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All Journal Jurnal Plastik Rekonstruksi Jurnal Pendidikan Indonesia (Japendi)
Rafeni Bunga Cikita
General Practitioner, Mayapada Hospital, Surabaya, Indonesia
Civil Engineering, Building, Construction & Architecture Education Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Other

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Beyond The Standard: Achieving Functional and Aesthetic Excellence in Unilateral Macrostomia Repair with Buccal Flap and Multi Z-Plasty Technique in Infancy Bimayudo Aprialdi; Affandi Wiramur; Rafeni Bunga Cikita
Jurnal Plastik Rekonstruksi Vol. 13 No. 1 (2026): (2026) Jurnal Plastik Rekonstruksi
Publisher : The Lingkar Studi Bedah Plastik Foundation and is affiliated with the Department of Plastic Surgery, Faculty of Medicine, Universitas Indonesia.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14228/jprjournal.v13i1.52

Abstract

Introduction: Macrostomia is a rare congenital craniofacial anomaly that significantly affects feeding, speech, aesthetics, and psychosocial well-being. Early surgical intervention using advanced techniques is essential to restore anatomical integrity and improve functional outcomes. This case report presents the management of a five-month-old female infant with a unilateral left-sided macrostomia (Tessier Cleft-7) using a combination of buccal flap and multiple Z-plasty techniques.Case Presentation: The patient presented with a unilateral left-sided macrostomia since birth, accompanied by feeding difficulties characterized by choking and audible “blup-blup” sounds during feeding. Physical examination confirmed a moderate unilateral macrostomia without signs of infection or systemic illness. Preoperative assessments, including laboratory tests and multidisciplinary consultations, confirmed the patient’s fitness for surgery.Discussion: Surgical repair was performed with a multi-layer closure approach, utilizing a buccal flap for the inner layer and multiple Z-plasty for the outer layer to achieve tension-free closure and optimal aesthetic results. This technique aligns with contemporary trends favoring individualized, anatomy-driven repairs over traditional methods. The absence of intraoperative and postoperative complications and the satisfactory functional and cosmetic outcomes underscore the effectiveness of this approach. Compared to conventional linear closure techniques, multiple Z-plasty minimize scar contracture and enhance commissural symmetry, particularly in complex cases of macrostomia. This case highlights the critical role of multidisciplinary collaboration and tailored surgical planning in addressing the anatomical challenges of macrostomia and achieving optimal reconstructive outcomes.Conclusion: Early, multidisciplinary management of macrostomia using combined buccal flap and multiple Z-plasty techniques can achieve excellent functional and aesthetic outcomes with minimal complications. This case contributes to the growing literature supporting anatomy-specific surgical approaches and comprehensive perioperative care in macrostomia reconstruction.
The Future of Personalized Rhinoplasty: Integrating AI with Genomics and Facial Typing Rafeni Bunga Cikita; Ahmad Fawzy Mas'ud
Jurnal Pendidikan Indonesia Vol. 6 No. 9 (2025): Jurnal Pendidikan Indonesia
Publisher : Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/japendi.v6i9.8627

Abstract

Rhinoplasty remains one of the most complex procedures in aesthetic surgery. Traditional standardized approaches often fail to capture the diversity of individual anatomy and cultural expectations. This review evaluates the role of artificial intelligence (AI), facial typing, and genomics in advancing personalized rhinoplasty. We systematically searched PubMed, Scopus, and Google Scholar in July 2025 using terms related to rhinoplasty, AI, facial typing, and genomics. We included studies addressing AI-driven planning or simulations, morphometric analysis, and genetic influences on nasal shape or wound healing. Two reviewers independently screened and extracted data. Because of study heterogeneity, we synthesized findings narratively. Five studies met inclusion criteria, including two narrative reviews, two cross-sectional analyses, and one experimental study. AI-based simulations improved planning accuracy and aligned patient expectations with surgical outcomes. Facial typing studies emphasized the need for culturally inclusive morphometric models. Genomic research identified genetic markers linked to nasal shape and wound healing, suggesting potential for biologically tailored interventions. AI, facial typing, and genomics are actively transforming rhinoplasty into a personalized discipline. To realize this potential, surgeons must expand diverse datasets, validate genomic insights, and communicate outcomes responsibly, ensuring that technology enhances safety, equity, and patient satisfaction.
Co-Authors Affandi Wiramur Ahmad Fawzy Mas'ud Bimayudo Aprialdi