Facial Plastic Surgery & Aesthetic Medicine最新文献

Experts in our field have previously issued guidelines to optimize the safety of filler injections. Despite the risks, a growing online trend of at-home self-injection of fillers in the face is putting patients in danger. This article reviews the acute clinical presentation and treatment protocol provided to a 49-year-old female who presented to the emergency department with acute vascular injury, just 3 h after injecting herself in the lips. This case highlights the importance of rapid detection of early signs of vascular injury and impending tissue necrosis. Based on the most recent literature, we share our protocol and its efficacy for this specific case. The fast-growing popularity of fillers in the beauty industry and the availability of online content and videos on how to perform self-injections likely give a false sense of safety to patients. Physician awareness is essential to prevent serious complications in our patient population. A strong knowledge of facial anatomy, the use of FDA approved products, and having the procedure performed by a trained medical professional are key elements to successful and safe filler injection.

Background: Treatment of head and neck cancer with radiation can cause osteoradionecrosis of the mandible (MORN), requiring removal of nonviable bone and free flap reconstruction. Objective: To compare surgical outcomes in patients with MORN treated with free tissue transfer who received hyperbaric oxygen therapy (HBO) to those who did not, measured by flap failure, nonunion, plate exposure, and postoperative infections. Methods: This retrospective cohort study evaluated 311 patients with advanced MORN treated at a single tertiary care academic center with segmental mandibulectomy and free flap reconstruction. One group received HBO preoperatively and postoperatively; the other group did not. Postoperative complications were compared using chi-square test or Fisher's exact test. Results: This study included 311 patients, 131 HBO group (74% male, 26% female, mean age 75.6 years), 180 in the non-HBO group (73% male, 27% female, mean age 76.3 years). Postoperative metrics included; complete flap failure (HBO = 4, non-HBO = 2), partial flap failure (HBO = 2, non-HBO = 3), nonunion (HBO = 10, non-HBO = 14) exposed plate (HBO-7, non-HBO = 8), wound infections treated surgically (HBO = 2, non-HBO = 7), wound infections treated with antibiotics alone (HBO = 5, non-HBO = 12). No differences were identified between groups. Conclusion: We found no difference in rates of postoperative complications between the HBO group and the non-HBO group.

Introduction: Bell's palsy, an idiopathic peripheral facial palsy, often resolves naturally but can benefit from electric stimulation therapy. However, efficacy and safety during the acute stage remain controversial and understudied. Objective: To measure the effectiveness of electrical stimulation therapy as an add-on treatment for patients in the acute stage of Bell's palsy, as measured by incomplete recovery rates. Methods: We searched nine databases for randomized controlled trials comparing add-on electric stimulation therapy with usual care or placebo in patients within 7 days of Bell's palsy onset. The primary outcome was incomplete recovery. Risk of bias was assessed using Cochrane RoB 2 tool, with results synthesized via random-effects meta-analysis and evidence certainty evaluated using GRADE. Results: Fourteen studies encompassing 1,311 participants were included. Electric stimulation therapy plus usual care reduced incomplete recovery rates compared with usual care alone (risk ratio 0.65, 95% CI: 0.48-0.88; 13 trials, n = 1,191; moderate certainty). The effect persisted after excluding six studies with a high risk of bias. Conclusion: Add-on electric stimulation therapy during acute Bell's palsy may reduce incomplete recovery risk. However, results had moderate certainty with limitations including risk of bias and short follow-up durations.