Facial nerve paralysis has significant effects on a patient’s daily social interaction, nevertheless, the functional deficits that the patient experiences with oral incompetence, speech and deglutition can be debilitating. We describe a novel technique “Valentine anguloplasty” which involves the excision of skin in the shape of a valentine at the corner of the upper lip on the paralytic side. The technique has been illustrated in the results section. We found that valentine anguloplasty has many advantages, including its ability to lift the corner lip improving static symmetry as well as oral competence. It also provides access to tunnel fascia lata sling from mid-face to anchor to the upper lip, lower lip and oral commissure to help provide further lift to the droopy corner of the lip on the paralytic side.

Bariatric interventions, both surgical and medical, are increasingly employed by patients to achieve weight reduction and enhance overall health. However, there is growing concern about the associated changes in soft tissue facial aesthetics resulting from these interventions. In this systematic review, the authors aimed to analyze the existing literature regarding soft tissue facial changes after bariatric interventions, with a focus on the influence of massive weight loss on facial aging, attractiveness, and considerations for facial rejuvenation. A systematic review was conducted until February 10, 2024, using electronic databases such as PubMed, Scopus, Web of Science, Embase, and Google Scholar. This review was registered in the open science framework. The Covidence software (Melbourne, VIC, Australia) facilitates title, abstract, and full-text screening, as well as data extraction. In total, 309 papers were identified, 94 duplicates were removed, and 194 studies were excluded on the basis of inclusion criteria. Of the remaining 21 studies, 13 met the inclusion criteria with an additional single study from the conference abstract. Descriptive analysis was conducted. We observed a correlation between massive weight loss and facial aging. The most significant fat regional devolumization was observed along the mid-cheek region and with central neck skin laxity. The apparent age of patients was higher among those with massive weight loss. In our study, we demonstrated that massive weight loss causes accelerated facial aging, manifested through fat devolumization, and increased skin laxity. Further quantitative volumetric facial analyses postbariatric surgery would yield valuable results.

Technology and Robotics in Rhinologic Surgery 2026