Ligasure-assisted submandibular gland excision in deep plane neck lift: review of 83 patients.

BACKGROUND: In performing a neck lift, the size and location of the submandibular gland (SMG) must be evaluated to achieve the ideal neck contour. Many surgeons, however, avoid SMG excision because of the technical difficulty, risks of hematoma, and nerve damage. LigaSure™ (Valleylab, Boulder, CO) is a bipolar energy-based instrument that permanently seals vessels and connective tissue which can make the SMG excision step easy and safe by reducing surgical risks. METHODS: A total of 83 patients who underwent SMG excision between 2018 and 2022 were included in the study. All patients' SMGs were partially excised by LigaSure™ (LS), and the complication rates were documented. RESULTS: Patients were followed up for an average of 21 months (9 months-2.4 years). No perioperative intraglandular bleeding or postoperative hematoma was observed in any of the patients. No sialoma was observed in any of the patients postoperatively. Only three patients underwent repeated seroma aspirations. Transient lower lip weakness was observed in 7 patients which all recovered in the first 6 months postoperatively. CONCLUSIONS: LS-assisted SMG excision in deep neck lift surgery was found to be technically easier, time-saving, safe, and highly effective in preventing hematoma and intraoperative bleeding.

Low-Cost and Simple Frontal Sinus Surgical Cutting Guide Modeling for Anterior Cranioplasty in Facial Feminization Surgery: How To Do It.

BACKGROUND: This study demonstrates a novel and simple design to create a low cost frontal sinus surgical cutting guide, using patient's frontal sinus cavities as references, to perform an anterior cranioplasty in facial feminization surgery. A clinical series demonstrates its clinical use and safety. MATERIAL AND METHODS: Authors used a 4 open-source software protocol for the virtual surgical modeling (VSP). Retrospectively, pre- and post-operative complications were reviewed, and a FACE-Q questionnaires were used to evaluate patient's postoperative "Satisfaction with forehead and eyebrows." Recordings of the VSP and surgical technic are presented. RESULTS: Sixteen patients were operated between November 2018 and November 2020 using in-house surgical guides. All were performed by authors in 5 to 10 minutes using Blender open-source Software. No complications were reported and authors always found an optimal retention of the surgical guide on the convex bony surface of the forehead and frontonasal area. FACE-Q questionnaire reported a very high satisfaction for all patients (mean score: 22/24). DISCUSSION: This simplify organic design can be performed efficiently by any surgeon even without previous training in home staging VSP. Patient satisfaction was very high, along with an absence of postoperative complications.