专业观点

「唇寒齿亡」，牙医师临床上许多的治疗都会大幅影响嘴唇的美观，例如贋复假牙、牙冠贴片、齿颚矫正治疗或正颚手术改变了齿槽骨及牙齿的形状、位置、角度同时也改变了嘴唇的外观及功能。事实上，许多硬组织颚颜面的问题或诊断都可以从软组织的嘴唇上看出一些端倪。本次报告讨论临床上咬合及脸型的“垂直向“变化如何影响软组织（嘴唇）功能及外观，该如何诊断？及在齿颚矫正-正颚手术协同治疗时的考量，改善患者嘴唇的位置、形状及功能，达到长期稳定的治疗结果。

许多患者因为齿列紊乱而接受牙齿矫正治疗，然而齿列紊乱常是因为上下颚骨发育异常而引起，通常颚骨的发育异常也会伴随颅颜部其他骨头代偿。常见的有中脸凹陷等脸型外观问题，甚至会影响到呼吸道而造成睡眠呼吸中止。谢医师分享关於这类型患者，可以透过除了正颚手术外其他的手术项目来综合规划患者的治疗计画。

正颚手术与矫正治疗之功能性评估 虽然绝大多数的患者是因为脸型与咬合问题求诊正颚手术或是接受矫正治疗，然而部分患者会因为其他功能性的问题需要接受正颚手术治疗，其中包含颞颚关节障碍或是睡眠呼吸中止症。下颚骨发育异常如歪斜的患者，因为两侧颞颚关节受力不同，会造成某侧颞颚关节磨损严重，接受正颚手术让两侧颞颚关节受力平均，进一步再针对颞颚关节治疗，才是釜底抽薪的治疗建议。另外，下颚过度後缩的患者在躺平睡觉时，造成呼吸道狭窄，导致打鼾或阻塞型睡眠呼吸中止症，藉由正颚手术将下颚骨向前旋转，也能拓宽上呼吸道。此两种为最大宗的功能性考量。

许多患者因为齿列紊乱而接受牙齿矫正治疗，然而齿列紊乱常是因为上下颚骨发育异常而引起，通常颚骨的发育异常也会伴随颅颜部其他骨头代偿。常见的有中脸凹陷等脸型外观问题，甚至会影响到呼吸道而造成睡眠呼吸中止。谢医师分享关於这类型患者，可以透过除了正颚手术外其他的手术项目来综合规划患者的治疗计画。

额头的形状和比例在整体面部美学中起着重要作用。发际线的高度决定了上半脸三分之一的长度与全脸比例。前额扁平往後倾斜度或是圆润澎满会影响脸部看起来像是阳刚的男性还是柔美的女性。本次演讲将介绍改变前额形状、倾斜度与发际线高度的各种技术。分为两种切口的方式，即冠状切口（在发箍位置）与发际线切口（若是要搭配发际线前移的患者，就需要从发际线切口）。客制化植入物已经普遍使用於额头美型手术中，也建议脸部整形医师将额头整形手术视为评估的手术项目或是在鼻整形、面部骨骼轮廓手术、下巴整形或正颚手术之外可一并评估整体的辅助效果。 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.

脸部老化的原因众多，起因由内而外可能是骨骼改变、脸部脂肪萎缩或移位、肌肉张力与厚度下降以及皮肤辩驳或松弛。治疗脸部老化前，深入了解成因至关重要，才能对症下药。了解脸部各个部位的解剖构造，可以帮助医师更准确更有效地治疗患者。本次的演讲将会探讨多种对抗脸部老化的骨骼对策，雕塑脸部骨骼、客制化植入物手术增加骨骼支撑、拉皮手术以及在施作其他手术时，如何避免对脸部造成加速老化。 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.

额头的形状和比例在整体面部美学中起着重要作用。发际线的高度决定了上半脸三分之一的长度与全脸比例。前额扁平往後倾斜度或是圆润澎满会影响脸部看起来像是阳刚的男性还是柔美的女性。本次演讲将介绍改变前额形状、倾斜度与发际线高度的各种技术。分为两种切口的方式，即冠状切口（在发箍位置）与发际线切口（若是要搭配发际线前移的患者，就需要从发际线切口）。客制化植入物已经普遍使用於额头美型手术中，也建议脸部整形医师将额头整形手术视为评估的手术项目或是在鼻整形、面部骨骼轮廓手术、下巴整形或正颚手术之外可一并评估整体的辅助效果。 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.

额头的形状和比例在整体面部美学中起着重要作用。发际线的高度决定了上半脸三分之一的长度与全脸比例。前额扁平往後倾斜度或是圆润澎满会影响脸部看起来像是阳刚的男性还是柔美的女性。本次演讲将介绍改变前额形状、倾斜度与发际线高度的各种技术。分为两种切口的方式，即冠状切口（在发箍位置）与发际线切口（若是要搭配发际线前移的患者，就需要从发际线切口）。客制化植入物已经普遍使用於额头美型手术中，也建议脸部整形医师将额头整形手术视为评估的手术项目或是在鼻整形、面部骨骼轮廓手术、下巴整形或正颚手术之外可一并评估整体的辅助效果。 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.