The purpose of this study is to investigate facial symmetry aesthetics (FSA) in the Saudi Arabian population using artificial intelligence (AI).Two hundred and ten people from a range of demographic backgrounds participa...The purpose of this study is to investigate facial symmetry aesthetics (FSA) in the Saudi Arabian population using artificial intelligence (AI).Two hundred and ten people from a range of demographic backgrounds participated in an observational cross-sectional study that was done at a hospital. Standardized posed photos of the face and smile were taken using a Canon camera utilizing a stratified random sample approach. Webceph software (Korea) with AI was used to evaluate macro, micro, and tiny aesthetic factors. The data were analyzed using paired -tests, post hoc Bonferroni testing, analysis of variance (ANOVA), and descriptive statistics. The computation of intraclass correlation coefficients (ICCs) was utilized to assess the dependability of AI evaluations.All variables had ICCs of more than 0.97, indicating exceptional dependability for the AI-based evaluations. Between the Class I and Class III malocclusion groups, there were significant variations in right mandibular body length ( < 0.001), with Class III patients exhibiting greater values. While no significant changes were identified for other characteristics, paired -tests showed a significant divergence in mandibular body length between the right and left sides ( = 0.001). In Class III malocclusion, there was a significant preference for right deviation in the direction of mandibular deviation ( = 0.005). These results imply that AI is capable of accurately identifying some anatomical characteristics associated with face aesthetics, especially when it comes to differentiating between Class III malocclusions.In conclusion, the Saudi Arabian population's facial symmetry assessments via AI have demonstrated a high degree of reliability and consistency. Notably, the length of the mandible on the right side has emerged as a crucial feature in discriminating between malocclusion classes. The study emphasizes how AI might improve the accuracy of assessments of face aesthetics and our knowledge of facial features connected to malocclusion.
Pterygium colli or webbed neck is a congenital deformity mainly found in Turner syndrome. It appears as a bilateral triangular fold extending from the mastoid to the acromion with hairy skin abnormality. Structural varia...Pterygium colli or webbed neck is a congenital deformity mainly found in Turner syndrome. It appears as a bilateral triangular fold extending from the mastoid to the acromion with hairy skin abnormality. Structural variation of the fold, as described by Mehri Turki's webbed neck classification, implies appropriate surgical repair. Despite the availability of a range of surgical techniques, it remains difficult to choose the most suitable one. Thus, this report aims to compare the lateral approach techniques by selecting those providing the best results. A literature search using PubMed and Google Scholar Database identified lateral approach techniques for pterygium colli. A critical reading led us to select criteria for comparison, linked to procedures and results. Moreover, according to aesthetic results, surgical techniques were classified into three categories. A total 16 articles were published from 1937 to 2020 and enrolling 48 patients were selected. The neck contour was obtained with all procedures. However, scars were hidden at the posterior neck in only 10 reports. Otherwise, the posterior hairline was corrected in only 6 reports. According to these outcomes, a classification of surgical technique was made allowing their pragmatic assessment. An objective assessment of lateral approach techniques was realized to help surgeons choose the most convenient one. From this study, a classification arises, based on aesthetic results, distinguishing three groups of surgical techniques and allowing their comparison. Techniques belonging to Group 2, using cervical advancement flap, were the most suitable, mainly both techniques described by Reichenberger and Mehri Turki.
Otoplasty has been described for nearly 200 years for children and adults. Although auricular deformity has been recognized in newborns, treatment options were lacking. With the development of ear molding techniques, new...Otoplasty has been described for nearly 200 years for children and adults. Although auricular deformity has been recognized in newborns, treatment options were lacking. With the development of ear molding techniques, newborn ear deformities can now be corrected nonsurgically. However, these techniques have distinct limitations with much dependent on the age of initiation of treatment and deformities present. Awareness of these early interventions is therefore crucial to initiate treatment in the early developmental period when the ear is still malleable. During the first few weeks of life, the ears are malleable, and the ears are rapidly growing, relatively. Therefore, the neonatal period provides a unique opportunity to contour the ears properly. Different techniques have been developed. However, the premise is that the ears are stabilized in a favorable contour continuously for several weeks to hold into proper position. This procedure carries minimal risk and can be quite efficacious, preventing a child from needing surgery later in life.
The aim of this study was to translate, validate, and culturally adapt the original English version of the Expectations of Aesthetic Rhinoplasty Scale (EARS) into Turkish for use in Turkish-speaking communities. Fifty-on...The aim of this study was to translate, validate, and culturally adapt the original English version of the Expectations of Aesthetic Rhinoplasty Scale (EARS) into Turkish for use in Turkish-speaking communities. Fifty-one patients who wanted to undergo primary rhinoplasty and were literate in Turkish were included in the study. The control group consisted of 81 healthy volunteers who did not require rhinoplasty. A Turkish version of the EARS (EARS-T) was created. The participants completed the EARS-T questionnaire twice, 4-week apart. The internal consistency of the scale (Cronbach's α), the test-retest reliability (intraclass correlation coefficient [ICC]), and differences between the patient and control groups (Pearson's chi-square test) were analyzed. A statistically significant difference was found between the age and gender of the patient and control groups ( = 0.001 and 0.001, respectively). Univariate analysis showed that this significant difference did not affect the study results (age: = 0.2; gender: = 0.12). In addition, a statistically significant difference was found between the scale scores of the control and rhinoplasty groups (all < 0.05). The EARS-T had good internal consistency, with high Cronbach's α scores ranging between 0.74 and 0.87. Test-retest reliability was demonstrated by high ICC scores ranging from 0.71 to 0.87. Our study revealed that the EARS-T has good internal consistency, reliability, and validity. Therefore, it can be used to assess the expectations of aesthetic rhinoplasty patients in preoperative consultation practice and in clinical studies related to rhinoplasty.
Lop ear deformity is the most common head and neck congenital malformation with an estimated incidence of 5% among newborns. Otoplasty is the surgical procedure designed for its correction. More than 200 surgical techniq...Lop ear deformity is the most common head and neck congenital malformation with an estimated incidence of 5% among newborns. Otoplasty is the surgical procedure designed for its correction. More than 200 surgical techniques have been described so far to treat this condition, most of them including a cartilage weakening maneuver to avoid the relapse of the original auricle shape a few months after surgery. Classic techniques, such as like Mustarde's, describe this maneuver through scoring the posterior side of the cartilage and stabilizing the new shape with sutures. Cartilage biomechanical properties work against posterior scoring since cartilage folding occurs in the contralateral side of the scoring. This critical point may explain the high rates of relapse in the posterior scoring otoplasty techniques. In this paper, we present our surgical otoplasty technique with anterior scoring and we discuss specific tips and its nuances. We believe that the anterior scoring otoplasty technique achieves natural ears with both low complication rates and significant reduced long-term relapses.
The correction of prominent ears is a rewarding operation. When choosing a surgical technique, we prefer a cartilage-sparing technique to a cartilage-splitting technique to achieve natural-looking long-term results. In t...The correction of prominent ears is a rewarding operation. When choosing a surgical technique, we prefer a cartilage-sparing technique to a cartilage-splitting technique to achieve natural-looking long-term results. In this article, we present our preferred technique of an anterior scoring technique combined with concha-mastoid sutures step by step.
Perioral rejuvenation is a critical component in the comprehensive approach to the aging face. The perioral region-comprising the lips, philtrum, and areas surrounding the oral commissures-plays a significant role in an...Perioral rejuvenation is a critical component in the comprehensive approach to the aging face. The perioral region-comprising the lips, philtrum, and areas surrounding the oral commissures-plays a significant role in an individual's perceived age, attractiveness, and emotional expressions. However, the perioral region is often the "forgotten area" and has the potential to undermine the success of otherwise outstanding rejuvenation surgeries. This article will shed light on 40 years of experience in perioral rejuvenation surgery, demonstrating techniques and methodologies that have consistently yielded long-term, reliable results in my practice.
In the First World War (WW1), different types of injuries became both political and economic factors for the main belligerent countries. This work illustrates the special role facial injuries played during and after the...In the First World War (WW1), different types of injuries became both political and economic factors for the main belligerent countries. This work illustrates the special role facial injuries played during and after the war and the profound impact they had on the field of Plastic Surgery in Britain and Germany.This is a historical work based on primary and secondary sources. English and German material was used to compile an overview of the development of Plastic and Reconstructive Surgery as a specialty during WW1 and up to the Second World War (WW2).Plastic and Reconstructive Surgery had the task of reconstructing male beauty and personalities, restoring the most intense, disfigured reminders of a terrible war in homes and the public. Looking at the significant role the specialty played during the war, remarkably, most of the contributors struggled to find financial support to develop designated specialized departments in the inter-war period. The specialty's connection to the emotional subject of facial disfigurement did not work in its favor at a time when people wanted to forget the horrors of the war.The developments in Britain and Germany during the WW1 were less isolated than often described and the inter-war period saw much effort for international collaboration. The different developments of WW2 further illustrate how essential the efforts of a strong group of individuals and support from authorities were for the evolution of Plastic Surgery as a specialty.
The anatomy and arborization patterns of the extraparotid facial nerve show considerable variation among different populations, impacting surgical approaches in plastic, head and neck, and ENT surgeries. This study focus...The anatomy and arborization patterns of the extraparotid facial nerve show considerable variation among different populations, impacting surgical approaches in plastic, head and neck, and ENT surgeries. This study focuses on the Indian population to provide a detailed understanding of these variations, specifically highlighting the Davis type IV arborization pattern's prevalence and its clinical relevance. We conducted a comprehensive dissection of 16 formalin-preserved Indian cadaveric hemifaces. The study meticulously mapped the facial nerve trunk (FNT), its furcation points, and branches. Key anatomical landmarks for locating these nerve structures were identified, including the tip of the mastoid process, the angle of the mandible, and a novel line between the lateral palpebral fissure and otobasion superioris. The most common arborization pattern observed was Davis type IV (31.3%). The study provided precise measurements for locating the FNT and its branches, using identifiable landmarks. These findings facilitate more accurate surgical planning, crucial for procedures involving nerve repair or grafting. This research offers vital insights into the facial nerve anatomy specific to the Indian population, with significant implications for surgical precision and patient outcomes. By establishing reliable anatomical landmarks and elucidating the predominant arborization pattern, the study enhances the understanding of facial nerve behavior during surgical interventions, particularly in the context of facial paralysis treatment and reconstructive surgeries. Due to the small sample size, however, this study only acts as a pilot for further research.
Many surgical techniques have been proposed to address the submental-cervical angle in neck lift. Despite the several advances, obstacles persist when dealing with platysma bands and redefinition of the obtuse cervical a...Many surgical techniques have been proposed to address the submental-cervical angle in neck lift. Despite the several advances, obstacles persist when dealing with platysma bands and redefinition of the obtuse cervical angle. The aim of this study was to quantify platysma bands recurrence, any neurovascular damage, and other complications following neck lift procedures involving platysma muscle. After the approval and registration on the International Prospective Register of Systematic Reviews (PROSPERO), the systematic review was performed in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A series of specific keywords and predefined MeSH terms were utilized in different search engines (Medline, PubMed, Google Scholar, and the Cochrane library databases). Primary outcome was the recurrence of platysma bands; secondary outcomes included any postoperative complications, including any nerve damage. Pooled analysis was performed using a random effects model. Twelve articles, encompassing 2,106 patients, were relevant to this issue and included data on neck lift surgery with any platysma transection outcomes. Twenty-six patients had a recurrence of platysma bands during the follow-up, with a pooled rate of 1.4%. The pooled overall nerve damage rate was 0.9%. At the reported follow-up, the pooled hematoma percentage was 1.8%, and the pooled sialoma rate was 0.3%. Even less common complications were long-lasting edema, dehiscence of the submental suspension, and skin necrosis. Cervicomental angle redefinition remains a controversial and complicated procedure, which can be approached with different maneuvers. However, more long-term outcome reports as well as standardized complication outcomes are warranted in order to compare different and new techniques. LEVEL OF EVIDENCE: III.
The auricle is susceptible to various injuries due to its location and projection from the scalp. The unique contours of the external ear makes reconstruction a challenging endeavor. This chapter provides a comprehensive...The auricle is susceptible to various injuries due to its location and projection from the scalp. The unique contours of the external ear makes reconstruction a challenging endeavor. This chapter provides a comprehensive overview of auricular reconstruction, based on the depth, location, and size of injury. Strategies for reconstructing superficial, composite, and full-thickness injuries are discussed in relation to the location of the defect. Targeted reconstructive options for injuries of the upper, middle, and lower thirds of the auricle are outlined. Methods for total auricular reconstruction and auricular prosthesis are discussed. Options for managing traumatic injuries are reviewed, including avulsion/amputation injuries, burns, electrical injuries, frostbite, and human/animal bites. This chapter provides a practical framework for surgeons faced with complex auricular defects, offering insights to recreate a discreet, harmonious ear.
Rhinoplasty is undergoing a transformation with the reemergence of dorsal preservation rhinoplasty (DPR) techniques. This article introduces a novel addition to the DPR repertoire, "bony dorsal preservation" (BDP), which...Rhinoplasty is undergoing a transformation with the reemergence of dorsal preservation rhinoplasty (DPR) techniques. This article introduces a novel addition to the DPR repertoire, "bony dorsal preservation" (BDP), which has particular application for the correction of crooked noses.This comprehensive overview summarizes current DPR concepts and techniques, the intricate considerations that go into the dorsal osseocartilaginous vault and septal management, and how these are modified to treat the crooked nose. However, current DPR techniques, particularly the low septal strip (LSS), have drawbacks, and the desire to address such issues led to the development of BDP.BDP is ideal for cases where there is no septal base pathology. It maintains the core principle of DPR by lowering dorsal humps without creating open roof deformities. Its unique feature is that it temporarily separates the upper lateral cartilages from the septum while leaving the septal base attachment intact, thus allowing the entire osseocartilaginous vault to be adjusted independently before reconnecting the preserved upper lateral cartilages. This technique offers direct visualization during septal excision and fixation and enables cartilaginous vault movement without sacrificing stability. Compared with LSS, there is more septal cartilage available for harvesting, the risks of a single point of septal fixation are eliminated, and there is the potential to transition to component reduction techniques, if needed. With shared indications and contraindications with other DPR methods, BDP emerges as a valuable addition to the evolving field of rhinoplasty, particularly in addressing the challenges of the crooked nose.
Genioplasty is a surgical technique that modifies the projection of the chin in three dimensions to achieve symmetry and facial harmonization. Virtual 3D planning is increasingly used, supplanting the conventional surgic...Genioplasty is a surgical technique that modifies the projection of the chin in three dimensions to achieve symmetry and facial harmonization. Virtual 3D planning is increasingly used, supplanting the conventional surgical technique due to the precise and predictable results obtained.The definition of the objective of the study was first carried out using the PICO (Patient, Intervention, Comparison, Outcome) question method. Posteriorly, an updated literature review was carried out in the "PubMed" database using the keywords "Genioplasty and Virtual 3D Planning," obtaining 11 articles for the study with the objective of defining the advantages and disadvantages of performing a virtually planned genioplasty, comparing it with the conventional technique.In the results, it is observed that virtually planned genioplasty presents greater precision, a reduction in surgical time, and a lower rate of complications than the conventional technique. Virtual planning using computer-aided design/computer-aided manufacturing technology presents good reproducibility in the patient with <2 mm variations between what was planned and what was obtained postoperatively, with statistically significant results ( < 0.001).In conclusion, virtually planned genioplasty with customized cutting guides and osteosynthesis plates achieves very precise surgery results with good reproducibility, reducing surgical time, intraoperative complications, and the difficulty of the surgical technique.
Ideal standards of beauty including preferred lip characteristics vary between ethnicities. Although plump, well-defined lips are globally associated with youth, variation exists with regard to the perceived ideal lip vo...Ideal standards of beauty including preferred lip characteristics vary between ethnicities. Although plump, well-defined lips are globally associated with youth, variation exists with regard to the perceived ideal lip volume and proportions between ethnicities. Proportions that may be assessed when planning lip augmentation include the upper-to-lower lip ratio, philtrum length, upper and lower vermilion heights, the ratio between the philtrum height and that of the upper vermilion, and the lip height-to-lip width ratio.It is important that accurate assessments of patients are made pre- and postaugmentation. However, many aesthetic assessment tools are based on Caucasian models with limited use in other ethnicities. We present a review of the ideal lip characteristics and assessment techniques accounting for ethnicity, with a view to providing practitioners an evidence-based approach to lip assessment and treatment planning for patients of all backgrounds.
INTRODUCTION AND PURPOSE: Congenital outer ear deformities stem from a sequence of disturbances during fetal auricular cartilage embryonic development. A significant gap exists in understanding their prevalence among the...INTRODUCTION AND PURPOSE: Congenital outer ear deformities stem from a sequence of disturbances during fetal auricular cartilage embryonic development. A significant gap exists in understanding their prevalence among the school-age group in Saudi Arabia. This cross-sectional study aims to address this knowledge gap to raise awareness about the impact of such disorders. METHODOLOGY: This cross-sectional study targeted parents of children in the school-age group. A multistage cluster sampling technique was employed to ensure the representation of schools. A self-administered Google form survey was used. Data were analyzed using IBM SPSS Statistics for Windows, Version 28.0 (IBM Corp., Armonk, NY). RESULTS: Our study revealed that the majority were males (56.2%), aged 6 to 10 years (49.3%), and attended primary school (69.5%). Chronic illnesses were present in 7.1% of children, with hearing impairment most prevalent (25.9%). Congenital ear deformities affected 2.7% of children, primarily Stahl's ear (35.4%). Limited knowledge about these deformities was observed among respondents (30.3%), yet a significant majority (73.9%) expressed belief in the potential of community awareness to decrease deformity prevalence. The awareness levels were impacted by parental education but showed no significant association with the child's age, gender, or presence of chronic diseases. CONCLUSION: Our study underscores the noteworthy occurrence of congenital ear deformities among the school-age group, coupled with a notable lack of awareness. Parental education emerges as a key factor influencing awareness levels. It is imperative to prioritize initiatives to bolster awareness and early detection to promote child health.
Mastering rhinoplasty surgical techniques requires extensive learning involving theoretical studies, internships, cadaver laboratories, simulators, nonhuman models, and hands-on practice. A novel method using chicken bre...Mastering rhinoplasty surgical techniques requires extensive learning involving theoretical studies, internships, cadaver laboratories, simulators, nonhuman models, and hands-on practice. A novel method using chicken breast simplifies skill development, offering flexibility and accessibility. Training on chicken breast allows surgeons to refine skills through various techniques and grafts. This study focuses on preservation techniques using chicken as a model. Surgical sequences simulate nasal structures using prepared chicken breasts. Documentation through media illustrates procedures from basic to advanced, using materials akin to traditional rhinoplasty but in reduced quantities. Chicken breast tissue, especially sternal cartilage, offers a suitable substrate for practicing techniques and grafting without live human or cadaveric tissue. This method provides an efficient, safe, and cost-effective approach to learning rhinoplasty.
This article discusses the process of patient selection for rhinoplasties and the many different psychological aspects that come into play. It is important to identify the warning signs and apply a multidisciplinary appr...This article discusses the process of patient selection for rhinoplasties and the many different psychological aspects that come into play. It is important to identify the warning signs and apply a multidisciplinary approach to the surgeons practice, in collaboration with specialist rhinoplasty psychologists. Patients' motivations and surgeon factors are also discussed, as this can lead to unhappy and unsatisfactory postoperative outcomes. Potential reasons for adverse outcomes throughout the pre- and postoperative periods are also described. Finally, a brief guide is provided to reduce the risks of an unhappy patient.