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Nationwide Analysis of Post-traumatic Breast Implant Complications: Predictors of Immediate vs Delayed Diagnosis and Management. 创伤后乳房植入并发症的全国分析:即时与延迟诊断和处理的预测因素。
IF 2.8 3区 医学 Q2 SURGERY Pub Date : 2026-02-09 DOI: 10.1007/s00266-026-05631-7
Jade E Smith, Noelle C Garbaccio, Dorien I Schonebaum, Lacey Foster, Morvarid Mehdizadeh, Justin J Cordero, Jose Foppiani, Henry Marsh, Umar Choudry, Samuel J Lin

Background: Post-traumatic breast implant and tissue expander (TE) complications are increasingly relevant as more patients undergo reconstructive or cosmetic breast surgery. Prior studies are limited to case reports, with little known about the mechanisms of injury or timing of clinical recognition.

Methods: Using the Nationwide Readmission Database (2017-2020), we identified adults with trauma admissions followed by breast implant-related diagnoses or procedures. Mechanisms of injury (MOI) and clinical presentations were characterized using ICD-10 codes. Patients were classified as having received "immediate" management (diagnosis or procedure during index admission) or "delayed" (on readmission). Cox regression identified predictors of earlier diagnosis or intervention.

Results: A total of 573 patients with post-traumatic implant complications were included (488 breast implants, 85 TEs). Falls were the most common MOI (53.2%), followed by transport accidents (25.0%). TEs were disproportionately associated with burn injuries (20.5% vs. 4.9% in non-TEs). At presentation, 78.2% of patients were diagnosed with implant rupture or underwent surgical correction. Rib or clavicle fractures (21.1%) and breast symptoms (12.6%) were associated with earlier diagnosis, but not with likelihood of surgery. Plastic surgery consultation significantly decreased time to surgery. Age, sex, and ZIP code did not have notable effects on diagnostic and surgical timing.

Conclusions: Post-traumatic breast implant complications often present without breast-specific symptoms, resulting in diagnostic delays. Trauma protocols should include routine breast imaging in patients with implants, especially after transport, burn, or blunt-force injuries. TE patients may be uniquely susceptible to thermal injury and warrant focused preventive counseling.

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 .

背景:随着越来越多的患者接受乳房重建或美容手术,创伤后乳房植入物和组织扩张器(TE)并发症越来越相关。先前的研究仅限于病例报告,对损伤的机制或临床识别的时间知之甚少。方法:使用全国再入院数据库(2017-2020),我们确定了创伤入院的成年人,随后进行了与乳房植入物相关的诊断或手术。损伤机制(MOI)和临床表现采用ICD-10编码进行表征。患者被分为“立即”治疗(入院时的诊断或手术)和“延迟”治疗(再入院时)。Cox回归确定了早期诊断或干预的预测因素。结果:共纳入573例外伤性假体并发症患者(488例乳房假体,85例TEs)。跌倒是最常见的MOI(53.2%),其次是交通事故(25.0%)。TEs与烧伤的相关性不成比例(20.5% vs. 4.9%)。入院时,78.2%的患者被诊断为种植体破裂或接受手术矫正。肋骨或锁骨骨折(21.1%)和乳房症状(12.6%)与早期诊断相关,但与手术可能性无关。整形外科咨询显著缩短了手术时间。年龄、性别和邮政编码对诊断和手术时机没有显著影响。结论:创伤后乳房植入并发症通常没有乳房特异性症状,导致诊断延迟。创伤方案应包括植入物患者的常规乳房影像学检查,特别是在运输、烧伤或钝力损伤后。TE患者可能特别容易受到热损伤,需要重点进行预防性咨询。证据等级iv:本刊要求作者为每篇文章指定一个证据等级。有关这些循证医学评级的完整描述,请参阅目录或在线作者说明www.springer.com/00266。
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引用次数: 0
Methodological Considerations in Studies of Combined Aesthetic Surgical Procedures. 综合美容外科手术研究的方法学考虑。
IF 2.8 3区 医学 Q2 SURGERY Pub Date : 2026-02-09 DOI: 10.1007/s00266-026-05695-5
Hatan Mortada

No Level Assigned This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. 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 .

本杂志要求作者为每一篇投稿指定一个证据水平,以适用循证医学排名。这不包括评论文章、书评和涉及基础科学、动物研究、尸体研究和实验研究的手稿。有关这些循证医学评级的完整描述,请参阅目录或在线作者说明www.springer.com/00266。
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引用次数: 0
Early Protein Supplementation Enhances Wound Healing and Reduces Complications Following Abdominoplasty: A Controlled Study in Non-bariatric Patients. 早期补充蛋白质促进伤口愈合并减少腹部成形术后的并发症:一项针对非肥胖患者的对照研究。
IF 2.8 3区 医学 Q2 SURGERY Pub Date : 2026-02-09 DOI: 10.1007/s00266-026-05626-4
Agostino Bruno, Alessio D'Antimi

Background: Protein intake plays a critical role in postoperative recovery and wound healing, particularly in procedures such as abdominoplasty. While ERAS protocols emphasize nutritional optimization, evidence in non-bariatric patients undergoing elective body contouring remains limited.

Objectives: To evaluate the effects of early postoperative protein supplementation on wound healing outcomes, complication rates and recovery time in patients undergoing full abdominoplasty.

Methods: A retrospective, observational cohort study was conducted on 200 non-bariatric patients undergoing standardized full abdominoplasty. Participants were divided into two groups: one receiving daily protein supplementation (≥1.2 g/kg/day using whey isolate or hydrolyzed collagen peptides) initiated within 24 h postoperatively for at least 14 days, and a control group with no supplementation. Outcomes measured included wound dehiscence, seroma formation, surgical site infections (SSI), time to complete healing, and patient satisfaction. Data were analyzed using chi-square tests, t-tests, and multivariate regression models.

Results: The supplemented group showed significantly lower wound dehiscence (6% vs. 17%, p = 0.018) and reduced seroma incidence (9% vs. 18%, p = 0.048). Time to complete healing was shorter in the supplemented group (16.8 ± 3.4 days vs. 20.5 ± 4.2 days; p < 0.001). While SSI incidence was not significantly different (4% vs. 10%, p = 0.092), a favorable trend was noted. Multivariate regression confirmed protein supplementation as an independent predictor of faster healing (β = - 2.94; 95% CI - 4.36 to - 1.52).

Conclusions: Postoperative protein supplementation significantly improves wound healing and reduces complications in patients undergoing abdominoplasty, even outside the bariatric population. These findings support the incorporation of targeted nutritional protocols into routine perioperative care pathways for abdominoplasty. While the study did not formally evaluate an ERAS protocol, its results are consistent with the general principles of enhanced recovery, emphasizing the role of early nutritional support in improving postoperative outcomes.

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 .

背景:蛋白质摄入在术后恢复和伤口愈合中起着关键作用,特别是在腹部成形术等手术中。虽然ERAS方案强调营养优化,但非肥胖患者接受选择性身体轮廓的证据仍然有限。目的:探讨术后早期补充蛋白质对全腹成形术患者创面愈合、并发症发生率及恢复时间的影响。方法:对200例接受标准化全腹成形术的非肥胖患者进行回顾性、观察性队列研究。参与者被分为两组:一组在术后24小时内开始每日补充蛋白质(≥1.2 g/kg/天,使用分离乳清或水解胶原肽),持续至少14天,另一组不补充蛋白质。测量的结果包括伤口裂开、血肿形成、手术部位感染(SSI)、完全愈合时间和患者满意度。数据分析采用卡方检验、t检验和多元回归模型。结果:添加组创面裂开明显降低(6%比17%,p = 0.018),血肿发生率明显降低(9%比18%,p = 0.048)。补充组的完全愈合时间较短(16.8±3.4天vs. 20.5±4.2天;p < 0.001)。虽然SSI发生率没有显著差异(4% vs. 10%, p = 0.092),但有良好的趋势。多因素回归证实补充蛋白质是更快愈合的独立预测因子(β = - 2.94; 95% CI - 4.36至- 1.52)。结论:术后补充蛋白质可显著改善腹部成形术患者的伤口愈合并减少并发症,即使在肥胖人群之外也是如此。这些发现支持将有针对性的营养方案纳入腹部成形术的常规围手术期护理途径。虽然该研究没有正式评估ERAS方案,但其结果与增强恢复的一般原则一致,强调了早期营养支持在改善术后结果中的作用。证据等级iii:本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述,请参阅目录或在线作者说明www.springer.com/00266。
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引用次数: 0
Response to "The Harms of Obesity in Abdominoplasty: Considerations of Methodological and Social Behavioral Factors". 对“腹部成形术中肥胖的危害:方法学和社会行为因素的考虑”的回应。
IF 2.8 3区 医学 Q2 SURGERY Pub Date : 2026-02-09 DOI: 10.1007/s00266-026-05693-7
Felix J Klimitz, Samuel Knoedler, Bohdan Pomahac, Martin Kauke-Navarro
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引用次数: 0
Simultaneous Reduction Malarplasty and Reduction Mandibuloplasty: Less Mandibular Hyperplasia with Masseter Elevation. 同时复位隆胸和下颌复位成形术:咬肌抬高后下颌增生减少。
IF 2.8 3区 医学 Q2 SURGERY Pub Date : 2026-02-09 DOI: 10.1007/s00266-026-05627-3
Panxi Yu, Qian Wu, Mengdie Wei, Li Liu, Li Teng, Chao Zhang, Yongqian Wang

Background: Bone hyperplasia after reduction mandibuloplasty can impair the aesthetic outcome of the surgery which may require a revision. The adjacent masseter has been reported to be a decisive factor in postoperative mandibular hyperplasia. Our clinical practice suggested that simultaneous reduction malarplasty with zygomatic arch elevation may reduce masseter accumulation after reduction mandibuloplasty and contribute to less mandibular hyperplasia. Thus, a retrospective study was conducted to clarify our observation.

Methods: From September 2015 to April 2024, patients who underwent reduction mandibuloplasty with or without simultaneous reduction malarplasty with zygomatic arch elevation were retrospectively reviewed. Computed tomography data were utilized to measure the preoperative, immediate postoperative, and follow-up postoperative mandibular volume. The volume of resected mandibular bone and regenerated mandibular bone was calculated. The measurements of masseter thicknesses, elevation distance of the zygomatic arch, as well as correlations analysis between them were performed.

Results: Fifty-two patients receiving reduction mandibuloplasty with simultaneous reduction malarplasty (combined-operation group) and 35 patients receiving reduction mandibuloplasty only (single-operation group) were included. After the operation, the masseter muscle in both groups became significantly thicker. The average masseter thickness increase was 0.89 ± 1.21 mm in the combined-operation group and 2.70 ± 1.10 mm in the single-operation group. Single-operation group had severer masseter thickening and mandibular hyperplasia. Pearson correlation analysis revealed that masseter thickening was positively correlated to mandibular resected volume, and that mandibular hyperplastic volume was positively correlated to masseter thickening with statistical significance.

Conclusion: Simultaneous reduction malarplasty with zygomatic arch elevation induced less masseter redundancy and mandibular hyperplasia. In maxillofacial contouring surgeries, if necessary, performing the two procedures simultaneously and applying the bracing technique with zygomatic arch elevation can effectively improve the aesthetic outcomes of reduction mandibuloplasty.

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 .

背景:下颌骨复位成形术后的骨增生会影响手术的美观效果,可能需要进行翻修。据报道,邻咬肌是术后下颌增生的决定性因素。我们的临床实践表明,同时颧弓提升的下颌复位成形术可以减少下颌复位成形术后的咬肌堆积,并有助于减少下颌增生。因此,我们进行了一项回顾性研究来澄清我们的观察。方法:回顾性分析2015年9月至2024年4月行下颌复位成形术同时或不同时行颧弓上凸下颌复位成形术的患者。计算机断层扫描数据用于测量术前、术后即刻和术后随访的下颌体积。计算切除下颌骨和再生下颌骨的体积。测量咬肌厚度、颧弓抬高距离,并进行相关性分析。结果:包括52例同时行下颌骨复位成形术的患者(联合手术组)和35例仅行下颌骨复位成形术的患者(单手术组)。术后两组咬肌均明显增厚。联合手术组咬肌厚度平均增加0.89±1.21 mm,单手术组咬肌厚度平均增加2.70±1.10 mm。单手术组有较严重的咬肌增厚和下颌增生。Pearson相关分析显示,咬肌增厚与下颌切除体积正相关,下颌增生体积与咬肌增厚正相关,差异均有统计学意义。结论:颧弓抬高同时复位下颌成形术可减少咬肌冗余和下颌增生。在颌面部整形手术中,必要时可同时进行这两种手术,并应用颧弓抬高支撑技术,可有效改善下颌复位成形术的美观效果。证据等级iv:本刊要求作者为每篇文章指定一个证据等级。有关这些循证医学评级的完整描述,请参阅目录或在线作者说明www.springer.com/00266。
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引用次数: 0
Botulinum Toxin Vascular Effectiveness: Low or High Doses? 肉毒毒素血管有效性:低剂量还是高剂量?
IF 2.8 3区 医学 Q2 SURGERY Pub Date : 2026-02-09 DOI: 10.1007/s00266-026-05685-7
Shahriar Nazari, Mohammad Saleh Sadeghi, Mohammad Reza Pourani, Cristina Muñoz-Gonzalez, Nabil Fakih-Gomez

Introduction: Botulinum toxin (BoNT) is increasingly recognized for vascular effects beyond its established neuromuscular use. Evidence indicates a dose-dependent mechanism in which BoNT either promotes vasodilation and perfusion or inhibits cholinergic vasodilatory activity, making it relevant for ischemic, vasospastic, and inflammatory conditions. This review evaluates current data on the dose-dependent vascular actions of BoNT and outlines its therapeutic relevance in aesthetic and reconstructive medicine.

Materials and methods: A narrative review was performed using PubMed, MEDLINE, Embase, and Google Scholar, focusing on studies published from 2000 to 2025. Search terms combined "botulinum toxin" with "vasodilation," "ischemia," "flap survival," "angiogenesis," and related concepts. Eligible publications included clinical trials, animal studies, in vitro models, and systematic reviews assessing vascular outcomes after BoNT exposure. Of 163 records identified, 57 met inclusion criteria and were analyzed.

Results: BoNT demonstrates dual vascular mechanisms. At higher doses, it enhances perfusion and promotes angiogenesis through vascular endothelial growth factor and nitric oxide pathways, supporting applications in ischemic flaps and Raynaud's phenomenon. At lower doses, it reduces excessive cholinergic vasodilation and neurogenic inflammation, offering benefits in conditions such as rosacea and hyperhidrosis. These effects are dose-dependent and tissue-specific, with variability across experimental models. Concentrations above 20 IU/ml may be considered high-dose, whereas lower levels represent low-dose BoNT.

Conclusion: BoNT exhibits versatile vascular activity. Higher doses support vascular regeneration and angiogenesis, while lower doses modulate hyperreactive vascular responses. Further research is needed to clarify mechanisms, refine dose-response guidelines, and assess long-term safety across clinical indications to optimize its vascular applications.

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.

介绍:肉毒杆菌毒素(BoNT)越来越多地认识到血管作用,而不是其既定的神经肌肉用途。有证据表明BoNT具有剂量依赖性机制,其中BoNT促进血管舒张和灌注或抑制胆碱能血管舒张活性,使其与缺血性、血管痉挛和炎症有关。这篇综述评估了BoNT的剂量依赖性血管作用的当前数据,并概述了其在美容和重建医学中的治疗相关性。材料和方法:使用PubMed, MEDLINE, Embase和谷歌Scholar进行叙述性回顾,重点关注2000年至2025年发表的研究。搜索词将“肉毒杆菌毒素”与“血管扩张”、“缺血”、“皮瓣存活”、“血管生成”和相关概念结合起来。符合条件的出版物包括临床试验、动物研究、体外模型和评估BoNT暴露后血管结局的系统综述。在确定的163份记录中,57份符合纳入标准并进行了分析。结果:BoNT显示双重血管机制。在高剂量时,它通过血管内皮生长因子和一氧化氮途径增强灌注并促进血管生成,支持在缺血性皮瓣和雷诺现象中的应用。在低剂量下,它可以减少过度的胆碱能血管扩张和神经源性炎症,对酒渣鼻和多汗症等疾病有好处。这些影响是剂量依赖性和组织特异性的,在不同的实验模型中具有可变性。浓度高于20 IU/ml可视为高剂量,而较低水平则代表低剂量BoNT。结论:BoNT具有多种血管活性。高剂量支持血管再生和血管生成,而低剂量调节高反应性血管反应。需要进一步的研究来阐明其机制,完善剂量反应指南,并评估其临床适应症的长期安全性,以优化其血管应用。证据等级v:本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述,请参阅目录或在线作者说明www.springer.com/00266。
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引用次数: 0
Satisfaction of Sexual Partner After Vaginal Tightening Surgery: A Systematic Review. 阴道收紧手术后性伴侣满意度的系统回顾。
IF 2.8 3区 医学 Q2 SURGERY Pub Date : 2026-02-06 DOI: 10.1007/s00266-025-05586-1
Sanaz Safarzadeh, Fatemeh Alavi-Arjas, Zohreh Keshavarz, Sepideh Hajian, Roghayeh Salmani

Introduction and hypothesis: The vaginal tightening surgery is on the rise all over the world, with improved sexual function being one of the benefits proposed for this surgery. This study aims to investigate the satisfaction of sexual partner with vaginal tightening surgery.

Methods: Electronic databases were systematically searched for related articles published between January 2000 and April 2025. The selection criteria included original English articles evaluating partner's satisfaction after any type of vaginal tightening surgeries in healthy women. After removing duplicates, a total of 2579 articles related to the topic of this study were retrieved.

Results: Six articles with 266 participants met the inclusion criteria. Only two articles had applied standardized tools such as International Index of Erectile Function-5 (IIEF-5), New Sexual Satisfaction Scale (NSSS), Golombok Rust Inventory of Sexual Satisfaction (GRISS), and Male Sexual Health Questionnaire Ejaculatory Dysfunction (MSHQ-EjD). The rest of articles had used a single question for assessing partners' satisfaction. All of the included studies indicated an increase in the partner's sexual satisfaction after surgery.

Conclusion: Findings of this systematic review show that satisfaction of sexual partners increases after vaginal tightening surgery. This is while, several factors influence this outcome.

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 .

介绍和假设:阴道收紧手术在世界范围内呈上升趋势,改善性功能是该手术的好处之一。本研究旨在探讨性伴侣对阴道收紧手术的满意度。方法:系统检索2000年1月~ 2025年4月发表的相关文献。选择标准包括评估健康女性阴道收紧手术后伴侣满意度的原创英文文章。剔除重复项后,共检索到2579篇与本研究主题相关的文献。结果:6篇文章266名受试者符合纳入标准。只有两篇文章应用了标准化工具,如国际勃起功能指数-5 (IIEF-5)、新性满意度量表(NSSS)、Golombok Rust性满意度量表(GRISS)和男性性健康射精功能障碍问卷(MSHQ-EjD)。其余的文章使用了一个问题来评估伴侣的满意度。所有纳入的研究都表明,手术后伴侣的性满意度有所提高。结论:本系统综述的结果显示,阴道收紧手术后性伴侣满意度提高。然而,有几个因素影响了这一结果。证据等级iii:本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述,请参阅目录或在线作者说明www.springer.com/00266。
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引用次数: 0
Not Merely an Enveloping Membrane: Anatomy of the Preaponeurotic Fat Membrane and Its Role in Blepharoptosis Correction. 不仅仅是一个包膜:腱膜前脂肪膜的解剖及其在上睑下垂矫正中的作用。
IF 2.8 3区 医学 Q2 SURGERY Pub Date : 2026-02-06 DOI: 10.1007/s00266-026-05625-5
Hanxing Zhao, Ying Zhang, Wilson A Wijaya, Zhixing Chen, Fengqin Song, Wencheng Fan, Linghuan Zeng, Zhiwei Zhao, Zhenyu Zhang, Zhengyong Li

Background: In blepharoplasty, a preaponeurotic fat pad has been considered to provide padding and structural support for the eyelid. In our practice, we have identified a dense fibrous membrane surrounding the preaponeurotic fat pad, which can transmit the uplift force of the levator muscle.

Objectives: As the preaponeurotic fat pad and its relationship with the surrounding layers remain controversial, this study aims to determine the histological characteristics of the preaponeurotic fat pad and to introduce a procedure involving the advancement of the posterior layer of the preaponeurotic fat membrane in blepharoptosis correction.

Methods: This retrospective study enrolled 42 eyes from 28 blepharoptosis patients who underwent a preaponeurotic fat membrane advancement procedure with or without levator aponeurotic advancement between October 2020 and June 2023. Six cadaveric upper eyelids from three fresh cadaver heads were harvested for histological examination, and one formalin-treated cadaver head was used for macroscopic anatomic evaluation.

Results: The mean preoperative MRD1 was 1.89 ± 0.89 mm. Among the forty-two upper eyelids, thirty-six underwent advancement of the preaponeurotic fat membrane. The other six upper eyelids had inadequate correction after performing the levator aponeurosis advancement, and therefore, a combined preaponeurotic fat membrane advancement was performed. Nine patients reported lagophthalmos during the first three months postoperatively, but this condition significantly improved by six months postoperatively. In anatomic evaluation, multilayered fibrous tissue structures were identified in and around the preaponeurotic fat pad.

Conclusions: Based on our clinical observations and anatomical studies, we believe that this fibrous envelope can be used to correct mild-to-moderate ptosis. The indications for this procedure range from mild-to-moderate ptosis. It can be used alone in patients with mild- or pseudo-ptosis due to overloading of the upper eyelid, or it can be used in conjunction with levator aponeurosis advancement in patients when the procedure is insufficient to achieve a proper correction.

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 .

背景:在眼睑成形术中,腱膜前脂肪垫被认为可以为眼睑提供填充物和结构支持。在我们的实践中,我们发现腱膜前脂肪垫周围有一层致密的纤维膜,它可以传递提提肌的抬升力。目的:由于腱膜前脂肪垫及其与周围层的关系仍然存在争议,本研究旨在确定腱膜前脂肪垫的组织学特征,并介绍一种涉及腱膜前脂肪膜后层的上睑下垂矫正手术。方法:本回顾性研究纳入了28例上睑下垂患者的42只眼睛,这些患者在2020年10月至2023年6月期间接受了腱膜前脂肪膜推进术,有或没有提上睑腱膜推进术。取3个新鲜尸体头部的6个尸体上眼睑进行组织学检查,用一个经福尔马林处理的尸体头部进行宏观解剖评价。结果:术前MRD1均值为1.89±0.89 mm。在42例上眼睑中,36例发生腱膜前脂肪膜前移。另外6例上眼睑在进行提肌腱膜推进术后矫正不足,因此,我们进行了联合腱膜前脂肪膜推进术。9例患者在术后前3个月报告眼球lagophthalmos,但这种情况在术后6个月显著改善。在解剖评价中,在腱膜前脂肪垫内和周围发现了多层纤维组织结构。结论:根据我们的临床观察和解剖学研究,我们相信这种纤维包膜可以用于纠正轻至中度上睑下垂。该手术的适应症为轻度至中度上睑下垂。它可以单独用于轻度或假性上睑下垂的患者,或者当手术不足以达到适当的矫正时,它可以与提上睑肌腱膜进展的患者联合使用。证据等级iii:本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述,请参阅目录或在线作者说明www.springer.com/00266。
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引用次数: 0
Comparing Minimally Invasive Modified Levator vs. Conjoint Fascia Sheath-Levator Suspension in Correcting Severe Congenital Ptosis. 微创改良提上睑肌与联合筋膜鞘-提上睑肌悬吊矫治重度先天性上睑下垂的比较。
IF 2.8 3区 医学 Q2 SURGERY Pub Date : 2026-02-05 DOI: 10.1007/s00266-026-05629-1
Shan-Yan Li, Jian-Shu Bai, Yun-Han Zhang, Yi-Ming Wu, Qian-Qian Guo, Rui Tian

Purpose: To analyze the clinical efficacy and differences between minimally invasive modified levator palpebrae complex and conjoint fascia sheath-levator muscle complex suspension surgeries in correcting severe congenital ptosis.

Methods: This retrospective analysis included 40 patients with severe congenital ptosis, of whom 22 (25 eyes) and 18 (21 eyes) underwent minimally invasive modified levator palpebrae complex and conjoint fascia sheath-levator muscle complex suspension, respectively. Palpebral fissure height, marginal reflex distance 1, scleral exposure, and eyelid mobility at 1 week and 1 and 3 months postoperatively were compared between the surgical groups.

Results: The overall correction rates did not differ significantly between the minimally invasive modified levator palpebrae complex and conjoint fascia sheath-levator muscle complex suspension surgeries (88% vs. 66.67%). At 1 month postoperatively, the average scleral exposure was significantly lower in the modified levator palpebrae complex group than in the conjoint fascia sheath-levator muscle complex group (1.28 ± 1.29 mm vs. 2.17 ± 0.96 mm). Additionally, at both 1 and 3 months postoperatively, eyelid mobility was significantly greater in the modified levator palpebrae complex group than that observed in the conjoint fascia sheath-levator muscle complex group (6.84 ± 1.16 mm and 7.08 ± 1.18 mm vs. 5.54 ± 1.43 mm and 5.91 ± 1.69 mm).

Conclusion: Both minimally invasive modified levator palpebrae complex and conjoint fascia sheath-levator muscle complex suspension surgeries effectively correct severe congenital ptosis; however, the former demonstrates superior eyelid mobility and closure function recovery as postoperative outcomes.

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 .

目的:分析微创改良提上睑肌复合体与联合筋膜鞘-提上睑肌复合体悬吊术治疗重度先天性上睑下垂的临床疗效及差异。方法:回顾性分析40例重度先天性上睑下垂患者,其中22例(25眼)和18例(21眼)分别行微创改良提上睑肌复合体悬挂术和联合筋膜鞘-提上睑肌复合体悬挂术。比较两组术后1周及术后1、3个月睑裂高度、边缘反射距离1、巩膜外露、眼睑活动度。结果:微创改良提上睑肌复合体与联合筋膜鞘-提上睑肌复合体悬吊术的整体矫正率无显著差异(88% vs 66.67%)。术后1个月,改良提上睑肌复合体组巩膜暴露明显低于联合筋膜鞘-提上睑肌复合体组(1.28±1.29 mm vs. 2.17±0.96 mm)。术后1个月和3个月,改良提上睑肌复合体组眼睑活动度明显高于联合筋膜鞘-提上睑肌复合体组(6.84±1.16 mm和7.08±1.18 mm vs. 5.54±1.43 mm和5.91±1.69 mm)。结论:微创改良提上睑肌复合体和联合筋膜鞘-提上睑肌复合体悬吊术均能有效矫正先天性重度上睑下垂;然而,前者表现出优越的眼睑活动能力和闭合功能的恢复作为术后结果。证据等级iii:本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述,请参阅目录或在线作者说明www.springer.com/00266。
{"title":"Comparing Minimally Invasive Modified Levator vs. Conjoint Fascia Sheath-Levator Suspension in Correcting Severe Congenital Ptosis.","authors":"Shan-Yan Li, Jian-Shu Bai, Yun-Han Zhang, Yi-Ming Wu, Qian-Qian Guo, Rui Tian","doi":"10.1007/s00266-026-05629-1","DOIUrl":"https://doi.org/10.1007/s00266-026-05629-1","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze the clinical efficacy and differences between minimally invasive modified levator palpebrae complex and conjoint fascia sheath-levator muscle complex suspension surgeries in correcting severe congenital ptosis.</p><p><strong>Methods: </strong>This retrospective analysis included 40 patients with severe congenital ptosis, of whom 22 (25 eyes) and 18 (21 eyes) underwent minimally invasive modified levator palpebrae complex and conjoint fascia sheath-levator muscle complex suspension, respectively. Palpebral fissure height, marginal reflex distance 1, scleral exposure, and eyelid mobility at 1 week and 1 and 3 months postoperatively were compared between the surgical groups.</p><p><strong>Results: </strong>The overall correction rates did not differ significantly between the minimally invasive modified levator palpebrae complex and conjoint fascia sheath-levator muscle complex suspension surgeries (88% vs. 66.67%). At 1 month postoperatively, the average scleral exposure was significantly lower in the modified levator palpebrae complex group than in the conjoint fascia sheath-levator muscle complex group (1.28 ± 1.29 mm vs. 2.17 ± 0.96 mm). Additionally, at both 1 and 3 months postoperatively, eyelid mobility was significantly greater in the modified levator palpebrae complex group than that observed in the conjoint fascia sheath-levator muscle complex group (6.84 ± 1.16 mm and 7.08 ± 1.18 mm vs. 5.54 ± 1.43 mm and 5.91 ± 1.69 mm).</p><p><strong>Conclusion: </strong>Both minimally invasive modified levator palpebrae complex and conjoint fascia sheath-levator muscle complex suspension surgeries effectively correct severe congenital ptosis; however, the former demonstrates superior eyelid mobility and closure function recovery as postoperative outcomes.</p><p><strong>Level of evidence iii: </strong>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 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Serrapeptase After Liposuction for Lipedema: Limited Evidence for Antifibrotic Efficacy. 吸脂后Serrapeptase治疗脂肪水肿:抗纤维化疗效的有限证据。
IF 2.8 3区 医学 Q2 SURGERY Pub Date : 2026-02-05 DOI: 10.1007/s00266-026-05638-0
Agostino Bruno, Valerio Saccoccio

Background: Postoperative fibrosis is a frequent complication following liposuction for lipedema. Serrapeptase, a proteolytic enzyme with purported anti-inflammatory and antifibrotic effects, is used empirically, but robust evidence supporting its efficacy is lacking. This study aimed to assess the clinical effectiveness of postoperative serrapeptase supplementation in reducing fibrosis following lower limb liposuction for lipedema.

Methods: This retrospective, observational cohort study included 50 female patients with a confirmed diagnosis of lipedema undergoing tumescent liposuction. Patients were allocated to either a serrapeptase group (n = 25), receiving 60,000 IU daily for 4 weeks, or a control group (n = 25) receiving standard care alone. The primary outcome was tissue stiffness measured by quantitative ultrasound elastography (QUS). Secondary outcomes included B-mode ultrasonography, patient-reported pain (VAS), and clinical assessment of induration. Evaluations were performed at baseline, 4 weeks, and 3 months.

Results: Baseline characteristics were comparable between groups. No statistically significant differences were observed in the primary outcome of tissue stiffness at 4 weeks (14.8 ± 3.1 kPa vs. 15.2 ± 3.0 kPa; p = 0.62) or 3 months (13.7 ± 2.9 kPa vs. 14.0 ± 3.2 kPa; p = 0.78). Similarly, no significant benefits were seen in secondary outcomes, including fibrotic changes on ultrasound, VAS pain scores, or clinical induration (p > 0.05 for all). Serrapeptase was well-tolerated with no adverse events reported.

Conclusions: Oral serrapeptase supplementation did not demonstrate measurable efficacy in preventing postoperative fibrosis or improving patient-reported outcomes following liposuction for lipedema. These findings do not support its routine use in this clinical setting.

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 .

背景:术后纤维化是脂水肿抽脂术后常见的并发症。Serrapeptase是一种据称具有抗炎和抗纤维化作用的蛋白水解酶,已被用于经验研究,但缺乏支持其功效的有力证据。本研究旨在评估术后补充serrapeptase在减少下肢吸脂治疗脂肪水肿后纤维化的临床效果。方法:这项回顾性、观察性队列研究包括50名确诊为脂肪水肿的女性患者,她们正在接受肿胀吸脂术。患者被分配到serrapeptase组(n = 25),每天接受60000 IU,持续4周,或对照组(n = 25)单独接受标准治疗。主要结果是通过定量超声弹性成像(QUS)测量组织刚度。次要结果包括b超、患者报告的疼痛(VAS)和临床评估硬结。在基线、4周和3个月时进行评估。结果:两组间基线特征具有可比性。4周(14.8±3.1 kPa vs 15.2±3.0 kPa, p = 0.62)和3个月(13.7±2.9 kPa vs 14.0±3.2 kPa, p = 0.78)时的主要终点组织僵硬度无统计学差异。同样,在次要结局中,包括超声显示的纤维化改变、VAS疼痛评分或临床硬结(p < 0.05),也没有明显的益处。Serrapeptase耐受性良好,无不良事件报道。结论:口服serrapeptase补充剂在预防术后纤维化或改善脂水肿抽脂后患者报告的结果方面没有可测量的疗效。这些发现不支持在这种临床环境中常规使用。证据等级iii:本刊要求作者为每篇文章指定证据等级。有关这些循证医学评级的完整描述,请参阅目录或在线作者说明www.springer.com/00266。
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引用次数: 0
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Aesthetic Plastic Surgery
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