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Background: Facial symmetry enhances attractiveness, with various therapies available to improve it. However, trends in facial asymmetry remain unclear. This study evaluates the differences between specific facial regions using 3D scanning to guide clinical treatment., Method: The 3dMD face™ system (3dMD Ltd, USA) scanned the faces of 88 participants. Geomagic Wrap 2021 analyzed the left and right sides. Differences in the eyebrow peaks, eyebrow tails, eye ends, and mouth corners were evaluated., Results: Several participants showed a drooping right side of the face in the eyebrow peaks, eyebrow tails, eye ends, mouth corners, tubercula mentale, and mandibular margin positions. A higher proportion had deeper left nasolabial folds and marionette lines, whereas several others had deeper right tear ducts and lateral chin depressions. Several participants exhibited prominent right forehead and parotid masseter region, with prominent left temporal and cheek regions., Conclusion: 3D scanning effectively assesses facial asymmetry in clinical practice. Research indicates significant differences in asymmetry between the facial regions. Evaluating these differences pre-treatment can guide the selection of therapeutic methods to improve facial asymmetry., Level of Evidence: 3 (Diagnostic)., (Copyright © 2024 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

Purpose: To explore the influencing factors of syncope in patients after plastic surgery, establish a syncope risk prediction model, and verify its accuracy., Methods: A total of 265 patients undergoing craniomaxillofacial surgery were included and divided into a syncope group and non-syncope group. Multivariate logistic regression analysis was used to screen for risk factors of syncope, and R language was used to establish a risk prediction nomogram of syncope in craniomaxillofacial surgery patients. The Hosmer-Lemeshow goodness-of-fit test was used to evaluate the fit of the model, and the receiver operating characteristic (ROC) curve was used to analyze the predictive value of the model., Results: Syncope occurred in 87 of 265 patients (32.8%), and no syncope occurred in 178 patients (67.8%). Multivariate logistic regression analysis revealed statistical differences in age, orthostatic heart rate, orthostatic diastolic blood pressure, syncope history, weight loss history, and medication history between the 2 groups (P < 0.05). A nomogram was constructed for predicting the risk of syncope after craniomaxillofacial surgery, and the Hosmer-Lemeshow goodness-of-fit test proved that the nomogram fitted well (P = 0.431). The results of ROC curve analysis showed that the alignment graph model had high prediction accuracy; the area under the curve was 0.886 (95% confidence interval, 0.8381-0.9332)., Conclusion: Evaluating the risk of syncope after craniomaxillofacial surgery is helpful and provides guidance for the formulation of preventive strategies., (Copyright © 2024. Published by Elsevier Ltd.)

Background: This study aimed to prospectively investigate the reference values for masseter muscle thickness and hardness using ultrasonography and shear wave elastography, respectively, in patients with hemifacial microsomia (HFM)., Methods: We enrolled 51 patients, aged 5-20 years, with HFM including 31 males and 20 females. The upper-lower, left-right, and anterior-posterior diameters of 102 masseter muscles and stiffness of 98 masseter muscles were determined by examining the unaffected and affected sides of each participant's face., Results: The upper-lower, left-right, and anterior-posterior diameters of the masseter muscle were significantly smaller at rest (4.26 ± 0.83, 2.94 ± 0.75, and- 0.80 ± 0.25 cm, respectively) and during contraction (3.95 ± 0.78, 2.71 ± 0.78, and 0.87 ± 0.29 cm, respectively) in the affected side than those in the healthy side (5.45 ± 0.66, 3.87 ± 0.49, and 0.97 ± 0.20 cm, respectively, at rest and 4.99 ± 0.45, 3.49 ± 0.53, and 1.07 ± 0.23 cm, respectively, during contraction, p < 0.05). In the resting state, the hardness of the masseter muscle on the affected side (0.77 ± 0.66 m/s) was significantly greater than that on the healthy side (0.42 ± 0.41 m/s; p < 0.05). The magnitude of changes in the upper-lower, left-right, and anterior-posterior diameters of the biting muscle in the occlusal state were significantly smaller on the affected side (-0.30 ± 0.27, -0.23 ± 0.17, and 0.08 ± 0.08 cm, respectively) than those in the healthy side (-0.47 ± 0.38, -0.37 ± 0.25, and 0.10 ± 0.12 cm, respectively, p < 0.05)., Conclusions: The knowledge of these values allows for better understanding of the disease characteristics of HFM, which may be used for its diagnosis, treatment, and prognosis. Patients experiencing different severity levels exhibited significant differences in the morphology and function of the masseter muscle on the affected-side (p < 0.05)., Evidence Level: Level III., Competing Interests: Conflicts of interest None declared., (Copyright © 2024 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

Background: Chin prosthesis implantation, a cosmetic procedure to correct chin asymmetry, depression, or retraction, is generally safe and simple. However, its long-term effects on surrounding tissues are a concern. This study aimed to use three-dimensional (3D) scanning to classify the mentalis muscle shapes and assess the impact of prosthesis implantation on these muscles., Method: This study evaluated 450 eligible female participants. Using three-dimensional imaging, data on the types, thickness, width, and length of the left and right mentalis muscles were collected and summarized. The impact of chin prosthesis on these muscle dimensions was assessed using analysis of variance, and the effect on muscle type was determined using χ 2 test., Results: Chin implant placement affected the mentalis muscles, resulting in increased length, thickness, and width. The subjects' mentalis muscles were categorized into 3 types and divided into 7 subtypes. χ 2 test results indicated that implantation influences the classification of these muscles., Conclusion: Recognizing how implant placement affects the mentalis muscle can guide the development of treatments to mitigate these changes. Additionally, understanding the muscle's morphology enables more precise treatment approaches for patients., (Copyright © 2024 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

Background: This study was performed to explore the clinical application of the Nagata's technique for combing tissue expansion in auricular reconstruction., Methods: The auricular reconstruction was performed in two surgical stages. At the first stage, an 80 ml expander was inserted in the mastoid region after preoperative evaluation. After a gradual expansion period and nearly 2-month rest time, the flap achieved the appropriate area and thickness. At the second stage, the expander was removed and a three-layer cartilage framework was inserted into the pocket through a Y-shaped lobule incision, and the earlobe and tragus were rebuild simultaneously., Results: From 2012 to 2016, 104 microtia patients underwent auricular reconstruction with this method in our hospital. Patients were followed up for between 6 months and 2 years. Ninety-six patients and their families were satisfied with the results, especially the clear outline, appropriate color, good projection, and the symmetry of bilateral ears. Complications of ischemic necrosis of the distal earlobe and skin of the concha cavity occurred in two cases, hematoma after the first stage occurred in two cases, and four patients needed further restorations., Conclusions: A novel two-stage strategy combing tissue expansion and Nagata's technique is an effective and efficient technique for auricular reconstruction with satisfying medium-term results., Competing Interests: Declaration of Competing Interest None., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Hyaluronic acid has been widely used for nonsurgical rhinoplasty. Little literature focuses on Chinese women of the Han nationality, who have a characteristic flattened facial contour. Projection of the nose, including the nasal dorsum, nasal tip, and columella, plays an important role in achieving an attractive face., Aim: The aim of this study was to investigate the application of multiplane hyaluronic acid in rhinoplasty using blunt and sharp needle technique., Method: From June 2011 to February 2014, 280 cases of nonsurgical rhinoplasty by hyaluronic acid were applied; 1-9 months follow-up showed satisfactory appearance., Result: Postoperative results showed no complications, such as infection or flap necrosis., Conclusion: For esthetic and safety considerations, we suggest multiple plane injections using blunt combined with sharp needle-filling techniques., (Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)

Objective: The objective of this study is to investigate the usage and effectiveness of postauricular advancement flap and conchal cartilage for surgical treatment of partial helix defect., Methods: Ten cases (eight males, two females) of unilateral partial ear defects were treated by using postauricular advancement flap combined with ipsilateral conchal cartilage graft. Of the 10 cases, nine cases were due to injury, one case was the result of frostbite. The patients ranged in age from 15 to 34 years (mean age=25.4 years)., Results: All cases were followed up for 3-12 months with satisfactory results, indicated by helix and scapha of similar color. No hypertrophic scarring was reported., Conclusions: The use of postauricular advancement flap, combined with ipsilateral conchal cartilage graft, is an effective way to repair partial helix defects, and a second procedure may be necessary to achieve a symmetrical cranioauricular angle., (Copyright © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.)