EP.FRI.749 Facial augmentation surgery: Perception vs. Reality

Background In recent years, aesthetic surgeries have gained significant momentum. A recent audit identified that more than 28,000 cosmetic surgeries were performed in the United Kingdom (UK) in 2018.1. We present an unfortunate case of morbid complications related to the use of malar implant for cosmesis. Case Presentation A 63-year-old Caucasian female presented to the Emergency department with sepsis related to a large painful, tender swelling of the right side of the face. There was discharge of pus from two cutaneous sinuses with additional ectropion/chemosis of the right eye. An orocutaneous communication due to infection/migration of the implant was also noted. The patient reported a history of bilateral malar implants placement three years ago. The patient initially required emergency drainage & subsequent removal of the infected malar implant. Discussion Malar implants provide suitable volume enhancement providing structural and aesthetic benefits including the ‘high cheek bone’ appearance. It is generally considered to be a safe surgical technique with multiple approaches possible to insert the implant. including transoral approach). Spadafora (1971) & Hinderer (1972) first described the use of malar implants for facial augmentation.2,3 Rayess et al.(2017) conducted a 10 year review of complications related to facial implants & noted that 75% of complications related to malar implants were due to infection with 38% of these implants needing removal.4 Conclusion There is a surge in presentations of complications related to cosmetic facial surgery and knowledge of these adverse effects is essential to appropriately manage these patients & their concerns.

Chin and Malar Augmentation

Facial attractiveness relies on a balance between the nose, cheekbones, and chin. An increasingly visual world with social media, teleconferencing, and online interactions heighten the demand for procedures that deliver facial harmony. Aesthetic facial augmentation changes the facial shape, establishes a more youthful appearance, and de-emphasizes unpleasant facial prominences, ultimately elevating one’s confidence. Facial implants provide a long-term solution to creating facial harmony and can be combined with other facial rejuvenation procedures at low morbidity. After studying this article, the participant should be able to understand the principles and practice of facial implant surgery, with particular attention to implants of the chin and midface. This review contains 9 figures, 6 tables and 32 references Keywords: aesthetic surgery, aging face, biomaterial, chin, facial analysis, facial augmentation, facial implant, facial rejuvenation, injectable filler, midface

Psychological Effects of Instagram on Females: Increase in Body Dissatisfaction & Facial Augmentation

Body dissatisfaction and facial augmentation are two alarming concerns in today’s generation. Previously done studies disclosed a sustainable relation between body image issues and media exposure. Statistics shows that 68% of Instagram users are females from the age group of 18-29 years. This research objected to conduct an empirical analysis to find the relationship between Instagram use, body dissatisfaction and facial augmentation. Questionnaire comprising of four parts Instagram Use, Body Image, Body Dissatisfaction and Facial Augmentation was designed for females specifically where the sample size of population was (n=100). Analysis showed that frequent use of Instagram and content like idealized beauty images have a direct effect on females’ mind resulting in body dissatisfaction. Hence the results proved that body dissatisfaction significantly positive relationship with facial augmentation. As body dissatisfaction will rise trend of facial augmentation will grow.

Alloplastic Facial Implants

As the face ages, there is thinning of the epidermis, volume loss and rearrangement of the soft tissues, and malabsorption of the skeletal framework. It is essential to have a thorough understanding of the aging process for successful facial augmentation and rejuvenation. Alloplastic implants can be used to provide a long-lasting solution for augmentation of skeletal deficiencies, restoration of facial irregularities, and rejuvenation of the face. In this study, we describe the ideal implant characteristics along with the advantages and disadvantages of various implant materials. We also present techniques in nasal and premaxillary augmentation, midface augmentation, mandibular augmentation, and lip augmentation. Additionally, computer-aided design and manufacturing as well as bioprinting are emerging technologies with growing applications in facial plastic and reconstructive surgery. We discuss their role in the creation of patient-specific custom implants. The overall goal of facial rejuvenation is to address multiple aspects of the facial aging process including deficiencies in the skin, soft tissues, and skeletal framework. The use of alloplastic implants alone or synergistically with additional surgical procedures can restore a wide range of anatomical deficits that occur with age.

Periorbital lipogranuloma after facial injection of autologous fat: A retrospective study of 18 cases

Objective: To investigate the clinical features of patients who develop periorbital lipogranuloma after injection of autologous fat. Methods: This retrospective case series included 18 patients who developed a periorbital mass or swelling after undergoing injection of autologous fat for facial augmentation. The patients’ medical records were reviewed for clinical history, radiologic findings, and treatment outcomes. Results: All patients were women aged 24 to 50 years (mean, 31.6 years). Five patients (27.8%) involved both orbits. Presenting eye symptoms were a palpable mass (61.1%), eyelid swelling (44.4%), and ptosis (16.7%). The interval between the final injection and onset of eye symptoms ranged from 1 to 36 months (mean, 11.5 months). Thirteen patients underwent radiologic imaging. Fifteen patients received only one injection of autologous fat and three received two injections with the cryopreserved fat used in the second injection. Surgical excision was performed in 12 patients to remove the mass and identify the pathologic abnormalities. No recurrence was found during 1 year of follow-up. Two of the six patients who had refused treatment showed spontaneous resolution at the 6-month visit. Conclusion: Periorbital lipogranuloma after facial injection of autologous fat should be considered as a specific orbital disease entity for which MRI is an effective examination method. Surgery is warranted for this condition when conservative treatment is ineffective.

Postoperative Care in Facial Implants

Facial augmentation is a growing field, secondary to the appreciation of the changes seen in the facial skeleton with aging and the growing acceptance/popularity of facial fat grafting and facial fillers. In addition, it plays a significant role in patients with congenital facial deficiencies as well as those interested in facial feminization/masculinization surgery. Several facial implants are discussed in this article including classic facial implants such as malar, submalar, chin, and prejowl implants as well as newer facial implants such as mandible, temporal, forehead, and skull implants. Special care is given to the postoperative care of these implants. Custom-made implants with three-dimensional computed tomography reconstruction are also discussed