Photogrammetric Facial Analysis of Attractive Celebrities Using the Glabella for Planning Rhinoplasty and Analyzing Surgical Outcomes

BACKGROUND: Identifying problems and making a surgical plan through a preoperative analysis is important in facial aesthetic surgery. Thus, popular conceptions of an attractive face must be analyzed beforehand. The landmarks used as reference points may change after rhinoplasty, resulting in errors in the prediction and assessment of outcomes. To reduce such errors, it is advantageous to use reference points and landmarks that are subject to minimal variation. This study measured and analyzed landmarks with little preoperative and postoperative variation in rhinoplasty, and established appropriate standards for landmarks indicative of ideal profiles. METHODS: A photogrammetric analysis was performed of 80 famous and attractive celebrities from Korea, Southeast Asia, Japan, China, and America. The nasofrontal angle, nasal angle, nasolabial angle, angle of facial convexity, and angle of total facial convexity were measured. RESULTS: The angle of total facial convexity differed significantly among countries (P=0.013). No significant difference in nasal angle, facial convexity, or total facial convexity was observed between Western and Eastern countries. A significant difference in the nasofrontal angle (Asian: 138.66°, Western: 134.35°; P=0.006) was observed. The nasolabial angle (Asian: 97.09°, Western: 104.59° degrees; P=0.007) was significantly more acute in Asian than in Western subjects. CONCLUSIONS: In this study, we performed a more accurate analysis using the glabella instead of the nasion to measure the facial profiles of patients planning to undergo rhinoplasty and proposed standard values through an analysis of ideal and attractive facial profiles.

Multiple Myopericytoma of the Face and Parotid Gland

Myopericytoma is a benign tumor that is composed of myoid-appearing oval to spindle-shaped cells with a concentric perivascular pattern of growth. The tumor is morphologically heterogeneous and can exhibit a broad histologic spectrum. We describe a case of multiple myopericytoma occurring in the head and neck skin region with involvement of the parotid gland where it is known to occur very rarely. A 40-year-old woman noticed multiple enlarging, painless, round-shaped masses on her left cheek. The patient had experienced a similar lesion of the same area 8 years earlier which was completely excised and the pathological diagnosis was spindle cell type myoepithelioma. On a computed tomographic image, one mass involved the superficial parotid gland and was well encapsulated. Excision of the facial masses and superficial parotidectomy with facial nerve preservation were performed. A diagnosis of myopericytoma was established in light of the immunohistochemical pattern with the histopathological findings. Over the 4-year follow-up period, there was no evidence of recurrence. As many perivascular myoid neoplasms share common morphologic features with myopericytoma, we should consider the differential diagnosis, and confirm the histological findings with appropriate immunohistochemical staining. After identifying myopericytoma, it should be treated with wide surgical excision to prevent local recurrence.

Various Modalities of Flap Surgery in Heel Pad Reconstruction

PURPOSE: The reconstruction of a soft tissue defect of the heel pad can be challenging. One vital issue is the restoration of the ability of the heel to bear the load of the body weight. Many surgeons prefer to use local flaps or free tissue transfer rather than a skin graft. In this study, we evaluated the criteria for choosing a proper flap for heel pad reconstruction. METHODS: In this study, 23 cases of heel pad reconstruction were performed by using the flap technique. The etiologies of the heel defects included pressure sores, trauma, or wide excision of a malignant tumor. During the operation, the location, size and depth of the heel pad defect determined which flap was chosen. When the defect size was relatively small and the defect depth was limited to the subcutaneous layer, a local flap was used. A free flap was selected when the defect was so large and deep that almost entire heel pad had to be replaced. RESULTS: There was only one complication of poor graft acceptance, involving partial flap necrosis. This patient experienced complete recovery after debridement of the necrotic tissue and a split thickness skin graft. None of the other transferred tissues had complications. During the follow-up period, the patients were reported satisfactory with both aesthetic and functional results. CONCLUSION: The heel pad reconstructive method is determined by the size and soft-tissue requirements of the defect. The proper choice of the donor flap allows to achieve satisfactory surgical outcomes in aesthetic and functional viewpoints with fewer complications.