Jirawatnotai Supasid, Sriswadpong Papat
Plastic and Reconstructive Surgery Unit, Lerdsin Hospital, Ministry of Public Health, Bangkok, Thailand.
Arch Craniofac Surg. 2021 Apr;22(2):78-84. doi: 10.7181/acfs.2020.00423. Epub 2021 Apr 20.
Facial feminization surgery and malarplasty require information concerning facial features in the malar area. Such information varies as a function of sex and race. The objectives of this study aimed to quantitatively evaluate the location of malar prominence across sexes in the Southeast Asian population, and identify sex-specific differences in malar prominence using a combination of two-dimensional (2D) computed tomography (CT) and three-dimensional (3D) CT.
The location of malar prominence was evaluated in 101 Thai adults, consisting of 52 men and 49 women. This study used both 2D CT and 3D CT to achieve greater accuracy, in which 2D CT was used to measure malar distance, malar summit width, facial width, and malar summitto-facial width ratio whereas 3D CT was used to evaluate the positional relationship between the zygomatic summit and four reference points of the zygoma.
The malar summit was positioned more laterally in males (p< 0.01) and was more projected in females (p= 0.01). The other 2D-parameters were wider in males. The ratio between the malar summit width and facial width showed similar results for both sexes. The vertical dimension did not show any statistically significant differences; however, a higher summit position was observed in males.
The zygomatic summit is positioned more laterally in males and is more projected in females. However, the ratio was similar, which indicates that the male cranium is larger in size. Based on the results in this study, when facial feminization surgery or malarplasty is performed on a Southeast Asian patient, the malar bone should be reduced horizontally and moved forward for better outcomes.
面部女性化手术和颧骨整形手术需要有关颧骨区域面部特征的信息。此类信息因性别和种族而异。本研究的目的是定量评估东南亚人群中颧骨突出的位置,并结合二维(2D)计算机断层扫描(CT)和三维(3D)CT识别颧骨突出的性别差异。
对101名泰国成年人(52名男性和49名女性)的颧骨突出位置进行评估。本研究使用2D CT和3D CT以提高准确性,其中2D CT用于测量颧骨距离、颧骨顶点宽度、面部宽度以及颧骨顶点至面部宽度比,而3D CT用于评估颧骨顶点与颧骨四个参考点之间的位置关系。
男性的颧骨顶点位置更偏外侧(p<0.01),女性的颧骨顶点更突出(p = 0.01)。其他二维参数在男性中更宽。颧骨顶点宽度与面部宽度之比在两性中显示出相似的结果。垂直维度未显示任何统计学上的显著差异;然而,男性的顶点位置更高。
颧骨顶点在男性中位置更偏外侧,在女性中更突出。然而,比例相似,这表明男性颅骨尺寸更大。根据本研究结果,对东南亚患者进行面部女性化手术或颧骨整形手术时,应水平缩小颧骨并向前移动以获得更好的效果。