• Archives of Craniofacial Surgery
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• v.22 no.1
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• pp.1-10
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• 2021

Botulinum toxin type A (BoNT-A), onabotulinumtoxinA (Botox) was approved by the United States Food and Drug Administration for temporary improvement of glabellar lines in patients 65 years and younger in 2002, and has also been used widely for aesthetic purposes such as hyperhidrosis, body shape contouring, and other noninvasive facial procedures. BoNT-A inhibits presynaptic exocytosis of acetylcholine (ACh)-containing vesicles into the neuromuscular junction at cholinergic nerve endings of the peripheral nervous system, thereby paralyzing skeletal muscles. ACh is the most broadly used neurotransmitter in the somatic nervous system, preganglionic and postganglionic fibers of parasympathetic nerves, and preganglionic fibers or postganglionic sudomotor nerves of sympathetic nerves. The scientific basis for using BoNT-A in various cosmetic procedures is that its function goes beyond the dual role of muscle paralysis and neuromodulation by inhibiting the secretion of ACh. Although the major target organs for aesthetic procedures are facial expression muscles, skeletal body muscles, salivary glands, and sweat glands, which are innervated by the somatic or autonomic nerves of the peripheral cholinergic nerve system, few studies have attempted to directly explain the anatomy of the areas targeted for injection by addressing the neural physiology and rationale for specific aesthetic applications of BoNT-A therapy. In this article, we classify the various cosmetic uses of BoNT-A according to the relevant component of the peripheral nervous system, and describe scientific theories regarding the anatomy and physiology of the cholinergic nervous system. We also review critical physiological factors and conditions influencing the efficacy of BoNT-A for the rational aesthetic use of BoNT-A. We hope that this comprehensive review helps promote management policies to support long-term, safe, successful practice. Furthermore, based on this, we look forward to developing and expanding new advanced indications for the aesthetic use of BoNT-A in the future.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.3
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• pp.254-261
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• 2006

Moderate to severe dentofacial deformities usually require combined orthodontic treatment and orthognathic surgery to obtain the most stable result with optimal function and facial esthetics. Accordingly, the orthodontist and oral maxillofacial surgeon must be able to exactly diagnose existing deformities, establish an appropriate treatment plan, and execute the recommended treatment. Especially, to obtain optimal result of the maxillary surgery, model surgery is essential. But, the preoperatively planned position of the maxillary dental arch often cannot be sufficiently achieved during actual surgery, and deviations in the sagittal and vertical dimensions are common. To achieve three dimensional repositioning of the maxilla exactly, several methods have been introduced so far. Recently Model Repositioning Instrument (MRI, SAM, Inc., $M\ddot{u}nchen$, Germany), one of these methods, has been introduced and applied clinically, which is reported as accurate, effective and prompt method for three dimensional repositioning of the maxilla. This article describes an introduction and a clinical application of this MRI.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.3
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• pp.284-287
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• 1999

The nose, a striking features of the human face, is regarded by many clinicians as the keystone of facial esthetics. Clinically, as the treatment of a dentofacial deformity, the soft tissue changes that occurred normally with movement of the skeletal bases. Changes of the soft tissue in the maxillary orthognathic surgery are widening of alar base, elevated nasal tip and flattening of upper lip. In addition, soft tissue change is difficult to predict, it has considerable variability in the response of soft tissue. We reviewed patients who received Le Fort I advancement osteotomy in our department and analysed preoperative and postoperative alar base width, nasal height in clinical measurement and cephalometry and patient's satisfaction of postoperative nasal appearance.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.2
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• pp.106-111
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• 1998

The aim of this article was to examine the usefulness of costochondral graft in the temporomandibular joint reconstruction. We performed costochondral grafting in the mandibular reconstruction including condyle replacement in 3 patients, which 2 of ankylosed cases and 1 destructed case. In one case, unexpected fracture of costochondral junction has developed at post-operative 2 months, but, normal mouth opening and facial appearance have been acheived by continuing exercise. These patients showed maximum mouth opening of 35-40 mm and no restriction of lateral side movement. They have been improved esthetics and function. We proposed that the costochondral graft is one of the useful method for functional reconstruction of defected mandibular condyle.

• Archives of Plastic Surgery
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• v.41 no.6
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• pp.630-637
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• 2014

A long nose with a drooping tip is a major aesthetic problem. It creates a negative and aged appearance and looks worse when smiling. In order to rectify this problem, the underlying anatomical causes should be understood and corrected simultaneously to optimize surgical outcomes. The causes of a drooping tip of a long nose are generally classified into two mechanisms. Static causes usually result from malposition and incorrect innate shape of the nasal structure: the nasal septum, upper and lower lateral cartilages, and the ligaments in between. The dynamic causes result from the facial expression muscles, the depressor septi nasi muscle, and the levator labii superioris alaeque nasi muscle. The depressor septi nasi depresses the nasal tip and the levator labii superioris alaeque nasi pulls the alar base upwards. Many surgical methods have been introduced, but partial approaches to correct such deformities generally do not satisfy East Asians, making the problem more challenging to surgeons. Typically, East Asians have thick nasal tip soft tissue and skin, and a depressed columella and alar bases. The authors suggest that multifactorial approaches to static and dynamic factors along with ancillary causes should be considered for correcting the drooping tip of the long noses of East Asians.

• Journal of the korean academy of Pediatric Dentistry
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• v.21 no.2
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• pp.540-546
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• 1994

The authors treated three patients who chiefly complained functional anterior crossbite due to premature loss of primary molars by using removable space maintainer and functional appliances. In orthodontic practice, the mandibular rest position and the possibility of taking construction bite have been as the criteria for evaluation of functional factors involved in anterior crossbite. Functional anterior crossbites, if left untreated, may have deleterious effects on the development and function of craniofacial complex and TMJ. Objectives of the treatment were as follows: 1) to recover vertical dimension 2) to eliminate functional disharmony 3) to correct anterior reversed occlusion 4) to attain good facial esthetics 5) to prevent unfavorable growth of jaw & dentition Characterized craniofacial morphology resulting from the premature loss of deciduous molars could be recovered following the correction of crossbite. Therefore, it is recommended that in orthodontic diagnosis of functional anterior crossbite due to premature loss of deciduous molars, the craniofacial abnormality affected by that should be considered.

• The korean journal of orthodontics
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• v.32 no.3 s.92
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• pp.175-183
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• 2002

Crouzon syndrome Is one of the craniofacial syndromes characterized by craniosynostosis, midfacial hypolpasia and ocular proptosis. Distraction osteogenesis is becoming Important technique to treat craniofacial dyplaisa. It has nuy advantages compared with standard orthognathic surgery. Maxillary distraction osteogenesis after Le Fort III osteotomy with the RED system presents successful maxillary protraction to Crouzon syndrome patient with severe maxillary deficiency. It also allows remarkable improvement of facial esthetics and respiratory functions.

• The korean journal of orthodontics
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• v.23 no.1 s.40
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• pp.123-136
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• 1993

The purpose of this report is to present the successful improvement of occlusal relationship and facial esthetics in class II division 1 malocclusion with severe labioversion of upper anterior teeth and severe overjet, and in class II malocclusion with infraversion of bilateral maxillary canines by MEAW mechanics, which enables us to get effective distal on mass movement of maxillary dentition, with upper second molar extraction. After treatment, there were natural contact points at canine and premolar regions, normal occlusal relation-ship and treatment results, satisfied the gnathologic concept, in this 2 cases. Compared with the routine treatment with premolar extraction, the treatment time and patients' discomfort were reduced. And the MEAW mechanics, which enables us to get effective distal on mass movement of maxillary dentition, resulted in reduction of the treatment time and getting the good treatment results. Consequently, the majot concerns in orthodontic treatment are appropriate diagnosis and treatment plan, so, the application of second molar extraction with appropriate case analysis and diagnosis is very helpful to orthodontic treatment.

• The korean journal of orthodontics
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• v.26 no.3
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• pp.241-246
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• 1996

The chin is one of the factors which express human character, and appropriately protruding chin is very important to harmonious profile, the purpose of genioplasty is to reshape the chin and improve the facial esthetics which is one of the purposes of orthodontic treatment. It can be classified as augmentation genioplasty which enlarge the chin vertico-horizontally and reduction genioplasty which smallen it. The examples to apply this procedure are as follows. 1. advancement of retruded chin 2. reduction of chin prominence 3. control of chin vertical dimension 4. correction of asymmetry

• The korean journal of orthodontics
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• v.27 no.4 s.63
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• pp.661-668
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• 1997

There is a variation in the range of normal occlusion, and we must fit our treatment to the needs of each patient. If the upper or lower incisors are congenital)y missing, malformed, or crowded, the extraction of the incisor has some advantages over the extraction of premolars and nonextractions. The advantages are 1)simple mechanics, 2)reduced treatment time, 3)less relapse tendency, and 4)fewer facial profile changes. In order to decide which incisor should be extracted, we must consider certain factors 1)discrepancies in anterior arch length, 2)anterior tooth ratio, 3)periodontal and tooth health condition, and 4)the relationship between the upper and lower midline. Diagnostic set-up can be helpful to plan the treatment and show us the post treatment result.