Objectives: The methods described in this review are used to develop minimally invasive non-surgical procedures for managing posttraumatic and paralytic face deformities. Following patients post treatment effects functional and facial symmetry improvement was observed.
Problems associated with a disability of closing the eye, mastication and speech difficulties have been reduced, while a clear improvement of facial symmetry and self-esteem have been seen in all cases.

Introduction: Facial paresis is a life changing condition associated with loss of facial muscle movement ability that can be permanent or temporary. The Human face is one of the most functionally, socially, and aesthetically important parts of the body. Modern approaches have their limitations, this is the reason for demand of less invasive procedures for overall functional and aesthetic improvement. Thread Methods can be a substitution to static surgical interventions, a mini-invasive procedure with long-lasting results which can improve functional and aesthetic problems associated with Facial paresis.

Materials / method: A 20-year observational study of patients who underwent correction of visual aesthetic manifestations of the paresis in different face zones by thread lifting method was analyzed.
Correction was performed at: one-sided brow ptosis, inferior eyelid edge, cheek soft tissues, angles of mouth and other parts of the face. The thread used in such patients was
P(LA/ CL)barbed threads, P(LA/ CL)Spiral threads, same barbed threads composed of non-absorbable material proline.

Results: Satisfactory facial symmetry, tissue elevation, and volume creation are obtained without surgical interventions. 90 % of patients evaluated their appearance as a more attractive version of per-procedural appearance. These results demonstrate that thread methods are mini-invasive procedures that treat cosmetic problems effectively with facial paresis. The following result lasts up to 2 years but due to muscular activity absence in patients with facial paresis results are preserved longer.

Conclusion: This review found consistent evidence of barbed threads placement as an effective treatment for improving quality of life in facial palsy patients, with minimal risk of complications, short procedural, and recovery time, and provide long-lasting functionally and aesthetically favorable results.

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Objectives: -to define the types of implant-based breast reconstruction
-to define the complications associated with implant-based breast reconstruction

Introduction: The gold standard of breast reconstruction remains the autologous reconstruction with a pedicled or a free flap. However, sometimes this is not an option either because microsurgery is not available or the patients prefer to avoid the morbidity associated with the donor site. Breast implants represent an alternative in such cases. The polyurethane implants have the advantage of lower rates of capsular contraction and lower risk of displacement/malposition permitting at the same time an aesthetic reconstruction – they reconstruct the footprint, the conus and reinforce the envelope

Materials / method: personal cases

Results: In delayed breast reconstruction they are employed in a hybrid fashion with a pedicled flap or fat grafting. A smaller volume is used, limiting the long-term complications. In LD+implant reconstruction, the risk of implant migration in the back is absent.
In direct to implant breast reconstruction, the polyurethane implants can be used pre-pectorally without the risk of skin breakdown and implant exposure. In skin reducing mastectomy a polyurethane implant with borosilicate micropsheres is even a better choice because it is 30% lighter, reducing thus considerably the tension on the skin flaps.

Conclusion: The polyrethane implants are versatile devices that come in various shapes and help the surgeon achieve an aesthetic breast reconstruction.

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Objectives: 1. Discuss the advantages of using surgical guides in facial cosmetic surgery.
2. Compare surgical guide’s manufacturing options (custom vs. in-house)
3. Step by step protocol: how to design in-house surgical guides for mentoplasty (main objective).

Introduction: Advances in 3D printing technology have the potential to significantly improve the workflow of facial cosmetic surgical planning. Custom positioning and surgical guides allow for intraoperative reproduction of pre-planned osteotomy cuts, which can result in greater surgical accuracy and patient safety while maintaining an acceptable cost-effectiveness ratio.

Materials / method: Three-dimensional planning models are visualized and segmented using open-source software (3D Slicer) from imported conventional computed tomography (CT) data. To design the desired osteotomy cuts, freeware (Autodesk Meshmixer) allows computerized manipulation of mandibular components and virtual surgical planning.

Individualized surgical guides, are fabricated in surgical guide resin with a resin 3D printer (Formlabs) and allows precise intraoperative positioning.The osteotomised segments are fixed using a pre-adapted plate with 2.0 no locking screws.

Results: The two main advantages of using in-house surgical guides are cost and manufacturing time savings. We have the high initial cost of the necessary equipment, the learning curve in the use of the required programs, and the time spent in the design to contend with.

A custom design plate and surgical guides for mentoplasty performed by a commercial company cost approximately € 1500 and have an average delivery time of 7 to 10 days. With in-house surgicsal guides, the total cost is reduced to around € 100 per case. The design and production times are less than 48 hours.

Conclusion: The use of in-house surgical guides seems a reliable and recommended alternative in mentoplasty surgery. It allows to determine the cuts with greater precision and in a predictable way to the surgical planning. It is also a cost effective option for saving surgical time.

The learning curve for developing expertise with planning software and printing settings is compensated by increased surgical predictability and decreased operating time, making this type of planning a valuable investment.

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