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1.
Aesthetic Plast Surg ; 2024 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-39014233

RESUMO

BACKGROUND: Having a well-defined jawline is a sign of youth and attractiveness among both men and women. Soft tissue fillers, such as calcium hydroxylapatite (CaHA) and hyaluronic acid (HA) fillers, offer nonsurgical alternatives for rejuvenating the lower face and enhancing the jawline. The aim of this study was to investigate the use of a premixed combination of HA with cohesive polydensified matrix technology (CPM, Belotero Intense, CPM-I) and CaHA to create a sharply defined jawline. METHODS: A total of 126 patients were enrolled in the study and treated with a premixed combination of CPM-I and CaHA using a retrograde fanning injection technique with cannulas. The injection volumes and product ratios were customized according to the patients' needs. RESULTS: The cohort consisted of 75 females and 51 males. The average injected volume of premixed CaHA:CPM-I was 5.83 mL. In the majority of patients, a 1:1 syringe ratio of CaHA:CPM-I was applied (n = 81, 64.2%). No adverse events were reported during the 6-month follow-up period. CONCLUSION: The hybrid filler approach investigated in this study shows promise for achieving well-defined, long-lasting jawline contours. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors   www.springer.com/00266 .

2.
Aesthetic Plast Surg ; 48(14): 2625-2633, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38858246

RESUMO

BACKGROUND: Facial balance significantly impacts aesthetics, particularly in the middle and lower thirds. Patients with chin retrusion often benefit from sagittal plane chin advancement in rhinoplasty, enhancing surgical outcomes and satisfaction. OBJECTIVES: This article presents a method for analyzing chin deformities and discusses a hybrid treatment approach to harmonize facial features, complementing rhinoplasty. METHODS: The chin positions of patients treated by the senior author were assessed. A retrospective analysis included 49 patients with chin retrusion of 2.5-6 mm. Among them, 22 patients initially offered chin implants declined, leading to planned chin augmentation. Fat grafting was exclusively performed for 20 patients lacking sufficient cartilage. The "Hybrid Chin Advancement" technique involved supporting tissues beneath muscles with nasal septum cartilage and fat injections and tissues above muscles with fat injection alone. RESULTS: Pre- and postoperative Legan angle measurements and chin advancements were compared across three groups. While preoperative Legan angles were statistically similar, postoperative Legan angles and advancement changes were significantly higher in the implant group (p < 0.0001). Comparing hybrid chin advancement and fat grafting groups, postoperative Legan angles and advancement changes were significantly higher in the hybrid chin group (p < 0.0001). CONCLUSIONS: Fat grafting suffices for mild advancements (~ 2 mm), while the hybrid chin method is effective for moderate advancements (~ 4 mm). For advancements exceeding 6 mm, implants or osseous genioplasty are optimal. Our study's hybrid approach offers an easy, safe, and reliable method for achieving facial harmony in the lower two-thirds without compromising patient expectations. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .


Assuntos
Tecido Adiposo , Estética , Rinoplastia , Humanos , Rinoplastia/métodos , Estudos Retrospectivos , Feminino , Adulto , Masculino , Queixo/cirurgia , Tecido Adiposo/transplante , Resultado do Tratamento , Adulto Jovem , Estudos de Coortes , Satisfação do Paciente , Cartilagem/transplante , Mentoplastia/métodos
3.
Aesthetic Plast Surg ; 48(11): 2018-2024, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38499874

RESUMO

BACKGROUND: Alloplastic chin augmentation is the most common esthetic surgical treatment to reshape the chin. However, factory-made chin implants are typically standardized rather than custom-made and have potential to cause complications. Although the fabrication of custom-made implants by using computer-assisted planning and 3D-printing technology has become widespread, the process has several disadvantages, including long preoperative prosthesis preparation times, high costs, and unsuitability for patients with asymmetric chins or those who undergo combined mandibuloplasty before implant placement. The present study developed an innovative chin augmentation technique involving stacked expanded polytetrafluoroethylene (e-PTFE) sheets that is suitable for most patients and has minimal side effects. MATERIALS AND METHODS: A retrospective review of a single surgeon's experience was performed over a 2 year period for patients who underwent a procedure involving piled-up e-PTFE sheets for alloplastic chin augmentation. This study analyzed the outcomes, complications (temporary nerve numbness, wound infection, hematoma formation, and implant displacement), and patient satisfaction during follow-up. RESULTS: Between January 2018 and December 2020, 38 patients underwent the procedure involving piled-up e-PTFE sheets for alloplastic chin augmentation. Six patients (15.8%) experienced nerve-related temporary numbness, and one (2.6%) experienced wound infection. None had developed major complications such as implant displacement or wound infection at follow-up. Moreover, the patients demonstrated a high level of satisfaction with the surgical results. CONCLUSION: Piled-up e-PTFE sheets can be used to produce custom-fit porous polyethylene chin implants that result in minimal complications and a very high satisfaction rate. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .


Assuntos
Politetrafluoretileno , Desenho de Prótese , Humanos , Estudos Retrospectivos , Feminino , Adulto , Masculino , Queixo/cirurgia , Pessoa de Meia-Idade , Estética , Satisfação do Paciente , Próteses e Implantes , Adulto Jovem , Resultado do Tratamento
4.
J Clin Aesthet Dermatol ; 17(2): 24-28, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38444424

RESUMO

Background: Microgenia resulting from congenital deficiency or aging can significantly affect the facial profile and render it less attractive. This study assessed the effectiveness of treatment with incobotulinumtoxinA (Inco) and calcium hydroxylapatite with integral lidocaine (CaHA[+]) for improving chin profile. Methods: Subjects with a hyperactive mentalis and at least moderate chin retrusion according to the Asian Chin Projection Scale (ACPS) were recruited. At Visit 1, subjects received Inco injection into the mentalis, followed by deep, pre-periosteal injections of CaHA(+) into the pogonion. The primary endpoint was an ACPS improvement of one point at one and six months. Photographs at baseline and each follow-up visit were rated by physicians using the Global Aesthetic Improvement Scale (GAIS). All subjects completed a satisfaction questionnaire. Results: Ten female subjects were recruited. Mean age was 42.5 years and all had moderate-to-severe chin retrusion at baseline (ACPS score ≥2). All subjects demonstrated at least a one-point improvement in ACPS compared with baseline at both the one-month and six-month posttreatment visits. Physician GAIS ratings of subject appearance confirmed that 100 percent of subjects experienced improved chin projection at each follow-up visit compared to baseline. All 10 subjects were pleased with their chin profile after treatment, with 90 percent noting that it was still "very much improved" at six months. Conclusion: Based on our results, combined treatment with CaHA and Inco appears to be effective and well tolerated for improving the facial profile of subjects with chin retrusion. Treatment was associated with a high degree of patient satisfaction and was well tolerated.

5.
Aesthetic Plast Surg ; 48(1): 52-54, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37814037

RESUMO

The article titled "Nonsurgical Chin Augmentation Using Hyaluronic Acid: A Systematic Review of Technique, Satisfaction, and Complications" by Ou et al. in Aesthetic Plastic Surgery presents a systematic review focused on categorizing complications associated with hyaluronic acid (HA) dermal fillers. However, concerns arise regarding the methodologies employed in the reviewed studies. It is essential to have precise knowledge of the properties of the active substance for treatment standardization. Gaining a comprehensive understanding of the key characteristics of the HA used is paramount to determine if there is an association between these properties and the risk of complications.Understanding HA's rheological properties, including viscosity, elasticity, and cohesiveness, is crucial for selecting the most suitable facial filler. While we acknowledge the authors' contributions, we strongly believe that further analysis should incorporate these factors.Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .


Assuntos
Técnicas Cosméticas , Preenchedores Dérmicos , Humanos , Ácido Hialurônico/efeitos adversos , Preenchedores Dérmicos/efeitos adversos , Técnicas Cosméticas/efeitos adversos , Queixo/cirurgia , Satisfação Pessoal
6.
Int J Surg Case Rep ; 114: 109174, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38154232

RESUMO

INTRODUCTION: The development of filler biomaterials with high hyaluronic acid concentrations, cohesiveness, and elastic modulus has become an option for chin augmentation, as the balance of these rheological properties promotes high lifting capacity, providing minimally invasive perceptible improvements in patient appearance. PRESENTATION OF CASE: The present study reviewed clinical and anatomical aspects of patients referred for chin augmentation and created a flowchart to assertively diagnose patients with an indication of Juvéderm® Volux™ for defining the lower third of the face. DISCUSSION: The chin is vital for facial proportions and attractiveness perception. Its relevance to facial appearance is noticed the most when chin size is less than ideal, making other facial areas seem larger or smaller. The adjacent soft tissues of the neck and jaw appear prematurely aged when chin projection or width is inadequate. Hyaluronic acid-based fillers have a confirmed history of safe and effective use for treating facial volume loss or deficiency. CONCLUSION: Juvéderm® Volux™ is a safe, effective, and long-lasting alternative for restoring and creating facial volume and sculpting, shaping, and contouring the chin and jaw.

7.
Cureus ; 15(11): e48807, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38098909

RESUMO

A frequent facial abnormality called chin retrusion, also known as retrognathia, can be detrimental to a person's self-esteem and overall face aesthetics. Hyaluronic acid (HA) injections are one non-surgical approach to this problem that may provide individuals seeking chin augmentation with a relatively less invasive and potentially more affordable alternative. The present literature does not provide enough in-depth systematic reviews of the use of HA in chin augmentation. By completing a complete examination of the information that is currently available, this study intends to fill this knowledge gap, supporting physicians and researchers in better comprehending the efficacy and implications of HA in chin augmentation. The safety and success of any esthetic procedure should be made based on the results reported by the patients, including satisfaction and quality of life. Patients need to receive comprehensive surgical instructions from a medical professional to optimize the results of the HA injections for chin enhancement surgery. Regardless of the reported safety of using HA injections, some unwanted side effects have also been recorded. Indeed, healthcare professionals can make more informed decisions and give a patient comprehensive information about the procedure's risks and benefits to the patients. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. EMBASE, OVID, and Google Scholar databases were searched up to June 2023. We concentrated on adult patients treated with HA for chin enhancement, and our research was limited to studies conducted in English. A total of 2,738 patients from 24 articles were studied, with 2,259 receiving HA injections for chin augmentation. When applicable, aesthetic outcomes were assessed using scales such as the Global Aesthetic Improvement Scale (GAIS)/FACE-Q and the Galderma Chin Retrusion Scale. Patient satisfaction increased noticeably. Among the studies, some reported complications following HA injection. While three studies found no significant negative effects, one highlighted a major necrotic complication. HA has proven to be an effective and safe alternative to chin augmentation surgery, with the majority of patients showing high satisfaction rates. However, large-scale randomized controlled trials are needed to obtain meaningful results, which will contribute to the further development of non-surgical cosmetic procedures. These studies may facilitate further innovation and refinement of these techniques and potentially expand the application of HA fillers in facial aesthetics.

8.
Aesthetic Plast Surg ; 47(6): 2401-2406, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37452130

RESUMO

BACKGROUND: Fat injection has become increasingly popular in aesthetic surgery, but there is a sparsity of literature regarding its role during genioplasty. In this study, we present the largest series of patients receiving fat injections to the chin for various indications. METHODS: Data were collected from January 2016 to December 2021 for patients who underwent chin fat injection for a variety of chin refinements. Patients with chin fat injection were divided into isolated genioplasty with fat injection (CF), combined facial and chin fat injection (CFC) and combined chin fat injection and osseous genioplasty (CFG). Complication rates and reoperations were compared using Fischer's exact test between each cohort. RESULTS: 181 patients were included in final analysis, with 14 patients in CF cohort, 130 patients in CFC cohort, 24 patients in CFG cohort, and 13 patients who underwent genioplasty alone. Repeat fat injections were required in 17 (9.4%) patients overall, which included 14 patients (10.8%) of CFC subcohort and three patients (12.5%) of CFG subcohort (p > 0.05). No patients who underwent genioplasty alone or CF required reoperation. There were no significant differences in complications between genioplasty alone group (0%) in comparison to CF (7.1%; p = 1.00), CFC (6.2%; p = .53), or CFG cohorts (7.7%; p = 1.00). CONCLUSION: Fat injection can safely correct minor chin deficiency or asymmetry, as either an isolated procedure or in combination with osteotomies. Additionally, fat injection enables advancement of the caudal segment to achieve superior outcomes by preventing unaesthetic deepening of labiomental groove which will not be advanced during sliding osteotomy. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .


Assuntos
Face , Mentoplastia , Humanos , Mentoplastia/métodos , Queixo/cirurgia , Osteotomia/métodos , Reoperação
9.
Exp Ther Med ; 26(1): 357, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37324516

RESUMO

From July 2020 to March 2022, 3 patients with papillary thyroid cancer (PTC) and microgenia underwent transoral endoscopic thyroid surgery via a vestibular approach or a endoscopic lateral neck dissection via the breast and transoral approaches with chin silastic augmentation genioplasty performed concurrently. Image documentation, patient satisfaction, complications and other factors such as demographics and clinicopathologic details were recorded. None of the patients developed major complications and there were no complications such as infection or displacement of the implant. All patients were satisfied with the cosmetic outcomes. Despite the study being limited to these 3 selected patients with PTC and microgenia, the follow-up to our initial description of the new technique established its safety and efficacy.

10.
Cureus ; 15(4): e37041, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37143644

RESUMO

Oftentimes patients are concerned about their facial esthetics and appearance. To achieve the desired look, patients have several augmentation procedures available to them. Appearance of the chin and its morphology plays a crucial role in facial aesthetics. It is an important anatomic component that not only helps in the definition of the jawline and face but is also required from a functional aspect. It is not uncommon in the field of plastic surgery for patients to undergo chin reconstruction and recontouring due to the chin deformities such as microgenia and jaw asymmetry. The treatment options mainly depend on the degree of the defect and the desired functional and esthetic requirements. Along with surgical augmentations like implants and osseous genioplasty, soft tissue augmentations like injectables are also gaining popularity. These procedures can lead to complications like many other augmentation procedures. If proper follow-up is not done on these patients, the complications can cause potential damage to vital structures in the vicinity. This case report shows a patient who underwent a chin augmentation procedure with a silastic implant and never had a follow-up and is now at risk of severe resorption of the underlying bone.

11.
12.
Aesthetic Plast Surg ; 47(4): 1560-1567, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37036507

RESUMO

BACKGROUND: Nonsurgical chin augmentation using hyaluronic acid (HA) has become a common procedure in cosmetic practices. This is offered to patients that prefer a nonsurgical, temporary method to correcting underdeveloped or retruded chin and restoring the volume loss. This systematic review highlights the main HA injection technique and associated patient satisfaction and complications of chin augmentation to further guide practitioners. METHODS: A systematic review was performed according to PRISMA guidelines. PubMed, Embase, and Web of Science were searched using the appropriate keywords. Data collected from each study included patient satisfaction and complications, in addition to injection protocol and technique. RESULTS: A total of 1305 studies were found based on search criteria. After full-text screening for inclusion and exclusion criteria, 8 studies were included. A total of 917 patients underwent HA chin augmentation, with different injection protocols. Most patients were satisfied with the results, and there were only 2 relatively major complications reported. The most common adverse events were local responses at the injection sites (swelling, bruising, pain, redness, and itching). There were no reports of vascular complications. CONCLUSIONS: HA filler is an effective temporary method to correct chin retraction and absorption for chin augmentation, with a high degree of patient satisfaction and a low risk of severe complications. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .


Assuntos
Técnicas Cosméticas , Preenchedores Dérmicos , Humanos , Preenchedores Dérmicos/efeitos adversos , Ácido Hialurônico/efeitos adversos , Queixo , Injeções Subcutâneas , Satisfação Pessoal , Técnicas Cosméticas/efeitos adversos , Resultado do Tratamento
13.
J Cosmet Dermatol ; 22(3): 784-791, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36700378

RESUMO

BACKGROUND: Even though the chin is considered a safe injection area for facial filler augmentation, tongue necrosis is a rare complication in this area. OBJECTIVE: Our aim was to present case series of rare complications from chin filler augmentation with possible pathophysiology and management. METHODS: From our thorough literature search found only one case report of tongue necrosis from chin filler augmentation. We present case series of unilateral tongue necrosis from vascular occlusion following hyaluronic acid injection in the chin, which was successfully treated with a high-dose hyaluronidase injection resulting in complete recovery in all patients. RESULTS: Variation in vascular anastomosis leads to a possible cause of vascular occlusion. The lingual artery is the primary arterial supply for the tongue, which is an exclusive target for embolism. Two main responsible arteries and branches are the deep lingual and sublingual arteries. The submental artery variation was previously described as the cause of this event. We proposed potential pathophysiology of the occlusion, not only the variation of vasculature but bone. The midline lingual foramen, an anatomical bone variation on the surface of the midline inferior jaw, was found to be another possible cause. This foramen contains a branch of the submental and sublingual artery, which includes the perforating artery, median perforating artery, or both. Filler injection with a sharp needle on the bone can potentially increase the risk of this vascular incident. A high dose of hyaluronidase administered with multiplane injections was accomplished with complete recovery. CONCLUSIONS: Tongue necrosis from vascular complications after hyaluronic acid filler injection can occur. Not only vessels but bone variation pathology were possible causes.


Assuntos
Técnicas Cosméticas , Preenchedores Dérmicos , Humanos , Ácido Hialurônico , Queixo , Hialuronoglucosaminidase , Língua , Necrose
14.
Oral Maxillofac Surg Clin North Am ; 35(1): 97-114, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36336599

RESUMO

In contemporary orthognathic surgery planning, the genium/chin constitutes an important part that contributes to the maxillofacial profile. The aesthetics of the lower face is affected by the position of the genium which makes reestablishment of genial morphology an essential component. It is hence necessary to evaluate the genium objectively on its individual merit, and any discrepancy is addressed accordingly. This review presents an overview of contemporary genioplasty techniques, their applications, and considerations on stability, osteosynthesis, complications, and the future developments.


Assuntos
Cirurgia Ortognática , Procedimentos Cirúrgicos Ortognáticos , Humanos , Mentoplastia/métodos , Estética Dentária , Queixo/anatomia & histologia , Queixo/cirurgia
15.
J Cosmet Dermatol ; 21(8): 3358-3361, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35579603

RESUMO

As a consequence of the current trend of performing minimally invasive surgery, the use of injectable fillers has progressively increased in aesthetic surgery. Vascular complications resulting due to the filling of hyaluronic acid (HA) in the chin have been previously reported. However, clinical evidence regarding the results of treatment of lingual artery occlusion with super-selective intra-arterial dissolution is lacking. Herein, we reported a case of lingual artery occlusion resulting due to HA filling for which tongue arteriography and catheter-directed dissolution were implemented via femoral artery intubation for the first time in the literature. The aim of this paper was to discuss the rare complications arising due to chin augmentation and their treatment to provide a deeper understanding of the use and side effects of HA in this procedure.


Assuntos
Arteriopatias Oclusivas , Técnicas Cosméticas , Preenchedores Dérmicos , Arteriopatias Oclusivas/induzido quimicamente , Arteriopatias Oclusivas/terapia , Artérias , Queixo , Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/efeitos adversos , Humanos , Ácido Hialurônico/efeitos adversos , Solubilidade , Língua
16.
Aesthetic Plast Surg ; 45(4): 1507-1517, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-33837461

RESUMO

BACKGROUND: Desire for improved aesthetic contour of the lower third of the face has resulted in an increase in chin augmentation. Although many fillers, including hyaluronic acid (HA), autologous fat and stromal vascular fraction gel (SVF-gel), have been used to improve facial morphology, chin augmentation requires fillers that provide greater support. METHODS: The elastic and viscous moduli of SVF-gel and Coleman fat were assessed in vitro by rheological testing, whereas their elasticity were evaluated in vivo by ultrasonic elastography. Results in vitro were compared with those of highly elastic HA (HE-HA) and highly viscous HA (HV-HA), whereas results in vivo were compared with HE-HA. Changes in chin volume, SVF-gel retention rate and absorptivity for at least 12 months were measured by 3D white light scanning. Questionnaires were administered to assess patient satisfaction. RESULTS: The elastic and viscous modulus of SVF-gel was, respectively, slightly lower than HE-HA and HV-HA but higher than the other two in vitro, with the elasticity of the three layers of SVF-gel lower than HE-HA but slightly higher than normal control in vivo. The average retention rate was 62.34±3.34% at 12 months. The absorptivity of 90% of the samples was <3% from 6 to 12 months, which was considered stable. Patients expressed satisfaction with their results. CONCLUSION: SVF-gel has ideal rheologic characteristics in vitro, which has slightly higher elasticity than normal fat tissue of chin in vivo, and could keep well retention rate for chin augmentation in clinic. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .


Assuntos
Face , Ácido Hialurônico , Tecido Adiposo/transplante , Queixo/diagnóstico por imagem , Queixo/cirurgia , Estética , Humanos
17.
Rev. bras. cir. plást ; 35(1): 83-87, jan.-mar. 2020. ilus
Artigo em Inglês, Português | LILACS-Express | LILACS | ID: biblio-1148319

RESUMO

Introdução: A falta da projeção mentoniana no terço inferior da face algumas vezes é responsável pela quebra da harmonia do contorno facial. A utilização de implantes aloplásticos, preenchimentos submetidos à ritidoplastia para correção destas deformidades. Neste estudo, propomos uma nova manobra para aumento da projeção mentoniana com uso de um retalho cervical associado à ritidoplastia. Métodos: Foram avaliados 11 pacientes operados no período de 01/2017 a 01/2018, utilizando-se o retalho cervical para projeção mentoniana, e tendo como critério de inclusão somente pacientes que almejavam um aumento mentoniano, sem utilização de próteses, preenchimentos ou abordagem óssea, e que seriam submetidos à ritidoplastia. Resultados: Através da análise cefalométrica evidenciou-se melhora da projeção mentoniana e do contorno cervical, e não houve complicações no pós-operatório imediato ou tardio. Conclusão: O retalho cervical utilizado para aumento mentoniano além de apresentar resultados e aceitação satisfatórios, elimina o uso de materiais sintéticos, redução de custos, segurança e durabilidade, alcançando um contorno mandibular mais refinado e uma projeção mentoniana mais natural.


Introduction: The lack of chin projection in the lower third of the face is sometimes responsible for the breaking of the facial contour harmony. Alloplastic implants, fillers, and osseous advancements have been used to correct these deformities. In this study, we propose a new maneuver to increase chin projection by using a cervical flap associated with rhytidoplasty. Methods: We assessed 11 patients who underwent operations using the cervical flap for chin projection between January 2017 and January 2018. The inclusion criteria were only patients who desired chin augmentation without the use of prosthetics, fillers, or osseous approaches, and those who would undergo rhytidoplasty. Results: A cephalometric analysis revealed improvements in chin projection and cervical contour, and no complications in the immediate or late postoperative period. Conclusion: In addition to presenting satisfactory results and acceptance, the cervical flap used for chin augmentation eliminated the use of synthetic materials, reduced surgical costs, and improved safety and durability, achieving a more refined mandibular contour and natural chin projection.

18.
J Cosmet Dermatol ; 18(6): 1821-1829, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30924247

RESUMO

BACKGROUND: Tongue and mouth floor infarction following filler injections for chin augmentation is a rare complication that has the increase in incidence been reported. OBJECTIVE: This study investigated the arterial anastomosis between the submental and sublingual arteries that can lead to the emboli and subsequent tongue infarction during chin augmentation. METHODS: Forty-two formaldehyde-embalmed cadavers and four soft-embalmed cadavers were dissected to verify the incidence and source of the ascending mental artery. Ultrasonographic study of the artery was performed in 10 healthy volunteers. Attention was paid to discriminate whether the ascending mental artery arose from the submental artery or the sublingual artery using the arch of the mylohyoid muscle as the discriminating landmark. RESULTS: Incidence of ascending mental artery from the sublingual artery was 7.1% in the studied population. All ascending mental arteries were 0.7 ± 0.2 mm in diameter at the mental protuberance and were branches of the submental artery that arose from the facial artery, except for two arteries that arose from the sublingual artery. Ultrasonographic study revealed that one left and one right sublingual artery from the lingual arteries penetrated the mylohyoid muscle near the midline to become the ascending mental artery in two volunteers. The ascending mental artery from the other side continued from the submental artery. CONCLUSION: Findings from the cadaveric dissections and ultrasonographic study revealed that the ascending mental artery may be a branch that continues from the lingual artery, or communicates with the sublingual artery through the mouth floor.


Assuntos
Variação Anatômica , Artérias/anormalidades , Soalho Bucal/irrigação sanguínea , Língua/irrigação sanguínea , Adulto , Idoso , Idoso de 80 Anos ou mais , Artérias/diagnóstico por imagem , Cadáver , Queixo , Técnicas Cosméticas/efeitos adversos , Preenchedores Dérmicos/administração & dosagem , Preenchedores Dérmicos/efeitos adversos , Dissecação , Embolia/etiologia , Embolia/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Soalho Bucal/diagnóstico por imagem , Ultrassonografia
19.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-805606

RESUMO

In December 2018, a 29-year-old female patient with lingual artery embolism after hyaluronic acid injection was admitted to the Second Affiliated Hospital of Kunming Medical College. The examination showed swelling tongue, the mucosa on the front and back of the right tongue became white, and the tip of the tongue slightly atrophied. The movement of tongue was disturbed. The patient′s pronunciation was unclear. The right tongue was numb, resulted by the weak circulation. Hyaluronidase was injected into tongue. The vasodilator was used. And hyperbaric oxygen chamber was applied. Thereafter, the blood supply and oxygen concentration of embolized area were increased, and collateral circulation was established. Antibiotic therapy and continuous treatment with neurotrophic drugs (rat nerve growth factor + methylcobalt ammonium) were given to promote the repair of nerve. After treatment, the embolism of lingual artery was significantly improved. Three months later, the patients had mild muscular atrophy on the right side of the tongue, with partial recovery of the right tongue mucosa. Tongue movement, sensory and taste functions recovered. Hyaluronic acid injection needs to be standardized, performed by surgeons who masters the anatomical structures, the injection layer and spot. If the vascular embolism occurs, hyaluronidase should be used as early as possible. It also needs to reduce local tension in both injected and affected area, reduce the pressure of injection on blood vessels, improve local blood circulation, so as to achieve better therapeutic effect.

20.
Chinese Journal of Plastic Surgery ; (6): 1266-1270, 2019.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-800222

RESUMO

The chin, located in the most prominent part of the lower facial profile, maintains the balance and coordination of the face. The chin size, shape, spatial position and proportion can all give rise to various chin malformations. Chin plasty plays an important role in improving facial appearance. Recent studies indicate that it’s difficult to completely meet the mental aesthetic requirements with a single procedure. The combination of different chin plastic surgery has become a hot spot in plastic surgery. In this paper, the morphological analysis of chin, the surgical progress in Chin plasty, the advantages and adverse effects of these methods, and the synthetic application of various surgeriesis were reviewed.

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