The influence of the skin tumors excision width in the postoperative facial asymmetry

  • Saša Milićević University of Defence, School of medicine of Military Medical Academy, Clinic for plastic surgery and burns
  • Aleksandar Jevtić Military Medical Academy, Clinic for Orthopedic Surgery and Traumatology
  • Nenad Stepić University of Defence, School of medicine of Military Medical Academy, Clinic for plastic surgery and burns
Keywords: facial neoplasms;, reconstructive surgical procedures;, postoperative period;, facial asymmetry;, lasers;, cephalometry

Abstract


Background/Aim. Planning an elliptical excision of the facial skin, caused by lines of minimum tension, is very important in order to achieve good aesthetic results. The width of the tumor excision affects the possibility of a direct closure of the post-excision defect. The aim of the study was to determine the minimum width of excision that does not affect postoperative symmetry of the face, in relation to the preoperative one, using an objective scanning method with a line laser scanner. Methods. The study included 50 patients of both sexes, older than 50 years, who had verified facial skin tumor and established medical indication for surgical elliptical excision and direct suture. All patients had laser scanning preoperatively, and then seven days and 90 days postoperatively, giving x, y, and z coordinates of 5 cephalometric points on the face, which determined the shape of the examined region. Patients were divided into three groups depending on the width of the excision (< 10 mm, 10–15 mm, > 15 mm). The shape of the examined region among different width of excision was compared, preoperatively, 7 days and 90 days postoperatively, using Procrustes analysis and analysis of the coordinates of cephalometric points. Results. Taking into account preoperative and postoperative x, y and z coordinates of the cephalometric points, statistically significant differences between the group of patients with the width excision < 10 mm and the other two groups (excision width 10–15 mm and > 15 mm) were found. Conclusion. The width of the skin tumors excision < 10 mm does not affect the postoperative facial asymmetry when a post-excisional defect is closed by direct suture.

 

Author Biography

Saša Milićević, University of Defence, School of medicine of Military Medical Academy, Clinic for plastic surgery and burns

Military Medical Academy

Clinic for plastic surgery and burns

References

Boyette JR, Vural E. Cervicofacial advancement-rotation flap in midface reconstruction: forward or reverse? Otolaryngol Head Neck Surg. 2011; 144(2): 196–200.

Cheong YW, Lo LJ. Facial asymmetry: etiology, evaluation, and management. Chang Gung Med J 2011; 34(4): 341–51.

Olesen OV, Paulsen RR, Højgaar L, Roed B, Larsen R. Motion tracking in narrow spaces: a structured light approach. Med Image Comput Comput Assist Interv 2010; 13(Pt 3): 253–60.

Khavkin J, Ellis DA. Standardized photography for skin sur-face. Facial Plast Surg Clin North Am 2011; 19(2): 241–6.

Couch SM. Correction of Eyelid Crease Asymmetry and Ptosis. Facial Plast Surg Clin North Am 2016; 24(2): 153–62.

Kang SH, Kim MK, An SI, Lee JY. The effect of orthognathic surgery on the lip lines while smiling in skeletal class III pa-tients with facial asymmetry. Maxillofac Plast Reconstr Surg 2016; 38(1): 18.

Galatius A, Goodall RN. Skull shapes of the Lissodelphininae: radiation, adaptation and asymmetry. J Morphol 2016; 277(6): 776–85.

Young NM, Sherathiya K, Gutierrez L, Nguyen E, Bekmezian S, Huang JC, et al. Facial surface morphology predicts variation in internal skeletal shape. Am J Orthod Dentofacial Orthop 2016; 149(4): 501–8.

Darby LJ, Millett DT, Kelly N, McIntyre GT, Cronin MS. The ef-fect of smiling on facial asymmetry in adults: a 3D evaluation. Aust Orthod J 2015; 31(2): 132–7.

Belcastro A, Willing R, Jenkyn T, Johnson M, Galil K, Yazdani A. A Three-dimensional Analysis of Zygomatic Symmetry in Normal, Uninjured Faces. J Craniofac Surg 2016; 27(2): 504–8.

Tominaga K, Habu M, Tsurushima H, Takahashi O, Yoshioka I. CAD/CAM splint based on soft tissue 3D simulation for treatment of facial asymmetry. Maxillofac Plast Reconstr Surg 2016; 38(1): 4.

Xiong Y, Zhao Y, Yang H, Sun Y, Wang Y. Comparison Be-tween Interactive Closest Point and Procrustes Analysis for Determining the Median Sagittal Plane of Three-Dimensional Facial Data. J Craniofac Surg 2016; 27(2): 441–4.

Thiesen G, Gribel BF, Freitas MP. Facial asymmetry: a current review. Dental Press J Orthod 2015; 20(6): 110–25.

Winkelbach S, Molkenstruck S, Wahl FM. Low-Cost Laser Range Scanner and Fast Surface Registration Approach. Berlin Heidelberg: Springer, Verlag; 2006. p. 718–28.

Riml S, Piontke A, Larcher L, Kompatscher P. Quantification of faults resulting from disregard of standardised facial photog-raphy. J Plast Reconstr Aesthet Surg 2011; 64(7): 898–901.

Popić Ramac J, Hebrang A, Ivanovi-Herceg Z, Vidjak V, Brnić Z, Novacić K, et al. The possibilities and limitations of direct digi-tal radiography, ultrasound and computed tomography in di-agnosing pleural mesotelioma. Coll Antropol 2010; 34(4): 1263–71.

Li G, Ballangrud A, Kuo LC, Kang H, Kirov A, Lovelock M, et al. Motion monitoring for cranial frameless stereotactic radiosur-gery using video-based three-dimensional optical surface imag-ing. Med Phys 2011; 38(7): 3981–94.

Eren G, Aubreton O, Meriaudeau F, Sanchez Secades LA, Fofi D, Naskali AT, et al. Scanning from heating: 3D shape estimation of transparent objects from local surface heating. Opt Express 2009; 17(14): 11457–68.

Hashimoto T, Thompson GE, Zhou X, Withers PJ. 3D imaging by serial block face scanning electron microscopy for materials science using ultramicrotomy. Ultramicroscopy 2016; 163: 6–18.

Borrett S, Hughes L. Reporting methods for processing and analysis of data from serial block face scanning electron mi-croscopy. J Microsc 2016; 263(1): 3–9.

Colon J, Lim H. Shaping field for 3D laser scanning microsco-py. Opt Lett 2015; 40(14): 3300–3.

Kim SH, Jung WY, Seo YJ, Kim KA, Park KH, Park YG. Accu-racy and precision of integumental linear dimensions in a three-dimensional facial imaging system. Korean J Orthod 2015; 45(3): 105–12.

Lippold C, Liu X, Wangdo K, Drerup B, Schreiber K, Kirschneck C, et al. Facial landmark localization by curvature maps and pro-file analysis. Head Face Med 2014; 10: 54.

Charlier P, Froesch P, Huynh-Charlier I, Fort A, Hurel A, Jullien F. Use of 3D surface scanning to match facial shapes against altered exhumed remains in a context of forensic individual identification. Forensic Sci Med Pathol 2014; 10(4): 654–61.

Masuda Y, Oguri M, Morinaga T, Hirao T. Three-dimensional morphological characterization of the skin surface micro-topography using a skin replica and changes with age. Skin Res Technol 2014; 20(3): 299–306.

Published
2021/04/12
Section
Original Paper