Facial Contour Refining after Surgery-First SSRO with Computer-Assisted Design in East Asians

Changes in mandibular angle and intergonial width after bilateral sagittal split ramus osteotomy or bimaxillary surgery with/without counterclockwise rotation

The aim of this retrospective study was to evaluate the morphological changes in the mandibular angle area after orthognathic surgery with or without mandibular counterclockwise rotation in Class II deformity patients, and to investigate the associated factors. Computed tomography scans obtained preoperatively (T0), within 1 month postoperatively (T1), and 6 months postoperatively (T2) were collected from 58 patients who underwent either bilateral sagittal split ramus osteotomy (group I), bimaxillary surgery with mandibular counterclockwise rotation (group II), or bimaxillary surgery without mandibular counterclockwise rotation (group III). The intergonial width increased after surgery, by 2.78 ± 2.02 mm in group I, 2.86 ± 2.81 mm in group II, and 2.53 ± 2.42 mm in group III (all P < 0.001). The mandibular angle (MA) increased in group I (ΔMA 4.76 ± 2.79°; P < 0.001) and group III (ΔMA 3.50 ± 2.58°; P < 0.001); however no significant increase was observed in group II. The increase in intergonial width was positively correlated with the lateral displacement of the proximal segment. Counterclockwise rotation of the proximal segment resulted in an increase in MA, while counterclockwise rotation resulted in a reduction in this increasing trend. The results indicate that reducing the displacement and rotation of the proximal segments is key to minimizing changes in the mandibular angle area.

Visualization Mapping and Current Trends of Facial Contouring Procedures: A Bibliometric Analysis Based on Web of Science

BACKGROUND

Facial contouring procedures become popular in recent years, but there has been no bibliometric analysis focused on this field.

OBJECTIVE

Construct visualization maps and analyze the hotspots and current trends in this field using bibliometric analysis.

METHODS

Publications on facial contouring procedures were extracted from the Web of Science Core Collection database from 2003 to 2022. VOSviewer, CiteSpace, and "Bibliometrix" R package were used to analyze data.

RESULTS

Seven hundred and twenty-one publications on facial contouring procedures between 2003 and 2022 were included. The United States was the leading country both in publications (206) and citations (3941). Shanghai Jiao Tong University was the institution with the greatest contribution (35 publications with 379 citations). Hu J (17 publications) from China had the most outputs, while the most cited author was Rohrich RJ (321 citations) from the United States. The Journal of Craniofacial Surgery (135 documents) published the most research, and Plastic and Reconstructive Surgery was the most cited journal (2755 citations). The most cited article focused on virtual surgical planning in mandibular reconstruction. Keywords co-occurrence analysis identified five clusters centered on "reconstruction," "augmentation," "reduction malarplasty," "face rejuvenation," and "orthognathic surgery," separately. "Hyaluronic acid," "facial feminization," and "orthognathic surgery" might be related to trend topics.

CONCLUSIONS

The research on facial contouring procedures is booming. In the past 2 decades, hotspots in this field included: facial defects reconstruction, facial augmentation cosmetology, facial skeletal contour plasty, and facial rejuvenation surgery. The following aspects may be trend frontiers: precision and personalization, combined treatments, transgender facial contour, and facial contour shaping with fat and hyaluronic acid.

Redefining Mandibular Sub-units: The "ABC" Classification and Surgical Strategies for Lower Face Contouring

BACKGROUND

In east Asia, lower face contouring surgeries including reduction mandibuloplasty and genioplasty are the most popular aesthetic craniofacial surgeries. Conventional selection of surgical strategies mainly relied on the visual judgment of the mandibular angle, without overall assessment of the mandibular sub-units. Furthermore, only a few studies offered quantitative assessment of the mandibular shape.

METHODS

From 2010 to 2021, 1241 patients diagnosed with square faces and received customized lower face contouring surgeries by the senior author were reviewed and analyzed to propose an "ABC" classification system for facilitating surgical planning.

RESULTS

Among them, 998 (80.42%) received bilateral mandible reshaping, 155 (12.49%) underwent bilateral mandible reshaping combined with genioplasty, and 88 (7.09%) received asymmetric mandible reshaping. A modified classification system composed of three critical parameters (height, morphology/thickness, divergence) in three aesthetic zones (mandibular angle, mandibular body, chin) was proposed based on quantitative summarization of the CT database and the senior author's 12-year experience. The way to facilitate surgical planning with this classification was demonstrated.

CONCLUSIONS

This modified classification system ushered a decision-making process that prioritized several critical measurements and proposed an operative planning form. Meanwhile, it can also be cooperated into the three-dimensional virtual surgical plan.

LEVEL OF EVIDENCE IV

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