第5回国際美容外科学会、東京 2008/11/15-17

■ Trans-racial surgery from Oriental to Caucasian look

Some of Oriental people desire to change their face to look like Caucasian. The upper blepharoplasty and nasal augmentation are not enough to meet their demands. We consider it is essential to give the eye more sculptured feature in order to make the oriental face to Caucasian like face. Augmentation of the forehead and nasal root is a key point of procedures. The most imperative part is the presurgical planning to determine the amount of augmentation required for each patient.

The injection with short-lasting hyaluronic acid is performed to determine the increased projection and shape of the forehead and nasal root to satisfy the patient. The increased thickness of the injected site was measured and used as a blueprint of the surgery.

41 Oriental patients received the injection for surgical simulation. 5 cases found the forehead augmentation was not suitable for them.

36 cases appreciated the result of the simulation. 25 cases underwent the operation.

None of 41 cases recognized the increased depth of the orbit when the increase projection of the supraorbital rim was less than 4 mm. The augmentation by 6 mm was enough for all the patients to realize the sculpted feature in the eye.

The amount of augmentation performed in 25 cases ranged from 3 to 9 mm (mean 5 mm). The coronal incision through the occipital scalp was used for the forehead augmentation. The material used was either methylmethacrylate or hydroxyapatite paste. PTFE or rib cartilage was used for nasal dorsum.

The additional procedures performed were epicanthoplasty, upper blepharoplasty, and septal elongation of nose, midface augmentation and chin augmentation according to individual request.

The augmentation of the forehead and nasal root was very effective to give the oriental eye a sculptured feature like Caucasian. The simulation with hyaluronic acid was found useful to provide the patient with prospect and the surgeon with precise surgical plan.