ABSTRACT
Lifting procedures of the upper face have gained significant popularity, and various methods and dissection planes have been described. The deep temporalis fascia (DTF) is a crucial structure for securing lifting sutures and allowing horizontal tissue vectorization. However, achieving vertical eyebrow lifting often requires bone maneuvers and introduces potential complications. This letter proposes a novel multiplanar dissection method for the temporal and forehead regions, obviating the need for bone maneuvers in lifting suture fixations. The presence of the subgaleal fascia in the temporal region has been identified, in addition to the DTF and superficial temporal fascia. Furthermore the superficial temporal fascia is divided into 3 layers, with attention paid to their medial connection with the structures of the forehead. Surgical techniques involve meticulous dissection down to the DTF and identification of the subgaleal fascia for lateral temporal dissection or transition to the subplane of the epicranial aponeurosis for forehead lifting. By leaving a thick layer, the subplane of the epicranial aponeurosis during forehead lifting eliminates the need for drilling and reduces the risk of relapse. The described multiplanar dissection method enhances the safety and effectiveness of forehead lift procedures, offers a viable alternative to bone drilling, minimizes flap-related complications, and provides valuable insights for facial rejuvenation surgery.
ABSTRACT
BACKGROUND: Open reduction with internal fixation is the preferred treatment option for displaced facial bone fractures. The superior mechanical properties of metallic plates have made them the most widely used material in existing bone fixation systems. However, after the healing period, these permanent plates can cause various problems. Alternative bioresorbable materials are being investigated to reduce these potential problems. This study compares bone stability and viability by using graphene oxide (GO)-doped poly-lactic-co-glycolic acid (PLGA) nanofiber plates and titanium plates for rats with fractured mandibles. MATERIALS AND METHODS: The study included 20 male Sprague-Dawley rats, divided into four groups: a control group (Group I), a mandibular fracture group with no additional application (Group II), a mandibular fracture group repaired with titanium plates (Group III), and a mandibular fracture group repaired with GO-PLGA plates (Group IV). After 2 months, all of the rats were euthanized. A bone compression test was performed to assess bone stability, and a histological examination was performed to evaluate bone healing. RESULTS: The osteocyte lacunae, Haversian ducts, canaliculi, and vascular structures of Group IV were found to be higher. In the compression test, vertical compression was applied to the bone axis, and Group IV had a higher maximum load and maximum stretch. GO-PLGA plates were found to be statistically superior to titanium plates in terms of both bone stability and bone healing (p < 0.05). CONCLUSIONS: The present study found that GO-PLGA plates are more effective than titanium plates for the treatment of mandibular corpus fractures.
