Prosopoplasty: A New Term?

Nowadays, scientific progress has increased the average human life span and life expectancy, and has certainly improved the quality of our lives. Today elderly people look considerably younger than they did 20 or 30 years ago. Plastic surgery helps us to regain our self-esteem and self-respect [1] [2] [3]. The word 'plastic' is derived from the Greek verb 'platho', which means 'to mould' or 'to give form'. Plastic surgery is the medical specialty that enables the moulding and re-forming of the human body. By the term 'surgery' we mean the use of a scalpel since the scalpel is the only tool that cuts the human skin without any damage to the surrounding tissues. A surgical approach is the only way to correct sagging skin and repair the damage of tissues that are beneath the skin, such as muscles and ligaments. All advertised products such as creams, serums, machines, lasers, and injectables cannot correct the relaxation of muscles and ligaments that are under the skin. They are all particularly useful in cleaning, maintaining, and moisturizing the skin, and decreasing the wrinkles of the skin, but not in correcting sagging. This is why the scalpel is irreplaceable and gives cosmetically pleasing, natural, and long-lasting results.

The plastic surgery procedure that can renew a face is called the 'face lift'. It is a procedure by which the correction of facial sagging can be achieved. Through this procedure, the above-mentioned muscles are tightened and excess skin is removed. The result lasts for at least a decade. Even after a decade, the appearance of the face will be better than it would have been if the surgery had not been performed. Today, facial procedures provide the option of a surgical makeover of the face. Each face is different, and therefore, each face requires an individual solution. Hence, the face lift can be combined with other procedures to achieve the desirable result, which is the total renewal of the face. For example, there are cases in which the person needs to have a better look of the neck as well. If the neck presents local fat, this can be corrected with liposuction. If there is relaxation of the region, then a neck lift may be applied as well. Through neck lift, simultaneous correction of the relaxation of the superficial musculoaponeurotic system, with the removal of excess skin and fat, can be achieved. Apart from the neck, the face lift can be combined with blepharoplasty. Blepharoplasty removes the fat and the relaxed skin, achieving a younger-looking eye area. Apart from the neck lift and blepharoplasty during the face lift, an eyebrow lift can be performed [4]. The desired aesthetic look requires eyebrows that are curved, modified upwards, and shaped like a vault. Moreover, the lines around the mouth may need to be reduced. This is achieved by dermabrasion (surgical peeling). Dermabrasion leads to rejuvenation of facial skin and smoothing of the wrinkles and markings.

All the procedures mentioned above (face lift, neck liposuction, neck lift, blepharoplasty, eyebrow lift, and dermabrasion) aim to achieve a natural renewal of the face. These procedures form the face and can be carried out together constituting one procedure. Sometimes, the plastic surgeon may need to simultaneously perform some more procedures other than the ones mentioned above as canthopexy. In my opinion, the international scientific community of plastic surgeons must introduce a new term: Prosopoplasty, which will include all these procedures. Prosopoplasty comes from the Greek phrase 'pros opa'. 'Pros opa' in the ancient Greek language means 'the part of the face which is towards the eyes'. I personally agree with this term and am in favour of this new terminology, mainly because of its Greek origin. All the terminology in plastic surgery, such as, blepharoplasty, rhinoplasty, abdominoplasty, mastoplasty [5], has a Greek origin as it expresses the procedures in the best possible way. Moreover, according to Pythagoras, the definition of beauty is harmony. The purpose of plastic surgery is the creation of beauty and therefore, the creation of harmony. Plastic surgeons can achieve harmony only if they see a face in its total appearance and not its separate characteristics. Added to this, humans are interested in having a fresh face and a new look on the whole since we do not imagine individual characteristics such as nice eyebrows or eyelids but nice 'faces', nice 'prosopa'. In my daily practice, when patients come to my office for a consultation for their face, what they are asking for is a plastic surgery procedure that will help them to gain a youthful face, what they are asking for is 'Prosopoplasty'.

Table 1.

Overview of our algorithmic approach and indications for gluteal reshaping in the massive weight loss patient

Operative technique	Clinical problem/constellation
Gluteal autoaugmentation	Easiest method without the need for additional operative procedures.
	Works well in all patients with pronounced tissue deflation but with some remaining subcutaneous tissue.
	The biggest disadvantage is the need for an extensive excisional procedure with a resulting long scar.
Gluteal augmentation with fat	Is ideal in patients with not too much skin flaccidity and sufficient fat deposits.
	Advantages include concomitant liposuction to improve body contour and minimal scars in the gluteal region.
	Disadvantages include uncertainty of fat retention and the need for an additional operative procedure.
Gluteal augmentation with implants	Is ideal in patients who do not want obvious scars but have too much skin surplus for fat grafting.
	Advantages include a permanent result with fixed volume and concealed scars.
	Disadvantages include the need for an implant with associated costs and prolonged postoperative reconvalescence.
Gluteal augmentation with implants and lifting procedure	Most extensive approach for gluteal reshaping.
	Best suited for patients with extensive tissue deflation and sagging.
	Advantages include its being the most versatile and powerful reshaping procedure.
	Disadvantages include possible wound healing complications with the risk of implant infection, being the most difficult operative approach, and having the longest postoperative downtime.

Conflict of Interest

No potential conflict of interest relevant to this article was reported.

• References

• 1 Horch RE. The role of plastic surgery in remodeling the body image. MMW Fortschr Med 2004; 146: 32-36
• 2 Foustanos A, Pantazi L, Zavrides H. Representations in plastic surgery: the impact of self-image and self-confidence in the work environment. Aesthetic Plast Surg 2007; 31: 435-442
• 3 Moss TP, Harris DL. Psychological change after aesthetic plastic surgery: a prospective controlled outcome study. Psychol Health Med 2009; 14: 567-572
• 4 Foustanos A, Zavrides H. An alternative fixation technique for the endoscopic brow lift. Ann Plast Surg 2006; 56: 599-604
• 5 Graf R, Biggs TM. In search of better shape in mastopexy and reduction mammoplasty. Plast Reconstr Surg 2002; 110: 309-317

Publication History

Received: 14 March 2014

Accepted: 17 March 2014

Article published online:
05 May 2022