ABSTRACT
We introduce a new silicone implanting method to correct facial depression caused by trauma or congenital anomaly. It resulted in good facial aesthetics in patients with facial depression. From August 1997 to January 1999, 5 patient (3 males and 2 females), in ages from 19 to 34 years, underwent silicone implantation for facial depression using our method. Three males were injured by traffic accident and had facial depression with or without bone defect. Two females had congenital forhead depression and requested aesthetic contouring. An impression of the face was taken with alginate backed with quick setting plaster. When set, a further stone plaster model was taken from the alginate-plaster, which was removed after fixation. Wax was then carved into the patient's stone model to fill the depression. Another stone cover was taken to cover this was-stone model. Then wax was melted away and medical implant grade room temperature vulcanized silicone adhesive was squeezed into the empty space. After cured, this precisely-shaped silicone imlant was inserted into the patient. We did not experience major complicaion such as infection, implant extrusion during 4 to 18 months' follow-up periods. All patients were satisfied with the results. The clinical result of this technique would be useful for accurate and excellent aesthetic implantation.
Subject(s)
Female , Humans , Male , Accidents, Traffic , Adhesives , Depression , Esthetics , Follow-Up Studies , SiliconesABSTRACT
Facial paralysis is a devastating problem, since such a patient can neither make facial expressions nor enjoy an active social relationship. If it persists for a long time, facial muscles will have irreversible changes and deformities. The goal in the treatment of facial paralysis is to achieve a normal appearance at rest and reconstruct a natural, symmetrical smile. One of the most distressing figures in a facial palsy patient is oral deformity. There have been numerous corrective methods of reanimating the paralyzed lips. Recently the one-stage muscle transplantation, innervated by the contralateral facial nerve, has been introduced to solve this distressing problem. From March 1998 to December 1998, 3 patients(2 males and 1 female), who ranged in age from 17 to 33 years, underwent one-stage reanimation surgery of paralyzed lips using rectus abdominis muscle neurovascular free flap. All patients had unilateral facial paralysis caused by tumor resection. The rectus abdominis muscle with long intercostal nerve and pedicle vessels(deep inferior epigastric vessels) was elevated and transferred to the preoperatively designed subcutaneous pocket. The upper end of the muscle was fixed to the zygoma and parotid fascia, and the lower end was fixed to the mouth corner, upper and lower lip. The intercostal nerve was repaired to the non-paralyzed buccal branch of the facial nerve through the subcutaneous tunnel of the upper lip, and the vascular pedicle of the muscle flap was anastomosed to the paralyzed side of the facial vessels. The onset of muscle function was reported in all the patients. Five months after the surgery, nerve conduction study and EMG showed compound motor action potential(CMAP) and motor unit action potential(MUAP) of the transferred muscle respectively. Nine months after the surgery, we observed volitional muscle contraction. The power of contraction increased constantly for 2 years after the surgery.