ABSTRACT
Since the time of its inception within facial anatomy, wide variability in the terminology as well as the location and extent of retaining ligaments has resulted in confusion over nomenclature. Confusion over nomenclature also arises with regard to the subcutaneous ligamentous attachments, and in the anatomic location and extent described, particularly for zygomatic and masseteric ligaments. Certain historical terms-McGregor's patch, the platysma auricular ligament, parotid cutaneous ligament, platysma auricular fascia, temporoparotid fasica (Lore's fascia), anterior platysma-cutaneous ligament, and platysma cutaneous ligament-delineate retaining ligaments of related anatomic structures that have been conceptualized in various ways. Confusion around the masseteric cutaneous ligaments arises from inconsistencies in their reported locations in the literature because the size and location of the parotid gland varies so much, and this affects the relationship between the parotid gland and the fascia of the masseter muscle. For the zygomatic ligaments, there is disagreement over how far they extend, with descriptions varying over whether they extend medially beyond the zygomaticus minor muscle. Even the 'main' zygomatic ligament's denotation may vary depending on which subcutaneous plane is used as a reference for naming it. Recent popularity in procedures using threads or injectables has required not only an accurate understanding of the nomenclature of retaining ligaments, but also of their location and extent. The authors have here summarized each retaining ligament with a survey of the different nomenclature that has been introduced by different authors within the most commonly cited published papers.
ABSTRACT
A prominent mandibular angle is considered to be unattractive in Asians because it gives the face a square, coarse, and muscular appearance. Asian women desire to have an ovoid, reduced, and slender face by aesthetic mandibular angle resection. Mandibular angle ostectomy has been known to be effective and to satisfy both surgeons and patients. Especially in Korea, it has become as popular as facial bone contouring surgery, which reduces lower facial width. However, a narrow surgical field hinders direct view of the site, making a procedure that is rather difficult to perform. Despite thorough presurgical planning and attention, there can be many complications and unfavorable results. The purpose of this study is to find out the cause of these complications of mandibular angle ostectomy and to develop methods that could prevent these complications from occurring. A questionnaire consisting of 30 questions regarding mandibular angle ostectomy was sent to 40 Korean plastic surgeons. Data from 33 surgeons were analyzed. The total number of operations was 1251, and among them complications appeared in 124 operations, a complication rate of 9.9%. In regards to severe complications, there were 8 cases of subcondyle fracture of the mandible and 6 cases of severe bleeding. Transient facial nerve injury, infection, trismus, asymmetry, undercorrection, overcorrection, secondary angle formation, and entrapped bony segment were also noted as complications. We will report the cause and the prevention methods for each complication.