Lifting the Mouth Corner: A Systematic Review of Techniques, Clinical Outcomes, and Patient Satisfaction

Fractional 1064 nm Nd:YAG picosecond laser for Asian skin rejuvenation: clinical efficacy and the role of photoprotective behaviours

Skin rejuvenation is a vital aspect of dermatology aimed at countering intrinsic and extrinsic aging effects, such as wrinkles, dyspigmentation, and texture irregularities. This study evaluates the efficacy and safety of the fractional 1064 nm Nd:YAG picosecond laser in a Vietnamese cohort, addressing unique challenges posed by Asian skin's high melanin content. 44 Vietnamese participants treated at the University Medical Center of Ho Chi Minh City for facial skin rejuvenation were retrospectively analyzed. Outcomes were assessed via standardized imaging and patient-reported satisfaction scores, with statistical analyses applied to evaluate changes in skin indices and identify epidemiological correlations. Measurements using the VISIA® system indicated statistically significant reductions in wrinkles, spots, and texture irregularities starting from the first month of treatment (p < 0.01) and sustained through three months (p < 0.0001). Adverse effects were minimal, with transient erythema being the most common (68.18%), and pain levels were generally mild to moderate. Epidemiological analysis revealed that prolonged sun exposure adversely affected UV spot improvement (p =  0.01), while consistent mask-wearing correlated with enhanced outcomes for pigmentation reduction (p =  0.03). This study underscores the fractional 1064 nm Nd:YAG picosecond laser's effectiveness as a safe and versatile tool for skin rejuvenation, particularly for Asian populations prone to post-inflammatory hyperpigmentation. Recommendations for consistent photoprotection and addressing environmental factors further optimize results. Future studies should explore long-term outcomes and comparative efficacy with alternative modalities.

A Unified Approach to Facial Contours and Volume Correction: The Role of the Cheek and the Chin

Background

Facial proportions and contours influence perceptions of beauty and youthfulness. In particular, the shape and definition of the midface and lower face impact the overall appearance of the face.

Methods

This review provides anatomical evidence to support a holistic approach to facial analysis and rejuvenation that starts with assessment and treatment of the midface and lower face to create an aesthetically desirable facial balance.

Results

The cheek and chin can be considered "anchors" or starting points within full-face treatment because of the noticeable impact of their treatment on the definition and contour of the entire face. Age-related changes in the cheek and chin affect overall facial appearance and can produce unintended facial emotional attributes such as looking tired, angry, or sad. Patients seek facial aesthetic treatment typically for a global improvement such as revitalization or genderization of facial features. Best practices in aesthetics have evolved from treatment of individual areas to a holistic paradigm that uses multimodal therapy to improve overall facial emotional attributes. Hyaluronic acid fillers are useful for volume replacement and smoothing abrupt transitions that develop with age throughout the midface, chin, and jaw. A combination of hyaluronic acid filler for volume restoration and sodium deoxycholate and/or onabotulinumtoxinA for volume reduction where appropriate may optimize lower facial contour.

Conclusions

This review highlights the importance of facial angles and contours as well as the significance of panfacial assessments and treatment, focusing on the relationships within areas of the face, specifically the midface and lower face, to optimize results.

Different Techniques and Quantitative Measurements in Upper lip lift: A Systematic Review

BACKGROUND

The upper lip area is an important component of facial aesthetics, and aging produces an increase in the vertical height of the upper lip. Different upper lip lifting techniques are described in the literature.

OBJECTIVES

This systematic review aimed to assess both invasive and noninvasive upper lip lifting techniques with patient satisfaction, adverse effects, and quantitative measurements of lifting efficiency.

METHODS

This study was conducted per PRISMA guidelines. MEDLINE (via PubMed), EMBASE (OvidSP), and Cochrane Library database were searched from September 14, 2022, to October 12, 2022. Inclusion criteria were reporting on upper lip lift efficiency with quantitative measurements of the lifting degree.

RESULTS

Out of 495 studies through the search strategy, nine articles were included in the systematic review, eight for surgical procedures and one for nonsurgical. Surgical procedures seem to have better longevity than nonsurgical techniques. Reported patient satisfaction for both surgical and nonsurgical treatments was good with no severe complaints. The quantitative measures differ between researches and may be classified into two metrics: anatomy ratio computation using photographic analysis or direct height measurement with a caliper and precise parameters utilizing a three-dimensional method.

CONCLUSION

In general, surgical therapies seem to have a longer-lasting lifting effect on upper lip lifts with an inevitable scar, while nonsurgical techniques are minimally invasive but temporary. There was a lack of consistency in the measurements used to assess lifting efficiency. A consistent quantitative assessment can be beneficial for both clinical decision-making and high-level evidence research.

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 .