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Endoscopic-Assisted Forehead Augmentation with Polyetheretherketone (PEEK) Patient-Specific Implant (PSI) for Aesthetic Considerations

  • Innovative Techniques
  • Face and Neck Surgery
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Abstract

Background

Forehead augmentation have become popular aesthetic procedures among Asians in recent years. However, the use of polyetheretherketone (PEEK) patient-specific implant (PSI) in the facial contouring surgery for aesthetic considerations is not well documented in the existing studies. The purpose of this study was to develop a novel method for forehead augmentation and assess the clinical outcomes and complications in patients who underwent forehead augmentation with PEEK PSI assisted by endoscopy.

Methods

The PEEK PSIs were fabricated using the virtual surgical planning (VSP) and the computer-aided manufacturing (CAM) for each patient, preoperatively. The implant pockets were dissected in the subperiosteal plane, and PEEK PSIs were placed in their designed position and fixed assisting by endoscopy via small incision within the hairline. All patients were asked to complete the FACE-Q questionnaire before and 6 months after the operation. Pre- and postoperative demographics, photographs, and other clinical data of patients were collected and analyzed.

Results

11 patients underwent forehead augmentation were enrolled in this study. All procedures were completed successfully with the help of endoscope. The average patient age was 30.63 ± 2.54 years. The mean thickness and size of PEEK PSI were 4.44 ± 1.77 mm and 38.43 ± 22.66 cm2, respectively. The mean operative time was 83.00 ± 29.44 min, and the mean postoperative follow-up period was 11.00 ± 6.50 months. No implant exposure, extrusion or removal were reported. The FACE-Q scores of patients in satisfaction with the forehead increased from 47.64 ± 7.15 to 78.81 ± 6.35.

Conclusions

PEEK PSIs can be prefabricated to achieve accurate remodeling of the frontal contour with good esthetic outcomes. The endoscope provides direct and magnified vision, which allow easy access to the supraorbital rim and lateral edge of the eyebrow arch and confirming the position of the implants without damaging nerves and vessels. Endoscopic-assisted forehead augmentation with PEEK PSI is safe and effective.

Level of Evidence IV

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Funding

None of authors has a commercial interest, financial interest, and/or other relationship with manufacturers of pharmaceuticals, laboratory supplies, and/or medical devices or with commercial providers of medically related services. The authors received no financial support for the research, authorship, and publication of this article.

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Authors and Affiliations

  1. Department of Plastic Surgery, The Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University, Nanjing, 210029, Jiangsu, China

    Kaili Yan, Zhiyang Xie, Shunchao Yan, Chongxu Qiao, Yuming Qu, Sheng Gao, Wensong Shangguan & Guoping Wu

  2. School of Medicine, University of Tasmania, Hobart, TAS, 7000, Australia

    Yarui Wu

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Correspondence to Guoping Wu.

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Conflict of interest

The FACE-Q Craniofacial Module, authored by Drs. Anne Klassen and Karen Wong, is the copyright of McMaster University and the Hospital for Sick Children. The authors declare that they have no conflicts of interest to disclose.

Ethical Approval

The study was approved by the Ethics Committee of the Affiliated Friendship Plastic Surgery Hospital of Nanjing Medical University and was conducted in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Informed consent was obtained from all subjects involved in the study. Written informed consent was also obtained from the patients to publish this paper.

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Yan, K., Wu, Y., Xie, Z. et al. Endoscopic-Assisted Forehead Augmentation with Polyetheretherketone (PEEK) Patient-Specific Implant (PSI) for Aesthetic Considerations. Aesth Plast Surg (2024). https://doi.org/10.1007/s00266-024-03899-1

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