical management of the periocular region in facial palsy is a critical aspect of addressing the ocular morbidity associated with facial paralysis. The reconstruction around the eye in facial palsy should take into account the duration of the facial palsy and underlying ocular pathologies. Exposure keratopathy can develop secondary to lagophthalmos, ectropion, and brow ptosis. Clinicians should optimize the function of the eye with medical treatments in the first instance and where required adjunctive static or dynamic surgical therapy. The cosmesis of the periocular region should also be taken into consideration when surgical reconstruction is being planned. This manuscript aims to provide a review of surgical solutions for patients with chronic eye manifestations of facial palsy.
The Pillars Concept: An Approach for Managing Hypertrophic Concha in Otoplasty.
Neves JC, Arancibia-Tagle D
Facial Plast Surg · 2025 Apr · PMID 39715621 · Publisher ↗
Prominent ear deformities often result from a combination of hypertrophic conchal cartilage and an underdeveloped antihelical fold. Traditional otoplasty techniques, such as antihelical folding sutures and conchal setbac...
Prominent ear deformities often result from a combination of hypertrophic conchal cartilage and an underdeveloped antihelical fold. Traditional otoplasty techniques, such as antihelical folding sutures and conchal setback maneuvers, may introduce tension and risk of relapse, leading to suboptimal aesthetic outcomes. The PILLARS CONCEPT: represents an alternative surgical approach specifically designed to address hypertrophic concha, ensuring stable and natural results.This study aimed to present the Pillars Concept as an alternative method for correcting hypertrophic conchal cartilage, highlighting its advantages over traditional techniques, and evaluating its effectiveness in maintaining long-term stability of the ear's position without relapse.A retrospective analysis was conducted on 89 patients who underwent otoplasty utilizing the Pillars Concept. The technique involves selective transection of two supporting pillars located in the superior and inferior conchal regions after partial resection of the hypertrophic concha. This releases the conchal cartilage and enables tension-free repositioning of the auricular framework.Of the 89 cases, no hypertrophic concha recurrences were noted during follow-up periods. Complications were minimal, with only two patients (2.2%) experiencing a sensation of "glued ears" following complete conchal resection. Retroauricular fullness was observed in two cases (2.2%) after conchal setback, primarily due to inadequate management of the residual cartilage length. Patient satisfaction was high, and the natural aesthetic of the auricle was consistently preserved.The Pillars Concept provides a reliable, tension-free method for addressing hypertrophic conchal cartilage in otoplasty, preserving the natural ear anatomy and ensuring long-term stability without the risk of relapse. This technique should be considered a valuable addition to the armamentarium of otoplasty procedures.
Incisionless Otoplasty: Current State of the Art.
Madsen Buba C, Gantous AM
Facial Plast Surg · 2025 Apr · PMID 39631750 · Publisher ↗
Prominent ears, also known as prominauris, inflict psychological distress and suffering on both children and adults. Otoplasty has become one of the most common aesthetic operations due to its high prevalence and signifi...
Prominent ears, also known as prominauris, inflict psychological distress and suffering on both children and adults. Otoplasty has become one of the most common aesthetic operations due to its high prevalence and significant impact on patients. Various surgical techniques for otoplasty have been documented and developed over time. While complications are rare, open and cartilage-resection techniques may result in hemorrhage, hematomas, contour deformities, hypertrophic scarring, and keloid formation. Incisionless otoplasty has been demonstrated in the literature to be an effective method, when correctly indicated, to correct prominauris with a shorter recovery time and reduced morbidity. A thorough preoperative evaluation, awareness of the different techniques, and assessment of their appropriate application minimize potential risks and unpleasant results.
Morphing of the Frontal View: Rhinoplasty as a Surface Contour Operation.
Golan I, Khodaei I, Vasilenko I … +1 more , Palma P
Facial Plast Surg · 2025 Oct · PMID 39592114 · Publisher ↗
Frontal view morphing is needed for better preoperative consultation and simulation process in rhinoplasty. Restoration of the correct light-shadow interactions in rhinoplasty demands a firm appreciation of the underlyin...
Frontal view morphing is needed for better preoperative consultation and simulation process in rhinoplasty. Restoration of the correct light-shadow interactions in rhinoplasty demands a firm appreciation of the underlying nasal structures. Chiaroscuro is a painting technique of dark and light contrasts that can be utilized in the morphing process, enabling the surgeon to explain possible results. Patients undergoing surgery in 2019. Encounters were divided into three. First visit: history taking, a list of desires and physical examination, photography. Second visit: photo analysis was presented as well as the hypothesis of correction expressed by morphing (morphing with Adobe Photoshop software). We termed the differences between light and shade of the lateral nasal walls, the dorsum and the brow dome line and nose cheek line as the "Chiaroscuro of the nose." This term is significant in the process of morphing of the frontal view. We used this method of morphing in the simulation process of 126 patients. The age range was 15 to 59 years old. A total of 67% (84) were females and 33% (42) were males. A total of 43% (54) of the cases were revision cases. At the postoperative visits, all patients were more satisfied with their operative result than with their "morphed" simulation. The chiaroscuro concept of the nose is an essential step in the analysis and morphing processes of the frontal view, and a logical tool in creating a realistic surgical game plan. The morphing of the frontal view enables the surgeon and patients to discuss the possible result with more details and refinements. Morphing may be a good option to educate young surgeons in both preoperative consultation and at the operating theater.
Assessment of Nasal Breathing Function and Tip Definition after the Implementation of the Cephalic Lateral Crural Advancement Flap Technique.
Macía G, Ortega A
Facial Plast Surg · 2026 Feb · PMID 39592113 · Publisher ↗
Cephalic trimming of the lower lateral cartilage (LLC) can result in the collapse of the internal and external nasal valves, pinched nose, and alar retraction. The cephalic lateral crural advancement flap (CLCAF) techniq...
Cephalic trimming of the lower lateral cartilage (LLC) can result in the collapse of the internal and external nasal valves, pinched nose, and alar retraction. The cephalic lateral crural advancement flap (CLCAF) technique is introduced as a method to prevent these complications by avoiding grafts in the LLC. A retrospective study was conducted on 126 open-approach rhinoplasties (82 female and 44 male) employing the CLCAF technique between January 2021 and March 2022. Preoperatively, 20 patients exhibited collapse of the internal nasal valve. CLCAF was performed in all patients following cephalic incision, leaving 7 to 8 mm horizontally and caudally of LLC, and preserving the scroll ligament. The CLCAF was advanced onto the lateral crura to reinforce it and tension the scroll ligament. The Nasal Obstruction Symptom Evaluation (NOSE) scale was used to assess the technique. The average postoperative follow-up period was 14 months. Overall, 114 patients (90.5%) experienced improved nasal breathing on the NOSE scale, and the overall NOSE score significantly decreased from a mean of 30.4 to 14.0 ( < 0.001). A statistically significant reduction in NOSE scores was observed in groups with moderate, severe, and extreme obstruction ( < 0.001), with greater improvement seen in the patients with more severe preoperative nasal breathing obstruction. Postintervention, no patient exhibited collapse of the internal valve, and all patients with preoperative collapse of the internal nasal valve showed an increase of at least 40 points in the NOSE scale. Two patients required revision due to tip asymmetry related to CLCAF. Pinched nose or alar retraction was not observed postoperatively in any patient. The implementation of CLCAF, combined with other techniques, enhances nasal breathing function, prevents the collapse of the internal nasal valve, and leads to optimal nasal tip definition, resulting in a better-shaped and functioning nose.
Double Triangular Cartilage Excision in Otoplasty Revisited.
Gualdi A, Cambiaso-Daniel J, Negrini FC … +1 more , Giordano S
Facial Plast Surg · 2025 Apr · PMID 39581191 · Publisher ↗
BACKGROUND: Prominent ears negatively impact the psychological and social health of individuals. Despite the availability of different surgical correction methods for this congenital condition, many of these techniques m...
BACKGROUND: Prominent ears negatively impact the psychological and social health of individuals. Despite the availability of different surgical correction methods for this congenital condition, many of these techniques might result in significant risks of complications and the condition often reappears. Herein, we present log-term outcomes of our suture-free method that employs various strategies to reduce these risks and prevent recurrences. METHODS: We analyzed the results of patients who had a bilateral double triangular cartilage excision otoplasty as an outpatient procedure. This previously described technique is designed to correct prominent ears by precisely removing sections of cartilage to reshape the ear mechanically without the need for sutures through the cartilage. We documented any complications after surgery and gathered feedback from patients over an extended follow-up period. RESULTS: A total of 146 patients (292 ears) met the inclusion criteria. The mean age was 23.2 ± 5.3 years. The mean follow-up period was 22 months. Complications were as follows: 3 ears (1.02%) showed superficial skin tissue necrosis at the front of the ear and 17 ears (5.8%) needed further surgery due to unsatisfactory ear rotation. Additionally, 2.73% experienced wound dehiscence, 0.68% had hematomas, 1.02% had external ear infections that were treated with local and systemic antibiotics, 4.1% developed hypertrophic scars, and 8.2% experienced temporary paresthesias. Patients reported being satisfied with the final outcomes at follow-up. CONCLUSION: Double triangular cartilage excision otoplasty is a safe procedure with few complications, low recurrence rates, and good patients' satisfaction at long-term follow-up. This sutureless technique should be included as an alternative to the existing surgical techniques and added to the skill set of surgeons. LEVEL OF EVIDENCE: IV.
Otoplasty and Ear Reconstruction Complications.
Buba CM, Gantous AM
Facial Plast Surg · 2025 Apr · PMID 39537130 · Publisher ↗
Prominauris, often known as prominent ears, is one of the most frequent congenital deformities of the head and neck. Therefore, otoplasty has gained significant popularity and is now one of the most performed procedures...
Prominauris, often known as prominent ears, is one of the most frequent congenital deformities of the head and neck. Therefore, otoplasty has gained significant popularity and is now one of the most performed procedures in the field of facial plastic surgery.Reconstructing and correcting ear abnormalities remains a challenging procedure in facial plastic and reconstructive surgery. These deformities, whether congenital or acquired, have a substantial influence on patients' lives and inflict psychological harm. Addressing the deformity and tissue loss will improve the overall quality of life.Throughout history, various surgical techniques have been reported for treating external ear abnormalities. While most of these surgeries are considered safe, a comprehensive preoperative evaluation and understanding of the different techniques and risks can minimize potential complications.
Effect of Facial Fillers on Post-rhinoplasty edema: A Hypothesis Based on Literature Review.
Maamari SA, Vansteelant G, Appan S … +1 more , D'Souza A
Facial Plast Surg · 2025 Oct · PMID 39532285 · Publisher ↗
The quest to achieve younger and media-driven facial aesthetics has resulted in an exponential increase in the use of facial fillers. Inevitably, this has meant that it is now commonplace for facial plastic surgeons to h...
The quest to achieve younger and media-driven facial aesthetics has resulted in an exponential increase in the use of facial fillers. Inevitably, this has meant that it is now commonplace for facial plastic surgeons to have patients with fillers in the face. In the senior author's experience (A.R.D.), it was observed that patients with facial fillers experienced persistent edema post-rhinoplasty. It was, therefore, hypothesized that this prolonged edema may be related to fillers affecting the lymphatic drainage impacting postoperative edema following facial surgery.This article aims to gather evidence from wider literature to support the hypothesis that fillers do indeed compromise lymphatic drainage. A narrative literature review was performed using selective articles on fillers and post-rhinoplasty edema. A methodological analysis was then followed to develop a standard theory characterized through the discussion.It is theorized that due to their hydrophilic characteristics, hardness, volume, and backflow phenomena, hyaluronic acid fillers can lead to prolonged edema. In addition, they can either directly block or indirectly exert pressure on the lymphatic pathways and hinder drainage.The research findings support the hypothesis that facial fillers impact postoperative facial edema. Further research is required to objectively measure the effect of fillers on facial lymphatic drainage.The level of evidence is IV.
Facial Rejuvenation: Comprehensive 2025 Experts' Update.
Fedok FG
Facial Plast Surg · 2025 Feb · PMID 39532142 · Publisher ↗
Abstract loading — click title to view on PubMed.
Frontal Bone Morphology in Different Age and Gender Groups Using Computed Tomography.
Hajizadeh Barfejani A, Noroozi A, Karagah A … +3 more , Tofangchiha M, Taghavi-Damghani F, Alizadeh A
Facial Plast Surg · 2025 Aug · PMID 39529315 · Publisher ↗
BACKGROUND: The shape of the forehead is primarily determined by the frontal bone, which holds significance for health and aesthetics. This study evaluated the morphology of the frontal bone in different age groups and g...
BACKGROUND: The shape of the forehead is primarily determined by the frontal bone, which holds significance for health and aesthetics. This study evaluated the morphology of the frontal bone in different age groups and genders using computed tomography (CT). METHODS: This cross-sectional study was conducted on CT scan results of 220 patients divided into three age groups: 20-29.27, 29.27-47.54, and 47.54-95 years. The investigation explored the lower and upper angles compared with the Sella-Nasion (SN) line, the maximum frontal projection with Nasion in the SN plan, and the variations in frontal thickness across different angles (15, 30, 45, 60, 75, and 90 degrees) relative to the SN plane. All data were analyzed using R software, considering the significance level < 0.05. RESULTS: Of 220 patients, 119 were men, and the mean age of the participants was 41.09 ± 18.06 years. The average upper frontal slope (UFS) angle was 56.96 ± 8.17 degrees, which was 59.35 ± 7.92 degrees in females and 54.94 ± 7.86 degrees in males. The mean lower frontal slope (LFS) angle was 86.30 ± 7.96 degrees, which was 90.71 ± 6.67 degrees in females and 82.55 ± 7.00 degrees in males. The average contour nasion (C-N) distance was 7.51 ± 3.72 mm. Also, the frontal thickness at an angle of 15 degrees had the highest value of 13.08 ± 2.68 mm and at 30 degrees had the lowest value of 5.81 ± 1.56 mm. A significant difference was observed between the UFS and LFS among males and females ( < 0.001). Across all age groups, men exhibited a steeper angle, indicating a greater posterior inclination than women. Moreover, males with upper ages reported a significant increase in C-N distance and frontal projection ( < 0.05). CONCLUSION: Our findings emphasize the importance of considering gender-specific variations in frontal bone structure when planning cosmetic or reconstructive procedures involving the forehead.
A Classification System of Asian Noses for Rhinoplasty.
Ng CL
Facial Plast Surg · 2025 Aug · PMID 39529302 · Publisher ↗
While Asian noses are generalized as having smaller bones and softer cartilages, thicker skin and soft tissue envelop (SSTE), there exists a diversity of morphology amongst Asian noses. The oversimplification of Asian no...
While Asian noses are generalized as having smaller bones and softer cartilages, thicker skin and soft tissue envelop (SSTE), there exists a diversity of morphology amongst Asian noses. The oversimplification of Asian noses diminishes the validity or generalizability of rhinoplasty research findings and makes comparison of outcomes challenging. A classification system is proposed that reflects the different structures and SSTEs of the nasal subtypes, the techniques required in the management of each of the subtypes, the challenges the surgeon will face intra- and postoperatively, allows for preoperative counselling of expected outcomes, and facilitate valid and fair comparison of study outcomes by comparing like for like. The classification system stratifies noses into four subtypes based on (1) the size and strength of the nasal bone and cartilages, and (2) the thickness of the SSTE. Type I noses have thinner SSTE and stronger structure. Type II noses have thinner SSTE and weaker structure. Type III noses have thicker SSTE and stronger structure. Type IV noses have thicker SSTE and weaker structure. Interrater variability in classifying noses among rhinoplasty surgeons was found to be very high with a kappa coefficient of 0.933 (95% confidence interval: 0.852-1.014; variance 0.013).
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