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Alloplastic facial contouring: Surgery of the fourth plane

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Abstract

Plastic surgeons are now better prepared to fulfill the primary goal of facial aesthetic surgery. By manipulating and combining the various new techniques, they can restore, rejuvenate, or enhance facial form and affect aging changes. Infinite variations in facial contour can now be achieved with alloplastic facial implants. By using techniques based on the concepts of zonal anatomy, the facial skeleton can be augmented with a minimum of complications. Alloplastic onlay techniques significantly improve facial contour to correct both hereditary deficiencies in youth as well as aging changes. The use of implants in the “fourth” skeletal plane, as defined by the author, represents the newest favorable manipulation of volume.

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References

  1. Agban GM: Augmentation and corrective malarplasty. Ann Plast Surg 2:306, 1979

    Google Scholar 

  2. Aufricht G: Combined plastic surgery of the nose and chin: resume of 27 years experience. Am J Surg 95:231, 1958

    Google Scholar 

  3. Aufricht G: Correction of microgenia by osteocartilaginous transplant from large hump nose. Am J Surg 25:292, 1934

    Google Scholar 

  4. Bell W: Correction of the contour deficient chin. J Oral Surg 27:110, 1969

    Google Scholar 

  5. Binder WJ, Kamer FM, Parkes ML: Mentoplasty—a clinical analysis of alloplastic implants. Larynogoscope 91:383, 1981

    Google Scholar 

  6. Binder WJ: Submalar augmentation, an alternative to facelift surgery. Arch Otolaryngol Head Neck Surg 115:797, 1989

    Google Scholar 

  7. Brennan HG: Augmentation malarplasty. Arch Otolaryngol 108:441, 1982

    Google Scholar 

  8. Broadbent TR, Matthews VI: Artistic relationships in surface anatomy of the face: application to reconstructive surgery. Plast Reconstr Surg 20:1, 1957

    Google Scholar 

  9. Brown JB, Fryer MP, Ohlwiler DA: Study and use of synthetic materials such as silicones and Teflon as subcutaneous prostheses. Plast Reconstr Surg 26:264, 1960

    Google Scholar 

  10. Connell BF: Cervical lift: Surgical correction of fat contour problems combined with full width platysma muscle flap. Aesth Plast Surg 1:355, 1978

    Google Scholar 

  11. Connell BF: Eyebrow and forehead lifts. In: Courtiss EH (ed): Male Aesthetic Surgery. St. Louis: C. V. Mosby, 1982

    Google Scholar 

  12. Converse JM: Reconstr Plast Surg. Philadelphia: W.B. Saunders, 1968, vols 2, 3

    Google Scholar 

  13. Figalova P: Asymmetry of the face. Antropologie 7:31, 1969

    Google Scholar 

  14. Friedland JA, Coccaro PJ, Converse JM: Retrospective analysis of mandibular bone absorption under silicone rubber chin implants. Plast Reconstr Surg 51:144. 1976

    Google Scholar 

  15. González-Ulloa M: Basic studies in preparation for profileplasty. In: Wallace AB (ed): Transactions of the Second International Congress of Plastic Surgery. Baltimore: Williams and Wilkins, 1961

    Google Scholar 

  16. González-Ulloa M:Building out of the malar prominences as an addition to rhytidectomy. Plast Reconstr Surg 53:293, 1974

    Google Scholar 

  17. González-Ulloa M: Planning for the integral correction of the human profile. J Int Coll Surg 36:3, 1961

    Google Scholar 

  18. González-Ulloa M, Stevens E: The role of chin correction in profileplasty. Plast Reconstr Surg 41:477, 1968

    Google Scholar 

  19. Gorney M, Harries T: The preoperative and postoperative consideration of natural facial asymmetry. Plast Reconstr Surg 54:187, 1974

    Google Scholar 

  20. Gorski M, Tarczynska IH: Surgical treatment of mandibular asymmetry. Br J Plast Surg 22:370, 1969

    Google Scholar 

  21. Guerrero-Santos J: The role of the platysma muscle in rhytidoplasty. Clin Plast Surg. 5:29, 1978

    Google Scholar 

  22. Hinderer U: Malar implants for improvement of the facial appearance. Plast Reconstr Surg 56:157, 1975

    Google Scholar 

  23. Hinderer U: Profileplasty. Int Micr J Aesth Plast Surg Card 1: No. 1, 1971

  24. Hinderer U, del Rio Legarretta O: Aesthetic surgery of the malar region. In: Regnault P, Daniel RK (eds): Aesthetic Plastic Surgery: Principle and Techniques. Boston: Little, Brown, 1984

    Google Scholar 

  25. Jobe R, Iverson R, Vistnes L: Bone deformation beneath alloplastic implants. Plast Reconstr Surg 1:169, 1973

    Google Scholar 

  26. Kent JN, Westfall RL, Carlton DM: Chin and zygomaticomaxillary augmentation with proplast: longterm follow-up. J Oral Surg 39:912, 1981

    Google Scholar 

  27. Laub DR, Spohn W, Lash H, Weber J, Chase RA: Accurate recontruction of traumatic bony contour defects of periorbital area with prefabricated silastic. J Trauma 10:472, 1970

    Google Scholar 

  28. Lilla JA, Bistines LM, Jobe RP: The long-term effects of hard alloplastic implants when put on bone. Plast Reconstr Surg 58:14, 1976

    Google Scholar 

  29. Mahler D: Chin augmentation, a retrospective study. Ann Plast Surg 8(6):468, 1982

    Google Scholar 

  30. Meyer RA, Gehrig JD, Funk EC, Beder OE: Restoring facial contour with implanted silicone rubber: report of two cases. Oral Surg Oral Med Oral Pathol 24:598, 1967

    Google Scholar 

  31. Millard RD: Adjunct in augmentation mentoplasty and corrective rhinoplasty. Plast Reconstr Surg 36:9, 1965

    Google Scholar 

  32. Millard RD. Augmentation mentoplasty. Surg Clin Am 51:333, 1971

    Google Scholar 

  33. Millard RD: Chin implants. Plast Reconstr. Surg. 13:70, 1953

    Google Scholar 

  34. Mittelman H: An implant to correct the geniomandibular sulcus. Personal communication, August 1989

  35. Moos KF, Jackson FT, Henderson G: The use of proplast in oral and maxillo-facial surgery. Br J Oral Surg. 26(3):187, 1979

    Google Scholar 

  36. Ousterhout DK: Feminization of the forehead; contour changing to improve female aesthetics. Plast Reconstr Surg 29(5):701, 1987

    Google Scholar 

  37. Parkes ML: Avoiding bone resorption under plastic chin implants. Arch Otolaryngol 98:100, 1973

    Google Scholar 

  38. Peled IJ, Wexler MR, Ticher S, Lax EE: Mandibular resorption from silicone chin implants in children. J Oral Maxillofac Surg 44:5346, 1986

    Google Scholar 

  39. Peterson R: The role of the platysma muscle in cervical lifts. Symposium on Surgery of the Aging Face. St. Louis: C.V. Mosby, 1978, p 115

    Google Scholar 

  40. Pitanguy I: Augmentation mentoplasty. Plast Reconstr Surg 42:441, 1968

    Google Scholar 

  41. Ribiero L: Protesis malares. 13 Congreso Brasiliero de Cirugia Plastica, 1 Congreso Brasilier de Cirugia Est. Porto Alegre Brazil, 1976

    Google Scholar 

  42. Robinson M: Bone resorption under plastic chin implants—follow-up of a preliminary report. Arch Otolaryngol 95:30, 1972

    Google Scholar 

  43. Robinson M, Shuken R: Bone resorption under plastic chin implants. J Oral Surg 27:116, 1969

    Google Scholar 

  44. Safian J: Progress in nasal and chin augmentation. Plast Reconstr Surg 37:522, 1966

    Google Scholar 

  45. Schultz RC: The voice of polite dissent: clinical experiences with Proplast as an implant. Plast Reconstr Surg 63(3):421, 1979

    Google Scholar 

  46. Snyder GB: Cervicomentoplasty with rhytidectomy. Plast Reconstr Surg 54:404, 1974

    Google Scholar 

  47. Spadafora A, De Los Rios E, Toledo Rios R: Pomulos planos (platizigion). Endoprotesis de polietileno insertadas por via subperiostica del arco cigomatico. Prensa Med Argent 58:1946, 1971

    Google Scholar 

  48. Stark RB: Building out the malar prominences as an addition to rhytidectomy, commentary. Plast Reconstr Surg 53:469, 1974

    Google Scholar 

  49. Serman NJ: Differentiation of double mental foramina from extra bony coursing of the incisive branch of the mandibular nerve—an anatomic study. Dent Med 5(3):20,21, July 1987

    Google Scholar 

  50. Terino EO: Malar, mandible and chin augmentation by alloplastic techniques. In: Ousterhout D (ed): Aesthetic Contouring of the Cranial Facial Skeleton. Boston: Little, Brown, 19XX

  51. Terino EO: Complications of chin and malar augmentation. In: Peck G (ed): Complications and Problems in Aesthetic Plastic Surgery. New York: Gower Medical Publishers, 1991

    Google Scholar 

  52. Tessier P: The definitive plastic surgical treatment of the severe facial deformities of craniofacial dysostosis: Crouzon's and Apert's diseases. Plast Reconstr Surg 48:419, 1971

    Google Scholar 

  53. Toranto IR: Mentoplasty: a new approach. Plast Reconstr Surg 69(5):875, 1982

    Google Scholar 

  54. Whitaker LA: Aesthetic augmentation of the malar midface structures. Plast Reconstr Surg 80(3):387, 1987

    Google Scholar 

  55. Whitaker LA, Pertschuk M: Facial skeletal contouring for aesthetic purposes. Plast Reconstr Srug 69:245, 1982

    Google Scholar 

  56. Wilkinson TS: Complications in aesthetic malar augmentation. Plast Reconstr Surg 71(5):643, 1983

    Google Scholar 

  57. Wolfe SA: Aesthetic procedures on the chin. In: Regnault P, Daniel RK (eds): Aesthetic Plastic Surgery: Principles and Techniques. Boston: Little, Brown, 1984

    Google Scholar 

  58. Zarem HA: Silastic implants in plastic surgery. Surg Clin N Am 48:129, 1968

    Google Scholar 

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Teriino, E.O. Alloplastic facial contouring: Surgery of the fourth plane. Aesth. Plast. Surg. 16, 195–212 (1992). https://doi.org/10.1007/BF00190065

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