Facelift: Current Concepts, Techniques, and Principles

The effects of aging on skin, including thinning and loss of muscle tone, result in a flabby or drooping appearance of the face. The demands of an attractive appearance and smooth skin are wanted all around the world. There are a lot of factors which influence the choice of rejuvenation techniques, including anatomy of the facial skeleton, the severity of aging changes, social and economic status of the patient, and structure of the skin. Facelifting is a facial rejuvenation procedure in which by dissection of subcutaneous layers and different suturing techniques we are able to stretch the skin and make the patient look younger. This chapter presents the technique, current concepts, complications, and indications of facelift surgery

Blood Biomarkers Alterations with Administration of Propofol for Anaesthesia Maintenance during Long term Oral and Maxillofacial Surgeries

Objective: This prospective study performed to evaluate blood biomarkers alterations with administration of propofol for maintenance of anaesthesia during long oral and maxillofacial surgeries in order to estimate the risk of Propofol Infusion Syndrome (PRIS). This rare syndrome often would be happened in long duration or high dose infusion which is characterized by the combination of metabolic acidosis, acute bradycardia and/or asystole, and rhabdomyolysis and can be fatal.Methods: Patients undergoing maxillofacial surgeries (>3h) were the subjects of this quasi experimental prospective clinical trial study. Induction of anaesthesia was performed with midazolam 0.025 mg/kg, fentanyl 2 µg/kg, thiopental sodium 5 mg/kg, and atracurium 0.5 mg/kg. Infusion of propofol was initiated (100 µg/kg/min) for maintenance of anesthesia. Serum potassium level, creatine kinase, lactate and blood PH, were evaluated at baseline, and at 2, 4, 6 hours following the initiation of propofol infusion. Generalized estimating equation was used to evaluate the longitudinal changes for each of the evaluated biomarkers. The relation between the biomarkers and the following factors were appraised by using covariance linear (enter mode) regression  analysis: age, gender, weight, administered dose of dexamethasone and epinephrine, duration of surgery, and a history of trauma prior to surgery.Results: A total of 55 participants, 31 women and 24 men, were studied. The mean duration of surgery was 4.8(1) hours. Despite the rise in the level of potassium and creatine kinase and the reduction of blood PH, no case of hyperkalemia or severe metabolic acidosis was observed. Serum lactate level gradually increased to higher than normal in few patients; though did not necessitate  any intervention. All alterations were statistically significant. Potassium and creatine kinase level at baseline had relation to pre-surgical trauma.Conclusion: Maintenance of anaesthesia with 100 µg/kg/min propofol along with administration of low-dose epinephrine and dexamethasone did not cause clinically important alterations in blood biomarkers during long-duration maxillofacial surgeries and might not cause PRIS

Synthesis And Characterization Of 3D-Printed Functionally Graded Porous Titanium Alloy

This study aims to 3D print titanium alloy constructs incorporating gradient of porosities, from the fully dense core to the porous outer surface. Gradient porous specimens were prepared using selective laser melting (SLM). Fully dense specimens fabricated by SLM were used as the control group. Characterization of samples was done using X-ray tomography, uniaxial compression testing, and optical and scanning electron microscopes. The biocompatibility of fabricated samples was investigated using human periodontal ligament stem cells via assessment of cell attachment, viability, and proliferation by direct and indirect assays. The data were analyzed using ANOVA and Tukey’s post hoc test. Characterization of constructs reveals interconnected gradient porosities and higher contact angle in porous samples. The introduction of porosity leads to a significant decrease in compression strength. However, Young’s modulus of the samples with gradient porosity was more similar to the natural bone modulus. The surface microstructure consists of loosely bonded spherical particles. Biocompatibility of the dense and porous samples is appropriate. Although the porosity size led to a reduced cell proliferation rate in the gradient sample, the extract of the gradient sample results in more cell proliferation than the dense sample’s extract. The study demonstrates that a biocompatible functionally graded porous titanium structure can be well fabricated by SLM, and this structure leads to a good match of Young’s modulus to that of the bone