專業觀點

「唇寒齒亡」，牙醫師臨床上許多的治療都會大幅影響嘴唇的美觀，例如贋復假牙、牙冠貼片、齒顎矯正治療或正顎手術改變了齒槽骨及牙齒的形狀、位置、角度同時也改變了嘴唇的外觀及功能。事實上，許多硬組織顎顏面的問題或診斷都可以從軟組織的嘴唇上看出一些端倪。本次報告討論臨床上咬合及臉型的“垂直向“變化如何影響軟組織（嘴唇）功能及外觀，該如何診斷？及在齒顎矯正-正顎手術協同治療時的考量，改善患者嘴唇的位置、形狀及功能，達到長期穩定的治療結果。

許多患者因為齒列紊亂而接受牙齒矯正治療，然而齒列紊亂常是因為上下顎骨發育異常而引起，通常顎骨的發育異常也會伴隨顱顏部其他骨頭代償。常見的有中臉凹陷等臉型外觀問題，甚至會影響到呼吸道而造成睡眠呼吸中止。謝醫師分享關於這類型患者，可以透過除了正顎手術外其他的手術項目來綜合規劃患者的治療計畫。

正顎手術與矯正治療之功能性評估 雖然絕大多數的患者是因為臉型與咬合問題求診正顎手術或是接受矯正治療，然而部分患者會因為其他功能性的問題需要接受正顎手術治療，其中包含顳顎關節障礙或是睡眠呼吸中止症。下顎骨發育異常如歪斜的患者，因為兩側顳顎關節受力不同，會造成某側顳顎關節磨損嚴重，接受正顎手術讓兩側顳顎關節受力平均，進一步再針對顳顎關節治療，才是釜底抽薪的治療建議。另外，下顎過度後縮的患者在躺平睡覺時，造成呼吸道狹窄，導致打鼾或阻塞型睡眠呼吸中止症，藉由正顎手術將下顎骨向前旋轉，也能拓寬上呼吸道。此兩種為最大宗的功能性考量。

許多患者因為齒列紊亂而接受牙齒矯正治療，然而齒列紊亂常是因為上下顎骨發育異常而引起，通常顎骨的發育異常也會伴隨顱顏部其他骨頭代償。常見的有中臉凹陷等臉型外觀問題，甚至會影響到呼吸道而造成睡眠呼吸中止。謝醫師分享關於這類型患者，可以透過除了正顎手術外其他的手術項目來綜合規劃患者的治療計畫。

額頭的形狀和比例在整體面部美學中起著重要作用。髮際線的高度決定了上半臉三分之一的長度與全臉比例。前額扁平往後傾斜度或是圓潤澎滿會影響臉部看起來像是陽剛的男性還是柔美的女性。本次演講將介紹改變前額形狀、傾斜度與髮際線高度的各種技術。分為兩種切口的方式，即冠狀切口（在髮箍位置）與髮際線切口（若是要搭配髮際線前移的患者，就需要從髮際線切口）。客製化植入物已經普遍使用於額頭美型手術中，也建議臉部整形醫師將額頭整形手術視為評估的手術項目或是在鼻整形、面部骨骼輪廓手術、下巴整形或正顎手術之外可一併評估整體的輔助效果。 Comprehensive Forehead Sculpture The shape and proportion of the forehead play an important role in overall facial aesthetics. The height of the hairline determines the upper third length. The inclination of the forehead has a direct impact on how the face looks masculine or feminine. This presentation will cover various techniques to alter the shape and inclination of the forehead. There are two basic approaches which are the coronal approach and the trichophytic incision. Three-dimensional assisted forehead implant augmentation is frequently used in forehead sculpture. It is recommended to all facial aesthetic surgeons that the upper third-forehead-temporal complex should always be treated either as a solo procedure or as an adjunctive procedure in addition to rhinoplasty, facial bone contouring surgery, genioplasty, or orthognathic surgery.

臉部老化的原因眾多，起因由內而外可能是骨骼改變、臉部脂肪萎縮或移位、肌肉張力與厚度下降以及皮膚辯駁或鬆弛。治療臉部老化前，深入了解成因至關重要，才能對症下藥。了解臉部各個部位的解剖構造，可以幫助醫師更準確更有效地治療患者。本次的演講將會探討多種對抗臉部老化的骨骼對策，雕塑臉部骨骼、客製化植入物手術增加骨骼支撐、拉皮手術以及在施作其他手術時，如何避免對臉部造成加速老化。 The process of facial aging can be explained by inside-out patterns including facial skeleton remodeling, fat pad atrophy/malposition, loss in muscle tone and thickness, and skin thinning/laxity. It is paramount for clinicians to treat these aging signs with a thorough understanding of their etiology. Recognizing the anatomical alterations of specific facial areas will help clinicians treat patients more precisely and effectively. Multiple strategies to rejuvenate facial aging will be presented including repositioning of the facial skeleton, subperiosteal augmentation with custom-made implants, subperiosteal facelift, and how iatrogenic facial aging can be avoided and treated.

額頭的形狀和比例在整體面部美學中起著重要作用。髮際線的高度決定了上半臉三分之一的長度與全臉比例。前額扁平往後傾斜度或是圓潤澎滿會影響臉部看起來像是陽剛的男性還是柔美的女性。本次演講將介紹改變前額形狀、傾斜度與髮際線高度的各種技術。分為兩種切口的方式，即冠狀切口（在髮箍位置）與髮際線切口（若是要搭配髮際線前移的患者，就需要從髮際線切口）。客製化植入物已經普遍使用於額頭美型手術中，也建議臉部整形醫師將額頭整形手術視為評估的手術項目或是在鼻整形、面部骨骼輪廓手術、下巴整形或正顎手術之外可一併評估整體的輔助效果。 Comprehensive Forehead Sculpture The shape and proportion of the forehead play an important role in overall facial aesthetics. The height of the hairline determines the upper third length. The inclination of the forehead has a direct impact on how the face looks masculine or feminine. This presentation will cover various techniques to alter the shape and inclination of the forehead. There are two basic approaches which are the coronal approach and the trichophytic incision. Three-dimensional assisted forehead implant augmentation is frequently used in forehead sculpture. It is recommended to all facial aesthetic surgeons that the upper third-forehead-temporal complex should always be treated either as a solo procedure or as an adjunctive procedure in addition to rhinoplasty, facial bone contouring surgery, genioplasty, or orthognathic surgery.

額頭的形狀和比例在整體面部美學中起著重要作用。髮際線的高度決定了上半臉三分之一的長度與全臉比例。前額扁平往後傾斜度或是圓潤澎滿會影響臉部看起來像是陽剛的男性還是柔美的女性。本次演講將介紹改變前額形狀、傾斜度與髮際線高度的各種技術。分為兩種切口的方式，即冠狀切口（在髮箍位置）與髮際線切口（若是要搭配髮際線前移的患者，就需要從髮際線切口）。客製化植入物已經普遍使用於額頭美型手術中，也建議臉部整形醫師將額頭整形手術視為評估的手術項目或是在鼻整形、面部骨骼輪廓手術、下巴整形或正顎手術之外可一併評估整體的輔助效果。 Comprehensive Forehead Sculpture The shape and proportion of the forehead play an important role in overall facial aesthetics. The height of the hairline determines the upper third length. The inclination of the forehead has a direct impact on how the face looks masculine or feminine. This presentation will cover various techniques to alter the shape and inclination of the forehead. There are two basic approaches which are the coronal approach and the trichophytic incision. Three-dimensional assisted forehead implant augmentation is frequently used in forehead sculpture. It is recommended to all facial aesthetic surgeons that the upper third-forehead-temporal complex should always be treated either as a solo procedure or as an adjunctive procedure in addition to rhinoplasty, facial bone contouring surgery, genioplasty, or orthognathic surgery.