Facial Plastic Surgery & Aesthetic Medicine最新文献

Background: Equal attention must be given to nasal aesthetics and function when reconstructing nasal defects after skin cancer resection. Little data exist on functional nasal outcomes following nasal reconstruction. Learning/Study Objective: Describe and analyze factors contributing to functional outcomes following nasal skin cancer defect reconstruction. Design Type: Retrospective review. Methods: Patients who underwent reconstruction of Mohs nasal defects were included. Reconstruction methods included primary closure, skin grafts, and local and interpolated flaps. Both subjective reports and physician-noted exam findings suggestive of nasal obstruction were noted. The obstructive domain of the Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS-O) was administered preoperatively and at follow-up intervals. Results: In total, 193 patients met the inclusion criteria. Female sex, medial or lateral ala primary defect subunit, and auricular cartilage use were associated with increased risk of postoperative nasal obstruction within the first year on multivariate analysis, while reconstruction with a skin/composite graft was associated with lower risk of obstruction. Average time from reconstructive surgery to first report of obstruction was 116 days, and time to reported resolution was 235 days. Conclusion: The incidence of nasal obstruction following nasal defect reconstruction is low. Female sex, ala involvement, and auricular cartilage may increase the risk of nasal obstruction postoperatively.

Background: Limited evidence exists regarding the incidence of revision cosmetic rhinoplasty in patients with psychiatric diagnoses. Objective: To assess the rate of revision cosmetic rhinoplasty in patients with psychiatric diagnoses. Methods: Adult patients at a single institution who underwent rhinoplasty were queried between December 1, 1979, and June 1, 2024. Exclusion criteria were noncosmetic rhinoplasties (e.g., functional) or history of nasal trauma, nasal tumor, cleft lip/palate, or congenital nasal deformities. Patients were split into those with psychiatric diagnoses (PD group) and those without (control group). Outcomes include proportion who underwent ≥1 secondary cosmetic rhinoplasty, mean secondary rhinoplasties per patient, patient satisfaction after secondary rhinoplasty, and breakdown of secondary rhinoplasties by psychiatric diagnosis. Results: The initial query found 1110 patients, leaving 961 patients (PD 135, control 826) after exclusion criteria. The cohort was 75% female (724/961) with a mean age of 48 years (standard deviation: 15). The proportion of patients with ≥1 revision rhinoplasty was higher in PD (24/135, 18%) than controls (95/826, 12%; p = 0.04). Age ≥46 and female gender were found to predict revision cosmetic rhinoplasty. Conclusion: In our cohort, patients with PD had higher rates of revision cosmetic rhinoplasty compared to those without PD.

Objective: To report in vitro, preclinical, and clinical effectiveness of nanofat in adults undergoing reconstructive or functional surgery and to produce a series of consensus statements about nanofat definition by experts. Methods: We conducted a systematic review using PubMed and Web of Science database, retaining studies about nanofat alone. To produce consensus recommendations about nanofat, we invited experts to answer a survey about manufacturing, biological characteristics, and nomenclature of nanofat. Results: A review of 39 articles showed that nanofat seems to have strong regenerative potential. There were 16 studies about the clinical effectiveness of the nanofat in wound healing, aesthetic surgery, and functional disabilities. However, majority of applications lack robust clinical evidence, mainly due to the design of the clinical studies. The experts suggested that nanofat refers to lipoaspirate that benefits from a washing step, followed by emulsification (20-30 passes) with a connector size between 1.2 and 1.6 mm, and a final filtration step (pore size around 300-500 µm). Conclusion: Nanofat seems to have strong regenerative potentials but with a lack of robust clinical evidences. Our experts have suggested the first consensus about a definition of the nanofat that can be used by the academic societies in the coming years.

Background: The rise of social media parallels a mental health epidemic. The effect of social media usage on rates and severity of body dysmorphic disorder is not well-understood. Objective: To determine if an association exists between social media engagement, body dysmorphia symptoms, and/or interest in cosmetic surgery in a demographically diverse cross-section of the U.S. adult population. Methods: In a Qualtrics platform-based survey study of the general U.S. adult population, responses to demographic information, social media activity questionnaire and the body dysmorphic disorder screening questionnaire, and interest in cosmetic surgery were collected. Descriptive statistics and a multivariate logistic regression model were carried out. Results: A total of 1,013 respondents completed the survey. The average age was 40.9 (SD, 14.8) years, 72% were women. Median time spent on social media (IQR) was 4 (2-7) h/day. Respondents who screened positive for symptoms of body dysmorphia had higher daily mean social media usage time (odds ratio [OR] 1.49), tend to be female (OR 2.17), younger (OR 0.97), identify as Caucasian (OR 1.65), and are more likely considering a cosmetic procedure in the next year (OR 2.98). Conclusion: This study demonstrates a positive association between daily social media usage, self-reported symptoms of body dysmorphia, and interest in cosmetic procedures.