Commentary on: Integrated Forehead and Temporal Augmentation Using 3D Printing-Assisted Methyl Methacrylate Implants.

Background: Achieving aesthetic results with forehead augmentation procedures remains challenging. We have developed a method of integrated forehead and temporal augmentation using a three-dimensional (3D) printing-assisted methyl methacrylate implant. Objectives: The study objective was to assess the importance of combined temporal augmentation when performing forehead augmentation. Methods: We identified 34 patients (from 2000 to 2010) who underwent forehead augmentation with a methyl methacrylate implant contoured in situ during surgery and 41 patients (from 2010 to 2016) who underwent integrated forehead and temporal augmentation with a prefabricated methyl methacrylate implant. We conducted a retrospective chart review of patient data including operation time, complications, and instances of revision surgery. Two blinded plastic surgeons scored the aesthetic results of the operations on a 4-point scale (1, poor, to 4, excellent) based on preoperative and posttreatment photographs. Results: The integrated augmentation method resulted in a lower frequency of posttreatment implant removal (one [2%] vs. six [18%]; P <.05), a lower frequency of filler injection for touch up (one [2%] vs. six [18%]; P <.05), and higher mean aesthetic scores (3.7 +/- 0.5 vs. 2.2 +/- 1.0; P <. 001) compared to the forehead augmentation method. There was no statistically significant difference in surgical complications between the two groups. Conclusions: Integrated forehead and temporal augmentation using a 3D printing-assisted methyl methacrylate implant may be the optimal available procedure, enabling the custom fabrication of contours requested by the patient and providing a rejuvenating and balancing effect on facial appearance.