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IMCAS World Congress 2020
Program

FOCUS ON S257

Contributed talks - Face surgery

Room: Room Passy - level 1
Date: Saturday 1 February 2020 at 08:00 to 09:00
Format: CONTRIBUTED TALKS > session made up of abstract submissions that were carefully reviewed and selected by the Scientific Board

Chairs

Dr Bianca KNOLL

Plastic Surgeon

Germany

Dr Debraj SHOME

Facial Plastic Surgeon

India

Lectures of the session

Hours	Speakers	Lecture title	Abstract	Number
08:00	Dr Burak ERSEN	Two-flap otoplasty	View	98599
08:09	Dr Jesper THULESEN	Small incisional pretrichial eyebrow-tail lift - Fast and simple with robust outcome	View	98240
08:18	Dr Yun Nan LIN	Micro-autologous fat transplantation for treating a gummy smile	View	94830
08:27	Dr Hsinchien HSU	Modified multiple layers auricular cartilage applications in dorsal augmentation	View	95791
08:36	Dr Yasser ELSAYED ELBADAWY	Septal extension graft versus columellar strut in open rhinoplasty	View	96418
08:45	Dr Khanh Ngoc Thi TRAN	Incidence and predisposing factors for infection post-rhinoplasty	View	98857
08:54		Q&A		100404

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Dr Burak ERSEN

Plastic Surgeon

Turkey

Other author(s) :

Two-flap otoplasty

Objectives: To describe a new technique and compare its effectiveness with classical methods

Introduction: To overcome the undesirable complications of cartilage-suturing
techniques, the postauricular fascial flap was described by Horlock et al
as an adjunct to suture otoplasty. Shortly after its description the technique gained increasing popularity. Recently, the number of publications demonstrating the utilization of this technique as a stand-alone prominent ear correction procedure has increased. This article aims to present a new postauricular flap technique that increases the control in the reshaping of ear cartilage, decreases operation time, and provides symmetric outcomes.

Materials / method: A total of 22 patients (14 male and 8 female patients) underwent
prominent ear correction surgery with the same surgeon. Patient ages ranged from 22 to 36 years. In total, 21 patients underwent bilateral prominent ear correction,
whereas only 1 patient underwent unilateral prominent ear correction procedure.
The helix-mastoid distances and concha-mastoid angles of
patients were measured preoperatively and at the end of the first year
for the late postoperative assessment. Patients were also evaluated
for suture extrusion, granuloma formation, deformity reccurrence.

Results: Average total operation time was 45 minutes (35–60 minutes).
The mean preoperative upper third ear proportion–scalp
distance was 33.5 mm, and the middle third ear proportion–scalp
distance was 29.2 mm. At the first year following the surgery, these
measurements were 10.2 and 10.4 mm, respectively.
None of the patients suffered from skin necrosis, suture extrusion,
hematoma, or wound infection at the early or late postoperative
period. Asymmetry was noted in 2 patients, and revision was performed.

Conclusion: This article aims to describe a novel posterior fascial flap technique.
By preparing a medially based U-shaped adipoperichondrial flap
and a laterally based U-shaped perichondrioadipodermal flap, the aim
was to increase the number of the layers in which scar formation occurs
and to add an additional flap for the distribution of mechanical force
being applied by ear cartilage. A decrease in average operation time
was observed, tension distribution was balanced, and control over
postoperative symmetry and cosmetic result increased.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Jesper THULESEN

Oculoplastic Surgeon

Denmark

Other author(s) :

Small incisional pretrichial eyebrow-tail lift - Fast and simple with robust outcome

Objectives: The demand for more open and well demarcated eye surroundings is high, but the surgeon often meets a physical barrier due to low position or drooping of the eyebrows. These changes due to gravitational and involutional forces are most pronounced laterally at the brow tail level due to lack of tissue support with ageing.

Introduction: Here we describe a variation of the pretrichial browlift procedure that has several advantages: minor discomfort, rapid procedure in local anesthesia, short learning curve, no visible scars, pronounced, and robust results.

Materials / method: Preoperatively, one incision line of appr. 5 cm is marked in the upper forehead just posterior to the hairline parallel to the eyebrow tail on each side. After incision with a blade no. 15 scalpel beveled at 70 to the subcutaneous level, peri-incisional undermining with a tenotomy scissor, and then submuscular with a forehead elevator of the lateral forehead region distally to the level of the eyebrow tail is performed. A gaze moistured with saline-epinephrine solution is used as a tamponade into the cleavage for a few minutes, while an incision of appr. 1.5 cm is performed in the mid-part of

Results: Follow-up evaluation is four-to-five-month postoperatively, but earlier in cases with a need for a supplementary upper blepharoplasty procedure.

Conclusion: The method provides aesthetic pleasant results that are reproduceable, predictable, and long-lasting.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Yun Nan LIN

Plastic Surgeon

Taiwan

Other author(s) : Tsai-Ming Lin, Sin-Daw Lin, Yur-Ren Kuo

Micro-autologous fat transplantation for treating a gummy smile

Objectives: This study sought to determine the long-term results of MAFT in patients with a gummy smile.

Introduction: A gummy smile is treated using a number of techniques, including botulinum toxin injection and various surgical interventions. Micro-autologous fat transplantation (MAFT) is a potentially advantageous alternative approach that has not been previously evaluated.

Materials / method: Seven patients with gummy smiles were evaluated for MAFT treatment between October 2015 and April 2017. Centrifuged purified fat was micro-transplanted into the nasolabial groove, ergotrid, and upper lip areas using the MAFT-GUN while the patients were under total intravenous anesthesia.

Results: The mean age of the 7 patients was 31 years (range, 23-40 years). The mean operating time for MAFT was 52 minutes (range, 40-72 minutes), and the mean volume of fat delivered to the nasolabial groove, ergotrid, and upper lip was 16.1 mL. The mean decreases of gingival display in the right canine incisor, left canine incisor, right canine, and left canine teeth were 4.9, 4.6, 3.8, and 4.4 mm, respectively. The smiles of the 7 patients showed significant improvement at an average follow-up time of 12.9 months.

Conclusion: Gummy smile treatment using MAFT is an effective, reliable, and relatively simple method, with high patient satisfaction and minimal risk of complications.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Hsinchien HSU

Facial Plastic Surgeon

Taiwan

Other author(s) :

Modified multiple layers auricular cartilage applications in dorsal augmentation

Objectives: Amongst the Asian population, deficiency of the nasal dorsum is common; therefore, nasal dorsum augmentation is important. In our study, we describe a multi-layered autologous auricular cartilage for nasal dorsum augmentation.

Introduction: Autologous cartilage grafts are widely used for nasal dorsum augmentation. Various donor sites are available for harvesting, such as nasal septum cartilage, auricular cartilage, and ribs. Amongst the Asian population, deficiency of the nasal dorsum is common; therefore, nasal dorsum augmentation is important. In our study, we describe a multi-layered autologous auricular cartilage for nasal dorsum augmentation.

Materials / method: Our study was a retrospective analysis of enrolled patients who underwent open rhinoplasty at the Taipei City Hospital from December 2015 to July 2018. The origins of presenting complaints of nasal dorsum deficiency include traumatic, iatrogenic, cosmetic factors as well as requiring secondary revision. Unilateral or bilateral modified multi-layered autologous auricular cartilage grafts were designed to improve the nasal dorsum height based on the degree of nasal dorsum deficiency.

Results: During the study period, thirteen patients (3 males and10 females) with an average age of 36.7 years received a modified multi-layered autologous auricular cartilage graft on nasal dorsum. There were 6 patients with cartilage donors on the left ear, 4 on the right ear, and 3 on bilateral ears. The harvesting of the auricular cartilage graft is made a postauricular incision. Overall satisfaction was excellent. No postoperative scars were visible at the transcolumellar incision and donor sites. No would infection, hematoma, or disfigurement was noted.

Conclusion: Modified multi-layered autologous auricular cartilage is a feasible method for nasal dorsum augmentation without serious complication.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Yasser ELSAYED ELBADAWY

Plastic Surgeon

Egypt

Other author(s) :

Septal extension graft versus columellar strut in open rhinoplasty

Objectives: The aim of this study was to compare the long-term effect of columellar strut and septal extension graft on the stability of nasal tip projection, rotation, and definition.

Introduction: For successful rhinoplasty, achieving or preserving adequate tip projection while reshaping the nasal tip is considered to be a key element. The surgeonÕs knowledge of nasal tip supporting structures and ability to remodel and reposition the nasal tip can prevent any unexpected results after completion of the surgical procedure

Materials / method: A comparison was done on the difference between early and long term results of the nasal tip projection in 52 patients divided into two groups between 2015 and 2018. All cases were done by the same surgeon.

Results: Both grafts have the effects of increasing tip projection and this effect was found to be stable over time. However, some increased values of nasal tip projection obtained in the early postoperative period, in columellar strut cases, were lost over time.

Conclusion: The tip projection and definition were more stable in cases with septal extension graft than in those with columellar strut.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

Dr Khanh Ngoc Thi TRAN

Otorhinolaryngologist

South Korea

Other author(s) : Yong Ju Jang

Incidence and predisposing factors for infection post-rhinoplasty

Objectives: To provide a better understanding of the incidence and clinical characteristics of postoperative infection following primary and revision rhinoplasty.

Introduction: Infection is a serious complication in rhinoplasty with significant impact on both surgical outcome and the doctor-patient relationship. In order to better manage this complication and consent and counsel patients accordingly, it is important to first understand the contributing factors of post rhinoplasty infection and its clinical course. This study is the largest of its kind in the literature.

Materials / method: This is a retrospective review of 2630 (2282 patients) cases of rhinoplasty by a single surgeon (YJ Jang), from July 2003 to June 2018. 1595 (69.9%) were male, 687 (30.1%) were female. The median age was 31. The incidence of infection was compared between the primary and revision surgeries and analyzed according to the grafts or implant used. We also evaluated the organisms cultured and the time between surgery and development of infection.

Results: This study includes 2134 primary and 496 revision cases. Costal cartilage was used in 413 cases, conchal cartilage in 572, homologous fascia lata in 829, homologous costal cartilage in 102, GoreTex in 373, and silicone in 32 cases. We identified 22 cases of postoperative infection (overall 0.84% incidence). Of these, 18 cases were revision. Notably, autologous costal cartilage had an infection incidence of 3.39% (14 cases) and simultaneous repair of perforation was 8.52%. In 50% of cases the infection developed within 1 month following surgery (12±7 days). MRSA was cultured in 8 cases.

Conclusion: CONCLUSION
Revision rhinoplasty requiring the use of costal cartilage or simultaneous correction of septal perforation showed a higher risk of post-rhinoplasty infection, which usually manifests as erythema and swelling of the nasal tip and the caudal septum and needs to be managed by surgical debridement. Revision rhinoplasty cases had 19 times increase in the incidence of infection compared to primary cases.

Disclosures

Did you receive any funding to support your research for this TOPIC?
No

Were you provided with any honoraria, payment or other compensation for your work on this study?
No

Do you have any financial relationship with any entity which may closely compete with the medications, materials or instruments covered by your study?
No

Do you own or have you applied for any patents in conjunction with the instruments, medications or materials discussed in your study?
No

This work was not supported by any direct or non direct funding. It is under the author's own responsability

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IMCAS World Congress 2020 Program

FOCUS ON S257

Contributed talks - Face surgery

Chairs

Lectures of the session

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IMCAS World Congress 2020
Program