Aesthetic Plastic Surgery最新文献

Objective: The aim of this in vivo study is to compare cartilage viability within diced cartilage grafts from the perspective of three wrapping biomaterials Group A acellular dermal matrix (FlexHD®), Group T bovine pericardium (Tutopatch®), and Group F allogeneic human fascia for a possible implementation in the clinical use.

Materials and methods: This in vivo study was conducted on 5 SCID (Severe Combined Immunodeficiency)/Gamma Mice with a duration of eight weeks. The cartilage within composite grafts were obtained from the remaining cartilage following secondary rhinoplasty performed on a single donor. Diced cartilage grafts were wrapped separately with acellular dermal matrix (ADM), bovine pericardium, and fascia to form three groups. A total of five mice were utilized in all three experimental groups, with a total of 15 experimental materials being examined. One composite graft from each group was implanted into the backs of the mice. The effects of the biomaterials on the viability and stability of the composite grafts were evaluated. Viability was evaluated through LIVE/DEAD cell analysis and histopathological examinations. Stability was assessed by comparing weight and volume changes of the grafts, measured using a precision balance and computed tomography, respectively.

Results: A significant increase in weight was found in the fascia group after implantation (p < 0.05). In the ADM (Group A) and bovine pericardium (Group T), no statistically significant weight change was observed (p > 0.05). A significant increase in volume was found in the ADM (Group A) group after implantation (p < 0.05). Flow cytometry showed the highest cartilage viability percentage in the fascia (Group F) and the lowest in the ADM (Group A). No significant difference was found in viability percentages between the groups. Histopathological examinations supported the flow cytometry findings.

Conclusion: Our study revealed that cartilage grafts wrapped in allogenic fascia (Group F) showed better viability and stability compared with ADM (Group A) and bovine pericardium (Group T). This suggests that while fascia may remain the gold standard, alternative biomaterials also hold potential. Further experimental and clinical studies with larger sample sizes are needed to support these findings.

Level of evidence i: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Background: Septoplasty is a common treatment for septal deviation in otolaryngology, and it is the recommended treatment for a deviated septum. However, it can lead to post-operative complications such as septal hematoma, adhesions, and perforation. Trans-septal quilting suture and intranasal silicone splinting effectively prevent complications after septoplasty.

Aim: This systematic review and meta-analysis aimed to evaluate the effectiveness of intranasal silicone splints compared to quilting sutures in managing post-septoplasty complications and patient tolerance.

Materials and methods: PubMed, Google Scholar, and CENTRAL databases were used with specific keywords, and the studies were screened using the Rayyan AI system and were selected based on the inclusion and exclusion criteria. Statistical analysis was done by using RevMan version 5.4 to generate forest plots. Regarding quality assessment, the JBI Critical Appraisal Tool for Systematic Reviews was used to evaluate the rigor of the included studies.

Results: This systematic review and meta-analysis identified 23 studies and only 18 were eligible. It showed that the three methods effectively prevent post-septoplasty complications; however, quilting sutures reduce post-operative pain and minimize the complications. It is essential to note that quilting sutures and intranasal splints showed a comparable incidence of nasal bleeding postoperatively to nasal packing.

Conclusion: It was found that trans-septal quilting sutures had considerable advantages over nasal packing in septoplasty procedures and clearly showed that it is a safe and effective technique. Nasal splints, specifically intranasal silicone splints, are indicated as an alternative to nasal packing to generally improve the patient's comfort, especially by reducing post-operative discomfort. The findings of the study can help medical practitioners make better decisions about the most effective surgical approach, also considering well-tolerated post-septoplasty care.

Level of evidence i: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Background: Many different endoscopic and non-endoscopic techniques for forehead and/or eyebrow lift exist, but to date there has been little research on what factors drive technique selection.

Objectives: To compare frequency of different forehead and/or eyebrow lift techniques between sexes, analyze factors affecting technique selection, and present an algorithm for technique selection.

Methods: This is a retrospective study of consecutive cosmetic patients who underwent direct eyebrow lift (DEL) or forehead/eyebrow lift (FEL) by a single surgeon between 2007 and 2022. Subjects with prior trauma or surgery, facial nerve palsy, trans-blepharoplasty technique, and functional rather than cosmetic indications were excluded.

Results: There were 1060 subjects. Three patient factors (type of lift request, hairline height, and forehead skin type) were considered in the algorithm. The most frequent procedure in female subjects was conventional endoscopic FEL (83.8%) followed by DEL (9.3%). Male subjects most frequently had DEL (63.1%) followed by conventional endoscopic FEL (16.5%). Patient factors, but not age, were significantly (p ≤ 0.001) different between the two sexes. While the above three patient factors and sex, but not age, had a significant effect (p ≤ 0.001) on technique selection on univariate analysis, sex was the only factor that remained significant (p ≤ 0.001) on multivariate analysis.

Conclusion: Endoscopic FEL was the first and second most frequent technique in female and male subjects, respectively. DEL was the first and second most frequent technique in male and female subjects, respectively. Sex, but not age, was a significant factor affecting the type of lift technique through three patient factors.

Level of evidence iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Background: Mandibular angular hypertrophy and hemifacial microsomia involve deformities in the mandibular region, resulting in facial asymmetry that severely affects patients' appearance. This study evaluated the masseter muscle-mandibular correlation in patients with hemifacial microsomia and those with mandibular angular hypertrophy using three-dimensional CT and compared them with normal individuals.

Methods: This study included 310 participants. Craniofacial scans were performed using three-dimensional CT in all participants to obtain masseter muscle and mandibular size and morphology data.

Results: In the normal population, there are sex differences in the shape and size of the masseter muscle and mandible, and the size of masseter muscle correlates with the mandible. In all three groups, there were differences in morphology and size of masseter muscle and mandible between the right and left sides (healthy and affected sides). Compared with the normal population, patients with hemifacial microsomia have a smaller masseter muscle and mandible on the affected side, while the healthy side is similar to the normal population. The measurement results significantly differed among patients with different severities of hemifacial microsomia and tended to worsen with increasing severity. In addition, the masseter muscle and mandibles on the left and right sides of patients with mandibular hypertrophy were larger than those of the normal population.

Conclusions: Three-dimensional CT proved reliable and accurate for measuring the masseter muscle and mandible size and morphology. We report masseter muscle and mandible characteristics in different populations. These findings can guide medical personnel in determining the diagnosis, treatment, and prognosis of these diseases.

Level of evidence iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Background: Mandibular angle osteotomy (MAO) using an intraoral approach is a common procedure for correcting square facial contours in the Asian population. While previous retrospective studies have primarily focused on complications rates, limited research has examined time-related trends and the epidemiological characteristics of the surgical population. A comprehensive study with a large sample size and long-term follow-up is crucial to enhance outcomes, minimize complications, provide evidence-based insights, and consolidate clinical experience.

Methods: This retrospective study reviewed 3,501 MAO cases performed via an intraoral approach between January 2008 and December 2022. Patients were categorized into three cohorts based on admission dates: group A (January 2008 to December 2012), group B (January 2013 to December 2017), and group C (January 2018 to December 2022). Demographic data, complication rates, and patient-reported satisfaction scores were analyzed across the groups.

Results: The average ages for groups A, B, and C were 27.38 ± 6.94, 27.41 ± 6.42, and 28.57 ± 6.65 years, respectively, with group C patients being significantly older than those in group B (P < 0.001). Gender distribution showed 48 males and 825 females in group A; 93 males and 1,097 females in group B; and 122 males and 1,316 females in group C, with significant difference between groups A and B (P = 0.039). Complication rates were 13.05% (114 cases) in group A, 5.54% (66 cases) in group B, and 2.50% (36 cases) in group C. Postoperative satisfaction scores for groups A, B, and C were 3.32 ± 0.64, 3.86 ± 0.54, and 4.42 ± 0.58, respectively, with significant improvements across groups (P < 0.05).

Conclusions: The demand for MAO has steadily increased, particularly among individuals aged 21 to 40, with a predominance of female patients. Expanding indications have led to more cases involving middle-aged, elderly, and male patients. Advancements in surgical techniques have contributed to better aesthetic outcomes and lower complication rates. The use of modified osteotomy procedures and digital technologies has enabled safer, more precise surgeries across diverse populations, resulting in significant improvements in lower facial contours.

Level of evidence iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Background: Clinical photography is a critical tool in plastic surgery practice. The primary aim of this scoping review was to assess the quality and reliability of various 2D and 3D photography modalities in plastic surgery.

Methods: The databases, MEDLINE via PubMed, Embase via Elsevier, and Scopus via Elsevier, were searched from inception to March 15, 2023, for any papers focused on evaluation of quality and/or reliability of photography in plastic surgery-related applications. Data regarding general article characteristics, study characteristics, participants, and study results were extracted by two reviewers and qualitatively synthesized.

Results: A total of 17 studies published from 1999 to 2023 were eligible for inclusion in the final analysis. Thirteen (76.5%) were cross-sectional and four (23.5%) were cohort studies. Photographed locations included craniomaxillofacial and oral (n = 11, 64.7%), scars (n = 3, 17.6%), breast and torso (n = 2, 11.8%), and wounds (n = 1, 5.9%). Assessed photographic modalities were found to be on par or better than comparators in almost all applicable cases (n = 13/14, 92.9%).

Conclusions: Multiple photographic modalities were found to have adequate quality and reliability. 3D photography was found to be a superior imaging modality for craniomaxillofacial and oral applications. For scar and wound assessment and images of the breast and torso region, 2D photography was sufficient. Overall, 2D photography using smartphone devices is sufficient for reliable and quality images in most clinical settings. With continued advances in technology, the ability to capture clinical images will undoubtedly improve, and there is a need for future studies to assess and compare these modalities.

Level of evidence iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Background: To investigate the clinical effect of the combination of tunnel shaped excision with radiotherapy and injection of type A botulinum toxin in the treatment of auricular keloids.

Methods: From June 2017 to May 2023, a total of 52 cases with auricular keloids were treated with tunnel shaped excision combined with radiotherapy and the injection of type A botulinum toxin. The effects of this sequential treatment were analyzed and evaluated.

Results: No recurrence of keloids was observed in the enrolled patients, and no abnormal conditions such as ear deformities occurred. The postoperative auricle appearance of most patients was satisfactory and the shape was good.

Conclusion: The combination of tunnel shaped excision with radiotherapy and injection of type A botulinum toxin in the treatment of auricular keloids can achieve good therapeutic effects, resulting in satisfactory auricle morphology, and is worthy of clinical promotion.

Level of evidence iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Introduction: Aesthetic surgery has gained significant popularity due to advancements in techniques and increased societal acceptance. However, it is not without risks, including complications and delayed healing, which have sparked interest in adjunctive therapies such as hyperbaric oxygen therapy (HBOT). This systematic review and meta-analysis evaluates the efficacy of HBOT in improving postoperative outcomes in aesthetic surgery.

Methods: A comprehensive literature search was conducted across multiple databases in December 2024, identifying studies involving patients who underwent aesthetic surgeries and received HBOT. Inclusion criteria focused on studies reporting outcomes related to wound healing, complication rates, and patient satisfaction. Primary outcomes assessed were healing time and complication rates, while secondary outcomes included patient satisfaction and overall aesthetic results. Study quality and risk of bias were evaluated using standardized assessment tools.

Results: Eleven studies with 734 patients were included, with 416 (56.7%) receiving HBOT. Predominantly used postoperatively (90.9%), HBOT reduced healing times, with a pooled mean healing time of 11.30 days [95% CI: 10.46, 12.14]. Procedures included abdominoplasty (36.4%) and breast aesthetic surgeries (27.3%). HBOT protocols varied, with sessions lasting 45-120 minutes at pressures of 2.0-3.0 ATA. Patient satisfaction was consistently high, with early satisfaction rates up to 88.2%.

Conclusion: HBOT is an effective adjunct in aesthetic surgery, promoting faster recovery and greater patient satisfaction. However, the variability in study designs and HBOT protocols underscores the need for well-designed randomized controlled trials to establish standardized guidelines for its application in aesthetic and reconstructive procedures.

Level of evidence ii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors  www.springer.com/00266 .