The Rhino-Lip-Lifting: A Novel Proposal for Midface Profileplasty Performed as a Single Surgical Procedure

2021 ◽  
Author(s):  
Michele Pascali ◽  
Gloria Marchese ◽  
Alberto Diaspro
Keyword(s):  
Strong Correlation ◽  
Surgical Procedure ◽  
Upper Lip ◽  
Anatomical Entity ◽  
Nasal Tip ◽  
Lifting Technique ◽  
Nasolabial Angle ◽  
Before And After ◽  
Beneficial Impact ◽  
Angle Width

AbstractAs facial aging occurs, aesthetic changes of the nasal tip and the senile upper lip include tip ptosis, increase in skin length, loss of vermillion height and Cupid's bow, and vertical wrinkles.Regardless of the rejuvenation procedure, the lips are not to be considered as a single anatomical entity, instead they should be placed in a strong correlation with the nose. The aim of this study is therefore to demonstrate the effectiveness of the association of primary closed rhinoplasty together with indirect subnasal lip-lifting technique.A total of 45 patients were enrolled in this study and underwent primary closed rhinoplasty with indirect subnasal lip-lifting. The result showed an overall average nasolabial angle width reduction of 10.9% and lip length shortening of 23.5%, as assessed 1 year after the surgical procedure. When comparing before and after photographs and using the Subjective Global Aesthetic Improvement Scale (sGAIS), the overall satisfaction was rated 4.4 on 5, as “much improved.”The authors show that lips should not be considered as a single anatomical entity but that they indeed must be placed in a strong correlation with the nose since a droopy nasal tip is likely to be considered unattractive and is often associated with the appearance of a long nose with covered philtrum and upper lip.Tip rotation to a normal nasolabial angle width could grant a beneficial impact on overall nose aesthetics; however, it may not fully balance the midface profile as it is the “lip position-to-incisal show” ratio that defines beauty, whereas the balance among forehead, nasal tip, upper lip, and chin is what defines the contour of harmonious profiles.This is the first patient series to show that the combination of closed rhinoplasty and indirect lip-lifting is a highly effective, safe, and reliable procedure to address profile rejuvenation.

scholarly journals Effects of Bimax and Segmental Surgeries for Correction of Bimaxillary Dentoalveolar Protrusion Class I on Soft Tissue Parameters: Upper lip Thickness and Curvature, Nasolabial Angle and Nasal Prominence

2013 ◽  
Vol 14 (6) ◽  
pp. 1087-1093 ◽  
Author(s):  
Amin Rahpeyma ◽  
Saeedeh Khajehahmadi
Keyword(s):  
Soft Tissue ◽  
Group Treatment ◽  
Anterior Segment ◽  
Class I ◽  
Upper Lip ◽  
Perpendicular Line ◽  
Lower Jaw ◽  
Nasolabial Angle ◽  
Before And After ◽  
The Mean

ABSTRACT Aim Results of this study can show if bimax surgery for posterior repositioning of maxilla and correction of BPCLI has priority to the currently used segmental orthognathic surgery or not. Materials and methods This study was done on 40 whiteskinned Iranian patients with bimaxillary dentoalveolar protrusion class I (BPCLI) who sought treatment for their deformity. In the first group, treatment includes segmental surgery for backward replacement of anterior segment of the upper and lower jaw. In the second group, treatment was bimax surgery, in which whole upper and lower jaw moved backward. Twenty patients were included in each group. For this purpose, we measured upper lip thickness (ULT, distance between LS and IA), nose prominence (NP, distance between nasal tip and the perpendicular line from upper lip vermilion on FHP), subsulcus depth (SSD, distance of SLS from this perpendicular line), SN to H line distance and finally, nasolabial angle (NLA) before and after surgery. Results In our study, 65% of patients were female and the mean of age was 27 (17-39) years old. The mean of SNA, SNB, ANB and INA in our patients were 81.7 ± 2.9, 78.8 ± 2.8, 4.50 ± 1.4 and 120 ± 8.7, respectively. All variables except SSD were analyzed with t-test to compare the results of two methods of surgery. Differences in the values of NP, NLA, SN to H line distance and ULT before and after segmental and bimax surgeries between before and after surgery were significant. After surgeries, ULT and the SN to H line distance reduced significantly, and NLA became corrected to its normal range (90-110). Conclusion The results of this study showed that bimax and segmental surgeries can effectively correct BPCLI. Because of possible dental and periodontal complications of segmental surgery, we highly recommend bimax surgery for treatment of BPCLI. How to cite this article Rahpeyma A, Khajehahmadi S. Effects of Bimax and Segmental Surgeries for Correction of Bimaxillary Dentoalveolar Protrusion Class I on Soft Tissue Parameters: Upper lip Thickness and Curvature, Nasolabial Angle and Nasal Prominence. J Contemp Dent Pract 2013;14(6):1087-1093.

scholarly journals Facial Profile Changes in Early Class II Correction with Cervical Headgear

2007 ◽  
Vol 77 (6) ◽  
pp. 960-967 ◽  
Author(s):  
Mirja Kirjavainen ◽  
Kirsti Hurmerinta ◽  
Turkka Kirjavainen
Keyword(s):  
Treatment Time ◽  
Class Ii ◽  
Upper Lip ◽  
Facial Profile ◽  
Nasolabial Angle ◽  
Lateral Cephalograms ◽  
Division 1 ◽  
Before And After ◽  
Profile Changes ◽  
Class Ii Division 1

Abstract Objective: To characterize the effects of early cervical headgear treatment on the facial profile of children in Class II division 1 malocclusion. Materials and Methods: Forty children aged 9.1 (7.2–11.5) years with Class II division 1 malocclusion were treated using a cervical headgear appliance. The headgear consisted of a long outer bow bent upward 15° and a large expanded inner bow. Lateral cephalograms were taken before and after treatment, and the facial profile was estimated from the cephalograms. The results were compared to an age- and sex-matched normal cohort of 644 Finnish children. Results: Class I molar relationship was achieved in all treated children. The treatment time was 1.6 (0.3–3.1) years on average. Compared to the controls, the treatment restricted the forward growth of maxillary A-point, and the SNA angle decreased 1.4° ± 1.2° per year (P < .00001). Decreased maxillary prognathism was associated with decreased facial convexity, g-sn-pg (P = .02), and the ANB (P < .00001) angles decreased compared to the controls. Upper lip protrusion (distance ls to sn-pg; P < .00001) was decreased, and the nasolabial angle (cm-sn-ls) widened despite the increased facial inclination of the upper incisors (P = .0005). The treatment significantly decreased the gap between the lips (P = .0009) in their relaxed position. Conclusion: Cervical headgear treatment in Class II correction is associated with a decreased facial convexity caused by the restriction of forward growth of the maxillary A-point, while the rest of the facial profile, including the mandible, continue to grow forward at a normal rate.

scholarly journals Perubahan profil jaringan lunak bibir sebelum dan setelah perawatan ekspansi lengkung gigi menggunakan alat ortodonti lepasanChanges of the lip soft tissue profile before and after dental arch expansion treatment using removable orthodontic appliances

2021 ◽  
Vol 5 (1) ◽  
pp. 1
Author(s):  
Araminta Nariswari Candraningtyas ◽  
Iwa Rahmat Sunaryo ◽  
Avi Laviana
Keyword(s):  
Soft Tissue ◽  
Dental Arch ◽  
Orthodontic Appliances ◽  
Upper Lip ◽  
Orthodontic Appliance ◽  
Lower Lip ◽  
Nasolabial Angle ◽  
Soft Tissue Profile ◽  
Before And After ◽  
Removable Orthodontic Appliances

ABSTRAK Pendahuluan: Penggunaan alat ortodonti lepasan dengan sekrup ekspansi bertujuan untuk memperoleh ruangan pada kasus gigi berjejal dengan cara melebarkan lengkung gigi. Pergerakan gigi yang dihasilkan dapat berpengaruh pada salah satu komponen estetika wajah yaitu profil jaringan lunak. Tujuan penelitian ini untuk mengevaluasi perubahan profil jaringan lunak bibir sebelum dan setelah  perawatan ekspansi lengkung gigi menggunakan alat ortodonti lepasan. Metode: Jenis penelitian ini adalah deskriptif analitik menggunakan metode purposive sampling pada subjek yang merupakan pasien ortodonti di Klinik Profesi Dokter Gigi RSGM Unpad yang dirawat menggunakan alat lepasan akrilik dengan sekrup ekspansi lateral maksila dan mandibula. Terdapat 4 subjek yang memenuhi kriteria inklusi yaitu sepuluh kali aktivasi yang dilakukan setiap minggu dalam waktu tiga bulan.  Subjek dilakukan foto lateral wajah dengan posisi standar sebelum dan setelah aktivasi. Pengukuran dilakukan menggunakan jangka sorong digital dari bibir atas (Ls) terhadap E-line (Ns-Pog), bibir bawah (Li) terhadap E-line (Ns-Pog), dan busur derajat digital untuk mengukur sudut nasolabial(Ns-Sn-Ls). Hasil dan Pembahasan: Nilai rerata perubahan jarak bibir atas terhadap E-line yaitu 0,59 mm, nilai rerata perubahan jarak bibir bawah terhadap E-line yaitu 0,63 mm dan nilai rerata perubahan sudut nasolabial yaitu -2,03o. Penelitian ini menunjukkan adanya perubahan posisi bibir  menjadi lebih ke anterior setelah dilakukan aktivasi sekrup ekspansi lateral rahang atas dan rahang bawah sebanyak 10 kali. Simpulan: Hasil penelitian menunjukkan adanya perbedaan yaitu  posisi bibir atas dan bibir bawah yang menjadi lebih ke anterior dan tidak terdapat perbedaan pada sudut nasolabial setelah dilakukan 10 kali aktivasi sekrup ekspansi lateral pada alat ortodonti lepasan.Kata kunci: perbedaan profil jaringan lunak; alat ortodonti lepasan; ekspansi lengkung gigi; sekrup ekspansi. ABSTRACT Introduction: The use of removable orthodontic appliance with expansion screws aim to gain a space in crowding teeth by expanding the dental arch. The resulting tooth movement can affect one of the aesthetic components of the face, the  soft tissue profile. The aim of this study to evaluate the change of lip soft tissue profile before and after treatment of dental arch expansion using removable orthodontic appliance. Method: The research method used is descriptive analysis and purposive sampling in patients of Rumah Sakit Gigi dan Mulut Universitas Padjadjaran’s Orthodontic Clinic treated by using removable appliance with lateral expansion screw in maxilla and mandible. There are 4 patients who meet the inclusion, namely the srew is activated 10 times, once every week in 3 months. Subjects photographed in lateral position before and after activation. Measurement is done by using a calipers from upper lip to E-line, lower lip to E-line, and nasolabial angle using a digital protractor. Results and Discussion: The average of the changes in upper lip to E-line distance are 0,59 mm, the average of the changes in lower lip to E-line distance are 0,63 mm, and the average of the changes in nasolabial angle are -2,03o . This study showed a lip position that became more anterior after 10 times the activation of the maxillary and mandibular expansion screws. Conclusions: The results showed a difference in the position of the upper lip and lower lip which became more anterior and there is no difference in nasolabial angle after 10 times the activation of lateral screws in removable appliances.Keywords: soft tissue profile differences; removable orthodontic appliances; dental arch expansion;  expansion screws.

scholarly journals Conservative treatment of a Class I malocclusion with 12 mm overjet, overbite and severe mandibular crowding

2012 ◽  
Vol 17 (5) ◽  
pp. 43-52
Author(s):  
Marcos Alan Vieira Bittencourt ◽  
Arthur Costa Rodrigues Farias ◽  
Marcelo de Castellucci e Barbosa
Keyword(s):  
Class I ◽  
Facial Features ◽  
Conservative Approach ◽  
Upper Lip ◽  
Facial Aesthetics ◽  
Lower Lip ◽  
Angle Class ◽  
Nasolabial Angle ◽  
Lower Arch ◽  
Lower Incisors

INTRODUCTION: A female patient aged 12 years and 2 months had molars and canines in Class II relationship, severe overjet (12 mm), deep overbite (100%), excessive retroclination and extrusion of the lower incisors, upper incisor proclination, with mild midline diastema. Both dental arches appeared constricted and a lower arch discrepancy of less than -6.5 mm. Facially, she had a significant upper incisors display at rest, interposition and eversion of the lower lip, acute nasolabial angle and convex profile. OBJECTIVE: To report a clinical case consisting of Angle Class I malocclusion with deep overbite and overjet in addition to severe crowding treated with a conservative approach. METHODS: Treatment consisted of slight retraction of the upper incisors and intrusion and protrusion of the lower incisors until all crowding was eliminated. RESULTS: Adequate overbite and overjet were achieved while maintaining the Angle Class I canine and molar relationships and coincident midlines. The facial features were improved, with the emergence of a slightly convex profile and lip competence, achieved through a slight retraction of the upper lip and protrusion of the lower lip, while improving the nasolabial and mentolabial sulcus. CONCLUSIONS: This conservative approach with no extractions proved effective and resulted in a significant improvement of the occlusal relationship as well as in the patient's dental and facial aesthetics.

Abstract W MP104: Quality of Acute Stroke Care at Primary Stroke Centers Before and After Certification in Comparison to Never-Certified Hospitals

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Nerses Sanossian ◽  
May A Kim-Tenser ◽  
David S Liebeskind ◽  
Justina Breen ◽  
Scott Hamilton ◽  
...  
Keyword(s):  
Los Angeles ◽  
Acute Stroke ◽  
Stroke Care ◽  
Care Quality ◽  
Acute Stroke Care ◽  
Phase 3 ◽  
Before And After ◽  
Beneficial Impact ◽  
Mean Time

Background: Primary Stroke Centers (PSC) provide better acute stroke care than non-PSC hospitals, including faster times to imaging and lytic treatment, and higher rates of lytic delivery. Nationwide less than 1 in 3 hospital has achieved this designation. We aimed to determine the extent to which the better performance at PSC is driven by improvements within hospitals after PSC designation versus better baseline hospital care among facilities seeking PSC certification. Methods: From 2005 to 2012, the NIH Field Administration of Stroke Therapy -Magnesium (FAST-MAG) Phase 3 clinical trial enrolled subjects with likely stroke within 2 hours of onset in a study of prehospital start of a neuroprotective agent. Subjects were routed to 59 community and academic centers in Los Angeles and Orange Counties. Of the original 59 centers, 39 eventually achieved PSC status during the study period. Each subject was classified as enrolled at a PSC before certification (pre-PSC), at a PSC post certification (post-PSC), or at a hospital that never achieved PSC (non-PSC). Results: Of 1700 cases, 529 (31%) were enrolled at pre-PSC, 856 (50%) at post-PSC, and 315 (19%) at non-PSC hospitals. Mean time in minutes from ED arrival to first scan was 33 minutes at post-PSC, 47 minutes at pre-PSC and 49 at non-PSCs [p<0.001 by Mann-Whitney]. Among cases of cerebral ischemia (CI) [N=1223], rates of TPA utilization were 43% at post-PSC, 27% at pre-PSC and 28% at non-PSC hospitals [p<0.001 by X2]. Time in minutes from ED arrival to thrombolysis in treated cases was 71 at post-PSC, 98 at pre-PSC, and 95 at non-PSC hospitals [p<0.001 by Mann-Whitney]. Hospitals that achieved PSC showed improvements in pre-PSC and post-PSC performance on door to imaging time, from 47 to 33 minutes [p=0.014]; percent TPA use in CI, from 27% to 43% [p<0.001], and reduced door-to-needle times, from 98 to 71 minutes [p=0.003]. There was no difference in time to imaging [47 vs. 49 minutes], time to thrombolysis [98 vs. 95 minutes] and percent TPA use [27% vs. 28%] between pre-PSC hospitals and non-PSC hospitals. Conclusions: Better performance of Primary Stroke Centers on acute care quality metrics is primarily driven by a beneficial impact of the PSC-certification process, and not better performance prior to seeking PSC status.

Premaxillary Injection for Perioral Rejuvenation and Lip Enhancement

2019 ◽  
Vol 40 (5) ◽  
pp. 560-567 ◽  
Author(s):  
Thuy-Van T Ho ◽  
Eric W Cerrati ◽  
Nimit D Gandhi ◽  
Arjun Kalbag ◽  
Steven H Dayan
Keyword(s):  
Hyaluronic Acid ◽  
Statistical Significance ◽  
Primary Objective ◽  
Upper Lip ◽  
Height Ratio ◽  
Level Of Evidence ◽  
Filler Injection ◽  
Nasal Tip ◽  
Tip Projection ◽  
Nasal Tip Projection

Abstract Background This is the first study to evaluate the effect of premaxillary filler injection on nasal tip projection, upper lip projection, and upper lip vermilion height. Objectives The primary objective of this study was to analyze the change in nasal tip projection (measured by the Goode ratio) and the change in upper lip projection (measured by the Z angle) following premaxillary hyaluronic acid injection. A secondary objective was to measure the change in upper lip vermilion height. We hypothesized that treated subjects will show an increase in nasal tip projection, upper lip projection, and upper lip vermilion height. Methods Twenty volunteer patients with signs of perioral aging or poor upper lip projection were enrolled in this prospective cohort study and underwent premaxillary hyaluronic acid filler injection between November 2017 and June 2018. Nasal tip projection, upper lip projection, and upper lip vermilion height were assessed from baseline and posttreatment photographs based on the Goode ratio, Z angle, and lip vermilion height ratio, respectively. Results No significant change was noted between pre- and posttreatment Goode ratio measurements (P = 0.841). There was a significant decrease in Z angle and therefore significant increase in upper lip projection with treatment (P &lt; 0.001). The lip vermilion height ratio demonstrated a trend of increased upper lip vermilion height but this did not achieve statistical significance (P = 0.561). Conclusions Premaxillary filler treatment resulted in a significant increase in upper lip projection. Premaxillary filler injection when performed in a safe manner is a valuable treatment option for perioral rejuvenation. Level of Evidence: 4

Auricular Sandwich Graft for Caudal Septal Augmentation

1986 ◽  
Vol 3 (4) ◽  
pp. 27-31
Author(s):  
Julius Newman ◽  
Abram Nguyen ◽  
Roger Anderson
Keyword(s):  
Surgical Procedure ◽  
Donor Site ◽  
Obtuse Angle ◽  
Nasal Reconstruction ◽  
Nasal Dorsum ◽  
Cartilage Graft ◽  
Nasal Tip ◽  
Aesthetic Results ◽  
Conchal Cartilage Graft ◽  
Primary Phenomenon

Retraction of columella and collapse of nasal tip may be a primary phenomenon or secondary to poor results of rhinoplasty. This may be due to excessive resection of dorsocaudal septum or inappropriate removal of the nasal spine. Reconstruction of the columella is a difficult surgical procedure and many techniques have been described. This report describes a technique of interposition of a composite skin-conchal cartilage graft between the caudal septum and columella. The graft will restore the projection of the nasal tip and correct a retracted columella by increasing its base. The newly positioned columella forms an aesthetically acceptable obtuse angle with the lip and is 2–3 mm lower than the alar rims. The cartilage from the concha of the ear is an excellent grafting material for nasal reconstruction. It has been used for augmentation of the nasal dorsum, tip grafting, and correction of vestibular atresia. The graft is harvested utilizing a technique that allows for minimal postoperative auricular deformity at the donor site. Aesthetic results have been satisfactory, with very low morbidity following this method.

scholarly journals A Survey To Evaluate The Nasolabial Angle (Nla) In Indian Population

2017 ◽  
Vol 07 (01) ◽  
pp. 004-006
Author(s):  
Vinaya Bhat ◽  
Chethan Hegde ◽  
Varun Raj
Keyword(s):  
Indian Population ◽  
Self Esteem ◽  
Upper Lip ◽  
Edentulous Patient ◽  
Anterior Teeth ◽  
Nasolabial Angle

AbstractEsthetics is an important factor in self-esteem of a person. Nasolabial angle is a key determinant in the fullness of the upper lip and it has been utilized to assess the esthetics while restoring upper anterior teeth. In the present study, the average nasolabial angle of the Indian population was assessed and identified which could be used as a guideline while replacing an edentulous patient with prosthesis.

scholarly journals The Effect of Nasal Tip Rotation on Upper Lip Length

2016 ◽  
pp. sjw234 ◽  
Author(s):  
Kevin Perkins ◽  
Ajul Shah ◽  
Anup Patel ◽  
Derek Steinbacher
Keyword(s):  
Upper Lip ◽  
Tip Rotation ◽  
Nasal Tip
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