[Fronto-temporal anatomy and its application for augmentation plasty].

OBJECTIVE: To decide the safe dissection plane and evaluate the multiple materials used for the fronto-temporal augmentation. METHODS: Clinical anatomical observation were made during the fronto-temporal operations. Forty-one patients were treated for the fronto-temporal augmentation with various granular or patched materials in different anatomical plane. RESULTS: Four relatively safe dissection planes were found in the fronto-temporal area: (1) subcutaneous or above superficial temporal fascia, (2) subgalea plane 1.5 cm above the zygomatic arch, (3) between the deep temporal fascia and the temporal muscle, and (4) beneath the temporal periosteum. With the follow-ups from 6 months to 1 year, the appearance after the fronto-temporal augmentation in each patient was satisfactory or improved, except for the fat granule group with partial absorption and the ePTFE or Medpor hypothesis group shown a stepped contouring at the margin in a few patients. CONCLUSION: Four dissection planes could be shown in the fronto-temporal region for the augmentation plasty with different advantages and disadvantages. The combination could be overcome the disadvantages to improve the results. Fat granule could be the best autograft for frontotemporal augmentation.

[Mask lift and facial aesthetic sculpturing].

OBJECTIVE: To improve the outcome of the face-lift with a craniofacial contouring procedure. METHODS: Thirty-seven patients aged 29-53 years (31 in female, 6 in male) were treated through a bicoronal incision. The facial tissue was lifted through a subperiosteal procedure and the facial skeleton was remodeled in three dimensions by osteotomies. RESULTS: The results were satisfactory after the 3-12 months of the follow-ups. CONCLUSIONS: The Face-lift combined with the facial aesthetic sculpturing may be more effective for the aging-face rejuvenating.

[The reverse forearm flap pedicled with the ulnar branch of the ulnar artery].

OBJECTIVE: To introduce a new flap for the repair of soft tissue defects in the hand. METHODS: The distally pedicled ulnar flap is based on the ascending branch of the upper-wrist cutaneous branch of the ulnar artery. The retrograde flow is ensured by the dorsal carpal arch via the descending branch. RESULTS: From 2000 to 2003, the flap was used to treat 8 cases of hand defects, including 3 dorsal defects, 2 palmar defects and 3 the first web defects. All flaps survived and the appearance was satisfactory. CONCLUSIONS: The reverse forearm flap pedicled with the ulnar branch of the ulnar artery provides a long vascular pedicle. The donor site scar is aesthetically acceptable.

[Contour changing of forehead].

OBJECTIVE: To bring forward a method to improve the prominence of the forehead contour. METHODS: 16 patients(age 29-53 years, female 11, male 5) were treated through a bicoronal incision. Following the incision, the forehead soft tissues are reflected down to the level of the superior orbital rims with the protection to the supraorbital neurovascular bundles. To adjust the forehead contour, both superior orbital rims and frontal bossing was reduced by burring down the excess bone or removing the anterior wall of the forehead. RESULTS: The operative effect were satisfactory during 3-12 months of follow-up. No recurrence or osteogenesis were found in the cases. Nasofrontal angle and forehead angle were normal. The prominence of the supraorbital ridges disappeared and forehead became nature. CONCLUSION: Cranioplasty via an osteomy or burring of the outer line of forehead bone are safe, compact and effective way to improve the prominence of the superior orbital rims or frontal bossing.