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The lips are the main aesthetic component of the facial lower third and simultaneously a substantial element for an ideally perceived smile. One of the most accepted and common procedures that is widely used to enhance the shape and contours of the upper lip is the lip lift. With a careful treatment plan and a professional surgery, a lip lift can reliably be used for the reduction of the philtrum height, enlargement of the upper vermilion, improvement of the dental show, restoration of facial aesthetic proportions, and creation of an enchanting smile.

Smile design is an ongoing challenge in both dentistry and facial cosmetics surgery. Herein, some very common smile design scenarios are shared with six world known masters. Each case will be reviewed by 2 cosmetic dentists, 2 periodontists, and 2 oral and maxillofacial surgeons. At the end, contributors will describe current advances and future prospects of this evolving field.

Preservative dorsal hump surgery is an old approach that has revitalized recently. Preservation rhinoplasty aims to shape the existing structures instead of resection/reconstruction approaches. A thorough understanding of the applied anatomy of the nose is the backbone of preservative hump surgery. In preservative hump surgery keystone works as a joint, and by lowering this joint the hump is eliminated.

Background The tongue in groove technique (TIG) is a useful technique for the correction of the nasal tip projection and the nasolabial angle. The purpose of this study was to determine the utility of this technique for nasal tip rotation and projection correction in the Iranian society. Methods This is a retrospective clinical trial study of 20 patients undergoing open septo-rhinoplasty using TIG technique from January 2017 to August 2019 at the oral and maxillofacial unit of Bu Ali Hospital and private sector. Preoperative and postoperative profile view photographs were compared to assess the changes in tip projection and rotation. Results Fifteen patients (75%) had normal angular size, and 5 of them (25%) were not within the normal range after the surgery. The Fisher exact test showed that this success was statistically significant (P = 0.006). Ten patients (50%) had normal projection size, postoperatively. The Fisher exact test showed that this effect was statistically significant (P < 0.01) Conclusion The study demonstrated the benefit of TIG on the correction of nasal tip projection and rotation.

The nasal soft triangles are extremely vulnerable subunits of the nose that are prone to severe unaesthetic deformities. A technique to overcome these problems, comprising an effective simple modification of the shield graft, is presented. Using this technique, many existing soft triangle deformities, notches, and defects are easily restored. It may also be applied effectively in susceptible cases in order to avoid these complications. This article presents technical details and the cases of two patients treated with the technique, which indicate its potential utility.

There has been a growing trend toward minimally invasive cosmetic procedures during the past decade. Fillers have great potentials and indications. Fillers are very simple to apply, there is no need for secondary donor sites, and in most patients there will be no need for off time. Meanwhile, new indications, use of fillers in critical areas of the face, and complications remain a big challenge, and here, we have tried to discuss some of these issues to find key points in applications of fillers in cosmetic medicine.

Periorbital rejuvenation is mostly accounted as the most important and determinant component in facial rejuvenation. Numerous noninvasive to very complicated and aggressive approaches are advocated. Meanwhile, sometimes it seems very confusing what to use and what to avoid. Here, I have tried to ask some of the most challenging issues with some of the key figures in facial aesthetic surgery.

Cosmetic or functional concerns, especially for multiple operated noses, are always a challenge even for an experienced surgeon. Some authors distinguish the term “revision” rhinoplasty which is done by the same surgeon with “secondary” rhinoplasty which refers to more extensive surgeries. Regardless of the term used, this chapter aimed to mention the major and minor problems in multiple operated noses and define some surgical or nonsurgical solutions for such cases. Finally, the surgeon should recognize the objective problems, correlating them with subjective complaints, to suggest the possibilities of surgical intervention.

Rhinoplasty as a combination of science and art has been popularized widely in order to make positive cosmetic and functional results. Many methods have been described over the years. In this chapter, we focus on useful techniques causing more effective results in our experience, and also at the end of this chapter, we discuss two challenging issues about the osteotomy or the use of piezosurgery embedded in the modern rhinoplasty and splinting or non-splinting treatment!

The use of botulinum toxin type A in facial cosmetics is extensively discussed in medical literature. Meanwhile, presence of many controversial issues and sometimes contradicting results precludes having unanimous guidelines in using this valuable remedy. Here, we have tried to discuss some of the challenging questions to find clinical solutions that are supported by evidence-based studies along with authors’ personal experience.

Preservative dorsal hump surgery is an old approach that has revitalized recently. Preservation rhinoplasty aims to shape the existing structures instead of resection/reconstruction approaches. A thorough understanding of the applied anatomy of the nose is the backbone of preservative hump surgery. In preservative hump surgery keystone works as a joint, and by lowering this joint the hump is eliminated.

Cephalic positioning of lateral cruras literally means that the cartilage does not support the nasal rim. Cephalic positioning is a relatively common anatomic variant of lower lateral cartilages that shows an extremely vulnerable rhinoplasty patient. In these patients, any reductive technique, such as cephalic trimming without compensation, worsens the situation and may lead to esthetic failures and airway compromise. True cephalic malpositioning needs to be diagnosed from pseudomalpositions preoperatively. The presence of the pseudomalposition does not mean that it can be ignored. Either malposition or pseudomalposition is best diagnosed and considered in the treatment plan.

Dorsal augmentation is commonly indicated in many primary and secondary aesthetic nose surgeries. Throughout the history, various synthetic and autogenous materials have been used for dorsal augmentation. In this article, we give an overview of basic concepts of cartilage grafting, review new concepts of dorsal augmentation, and discuss some emerging engineering modalities.

Dental implant is currently the gold standard in the rehabilitation of missing teeth. Like all other surgeries, placement of implants may be accompanied by a wide range of minor to serious complications. These unwanted events may stem from any stage of implant therapy from the first consultation appointment up to several years after a seemingly successful treatment. Here, authors have tried to review a variety of complications which, in spite of their importance, are not sufficiently addressed elsewhere. Diagnosis, management, and prevention of each group of complications will be briefly discussed.

Dental implant therapy is currently considered the gold standard in restoring missing dentition. However, with the surge in dental implant placement over the past decade, the incidence of associated complications has also steadily increased in this period. To date, these complications have been extensively discussed in the literature. Complications can occur at any step in the implant process, including the preoperative planning phase, intraoperatively, or postoperatively (even many years after implant placement). In contrast to preoperative and postoperative complications, intraoperative complications usually occur unexpectedly and need to be dealt with in an urgent fashion. This chapter will review some of the significant complications that may arise during the surgical phase of implant placement. It will also focus on avoiding critical errors and discuss how to manage potential complications in a timely and efficient manner.

Biodynamics of mandibular angle fractures has been extensively discussed in the literature in search for the best way to fixate and expedite recovery of trauma patients. Pioneers like Michelet and Champy had the greatest impact on evolving of osteosynthesis in maxillofacial traumatology; they introduced their basic principles frequently used to describe the biomechanics of mandibular fixation. Their concept states when a physiologic load is applied on mandibular teeth a negative tension will be created at superior border and a positive pressure will appear at inferior border. These simple definitions are the basis for the advent of fixation modalities in mandibular angle fracture. This article sought to reassess these principals based on load location via finite elements method. Keywords: Mandibular angle, Fracture, Osteosynthesis

The purpose of this study was to evaluate four standard techniques for radix augmentation during primary rhinoplasty: Skoog, crushed septal cartilage, temporalis fascia, and crushed cartilage wrapped in temporalis fascia. The main criterion for a patient to be included in this study was the need for radix augmentation, which was determined through preoperative evaluations. All patients requiring total dorsal augmentation were excluded from the study. This study included 63 rhinoplasty patients who underwent radix augmentation. The Skoog technique was applied in 15 patients, crushed septal cartilage in 16, temporalis fascia in 17, and crushed cartilage wrapped in temporalis fascia in 15. In those undergoing the Skoog technique, sharp edges of graft were palpable in three patients and were even visible in one patient. In the crushed cartilage group, seven patients showed irregularities during the postoperative follow-up. The results of this study indicate that all four autologous grafts represent acceptable graft material for radix augmentation. The algorithm suggests using the easier techniques first and that secondary donor sites should be considered only when the ideal result is not achieved.

Oral and maxillofacial surgery (OMS) is a specialty of dentistry and medicine that includes the diagnosis and surgical and adjunctive treatment of diseases, injuries, and defects involving maxillofacial and contiguous head and neck regions. The present chapter aims to further introduce the origin and scope of OMS and discuss the most common procedures done on pregnant patients. While the obstetrician (OB-GYN) serves as the primary physician during pregnancy, there are a myriad of situations in which intervention of an oral and maxillofacial surgeon (OMFS) is beneficial and/or inevitable. These may range from prevention to acute, subacute, or chronic conditions in need of elective, semi-urgent, or urgent management. The authors have provided an overview of these scenarios with an emphasis on infection, trauma, and pathology. Close cooperation between the OMFS and the OB-GYN, and an understanding of each other’s role in the care of the pregnant female, seems crucial to optimal mother and fetus care.

Meningoencephlocele is a relatively rare deformity, usually characterized by penetration of brain or meningeal tissues through a defect in skull. This protruding tissue may affect facial structure and subtle to severe facial deformities may appear. Surgical treatments of these deformities are usually done by a team including a neurosurgeon and craniofacial surgeon. The conventional treatments includes several complicated operations to relocate herniating tissues, then correcting malformed facial structure. The nasal framework osteotomy, is an innovative approach that uses transfacial incisions to gain access to herniating tissue. Then, by completing the osteotomy around the nose, the entire nasal structure is lifted and transposed to it is original position. The authors believe that this technique may considerably reduce the complexity and risks of conventional approaches, while aesthetic demands are readily achieved at the same stage.

Purpose Perforation of the nasal septum is a frustrating problem frequently reported in the literature. Surprisingly, in most reports, iatrogenic perforation during septoplasty and electrocautery are the leading causes of this complication. This article presents the management of septal perforations and the indications for an extracorporeal approach. Materials and Methods Fourteen patients with septal perforations were referred for treatment. Treatment was chosen based on defect size. Flaps, extracorporeal repair, or no treatment was used as indicated. Results Two of 14 perforations were small and were repaired by local flaps, 5 cases were treated by extracorporeal repair, and the 7 remaining cases required no surgical procedure. Conclusions The extracorporeal technique, when indicated, can be used effectively for the repair of nasal septum perforations in selected cases.