Aesthetic surgery journal. Open forum最新文献

Background: Extraction of adipose-derived stem cells (ASCs) from the stromal vascular fraction (SVF) has gained significant attention lately in the realm of regenerative medicine. However, finding highly efficient methods of extraction that also comply with the US regulations has prevented widespread clinical use.

Objectives: The objective of this study was to evaluate a novel ASC extraction device to quantify viable ASC extraction and processing efficiency.

Methods: SVF extracted from abdominal fat samples and processed using a novel shock-assisted viable extraction (SAVE) device was tested for stem-cell count and viability. Additionally, time required for processing was recorded.

Results: Twelve adipose samples were utilized for this study. After a mean time of 3 min, cell count yield ranged of 47,400 to 189,400 of viable regenerative cells per cc, with an average of 122,464 viable regenerative cells per cc.

Conclusions: SAVE is a novel fat-processing technique with high stem-cell extraction that shows promise from a regulatory, yield, time efficiency, and cost perspective.

Level of evidence 5 therapeutic:

Background: Application of helium-based plasma radiofrequency (RF; Renuvion, Apyx Medical, Clearwater, FL) in the subcutaneous plane results in tissue coagulation and contraction. Although, traditionally, the impact of thermal devices on skin laxity is assessed by measuring changes in skin surface area, this indirect measure does not permit intraoperative assessment or differentiation of effects from various treatments.

Objectives: To determine the amount of soft tissue contraction achieved by multiple passes of helium plasma RF energy to the subcutaneous connective tissues following power-assisted liposuction (PAL).

Methods: In this single-center study, 4 patients were assessed using real-time ultrasound measurements at baseline and following both PAL and each pass with helium plasma RF.

Results: Based on changes in the distance from the skin (dermal basement membrane) to Scarpa's fascia, PAL produced an average reduction of 36.7% (standard deviation [SD] 14.6; range, 24.7%-58.6%) because of the fat removal. Contraction observed with helium plasma RF was greatest for the first pass, with a mean decrease of 27.0% (SD 19.6; range, 4.5%-52.1%) in distance relative to distance measured following liposuction. Subsequent passes resulted in additional incremental contraction relative to previous treatment pass: 17.0% (5.1) for Pass 2, 7.7% (17.5) for Pass 3, and 7.1% (5.5) for Pass 4. Overall, helium plasma RF resulted in an average contraction of 44.0% (SD 17.2; range, 27.1%-59.4%) in the skin-to-Scarpa-fascia measurement.

Conclusions: Helium plasma RF improved tissue contraction following PAL by an average of 44%, and data suggest that the greatest increase in tissue contraction is obtained by the first treatment pass.

Level of evidence 5 therapeutic:

Background: Wrinkles and sagging, characteristics of aging, are associated with reductions in collagen and fat. Poly-L-lactic acid (PLLA) is widely used clinically as a tissue filler owing to its good biocompatibility and ability to improve wrinkles and signs of aging. Despite extensive studies of the mechanism of action of PLLA when used as a dermal filler, few studies have examined its effects on adipose tissue.

Objectives: The short-term effects of PLLA-b-polyethylene glycol (PEG) microspheres implanted in subcutaneous back adipose tissue (BAT) and visceral epididymal adipose tissue (EAT) of rats were examined.

Methods: The authors divided 15 male Sprague-Dawley rats into 5 groups based on implantation time, and PLLA-b-PEG microspheres were implanted into the BAT (3 groups were sampled at 6, 8, and 12 weeks) and EAT (2 groups were sampled at 6 and 12 weeks) of rats. Tissue samples were collected at different time points postimplantation and subjected to histological analyses using hematoxylin and eosin, Masson's trichrome, and immunofluorescence staining.

Results: Implantation of PLLA-b-PEG microspheres into different adipose tissues resulted in a mild and persistent inflammatory reaction, increased fibrous connective tissue, and noticeable collagen regeneration. Immunofluorescence showed the upregulation of uncoupling protein (UCP) 1 and UCP2 in the visceral adipose tissue surrounding the implant.

Conclusions: PLLA-b-PEG microspheres exhibited good tissue compatibility and induced an increase in fibrous connective tissue postimplantation, potentially mitigating oxidative damage and improving adipose tissue quality.

Level of evidence 5 therapeutic:

Tranexamic acid (TXA) is an antifibrinolytic agent that is considered as one of the latest interventions currently being investigated in the field of facial aesthetic surgeries, as it is predicted to be effective in reducing intraoperative and postoperative complications of facial aesthetic surgeries. This review focuses on giving readers a comprehensive overview regarding the use of TXA in facial aesthetic surgeries. In this umbrella review, data were extracted from existing systematic reviews and meta-analysis that focused on the use of TXA in facial aesthetic surgeries. The authors searched PubMed, Embase, and Scopus databases. The data were extracted using a standard format, and the AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews) tool was used to assess the quality of the included reviews. In total, this study included 14 systematic reviews and meta-analyses all of which evaluated the effect of TXA on facial aesthetic surgeries, which included rhinoplasty, septorhinoplasty, rhytidectomy, and blepharoplasty. The majority of the included studies focused on reporting the effect of TXA on blood loss volume (BLV) and duration of surgery (DOS) as well as other postoperative complications. Eleven out of the 12 studies that focused on rhinoplasty showed that TXA used reduced BLV. In addition, in 8 studies that were focusing on DOS, the majority showed a reduction in DOS with TXA use. While in the case of septorhinoplasty, 3 studies revealed that TXA use decreased BLV. Moreover, in the case of rhytidectomy, 3 out of 6 systematic reviews showed reduction in BLV, while 2 reported reductions in DOS. Finally, the authors conclude that the use of TXA is indeed efficient in reducing BLV and DOS, in addition to some of the complications that can occur during or after facial aesthetic surgeries. However, in order to reach a final decision on the implication of the use of TXA in facial aesthetic surgeries, further studies should be established using a standardized protocol in assessing the desired outcomes.

Background: In light of the escalating cost of cosmetic surgery in Bahrain, the burgeoning "Cosmetic Surgery Tourism" sector has captured the attention of many Bahrainis. Neighboring countries aggressively promote affordable packages on numerous social media platforms, luring individuals with the allure of a vacation experience. However, insufficient postoperative care abroad has far-reaching implications that jeopardize both patient well-being and the integrity of the healthcare system.

Objectives: This study aims to assess the present patterns of complications related to cosmetic surgery tourism and the resulting financial burden on the Bahraini healthcare system.

Methods: A retrospective cost analysis and chart review were performed for all patients who presented with complaints associated with cosmetic surgeries between January 2018 and September 2023. After identifying patient demographics, procedure characteristics, admission data, length of stay, and intervention needs, a comprehensive cost analysis was conducted.

Results: A total of 30 patients manifested complications. The complications associated with abdominoplasty were the most prevalent. Iran emerged as the most frequented destination, with Egypt and Turkey following in order of prevalence. Surgical-site infections constituted the most common complications. Required interventions included admission for intravenous antibiotics, hyperbaric wound care, implant removal, and critical care admission. The projected expense to the hospital was 65,970 BHD (175,000 USD), equating to an average expenditure of 2200 BHD (5852 USD) per patient.

Conclusions: The allure of cost-effective cosmetic treatments often leads to complications that impose substantial economic burdens. The study concludes with policy recommendations to balance individuals' freedom to seek healthcare abroad with long-term sustainability and equitable access to Bahrain's healthcare system.

Level of evidence 5 risk: