Aesthetic Plastic Surgery最新文献

Background: Upper eyelid ptosis is a common aesthetic concern among Asian patients, resulting in a tired and drowsy appearance that affects their attractiveness. The levator advancement technique is widely used for ptosis correction; however, achieving precise results remains challenging.

Objectives: This study introduces a modified approach to improve the accuracy of levator aponeurosis advancement by focusing on precise measurements and anterior displacement within a defined corneal range.

Methods: The study included patients with mild to moderate ptosis. We measured the mean margin reflex distance 1 (MRD-1) preoperatively and 12 months postoperatively. Histological evidence was obtained through staining of levator aponeurosis complexes using Hematoxylin and Eosin and Masson's trichrome.

Results: In this prospective study, 29 patients showed a significant increase in mean MRD-1 from 2.56 ± 0.84 mm (range 1.02-3.98 mm) preoperatively to 4.38 ± 0.55 mm (range 3.09-5.35 mm) at the 12-month follow-up (paired t-test; P < 0.001). Masson's staining revealed that the levator aponeurosis tissue primarily consists of collagen fibers, which minimize potential errors due to their toughness and lack of elasticity during the surgical procedure.

Conclusions: The modified technique enhances the accuracy of levator aponeurosis advancement in ptosis correction, resulting in minimal surgical trauma and high patient satisfaction. Our technique appears to have a low incidence of severe adverse effects, based on the available data from the current case series.

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: Deepening of the nasolabial fold (NLF), drooping of the nasal tip, and facial expressions perceived as angry face, are common esthetic concerns. However, no studies have correlated this set of signs and symptoms with common anatomical causes. We review anatomical considerations of the region and propose a combined treatment modality.

Methods: We performed a retrospective analysis of cases treated with combined botulinum toxin (abobotulinumtoxinA) using an injection pattern encompassing the nasal muscles and hyaluronic acid (HA) fillers in the deep pyriform space. Photographs were taken at rest and during motion (frontal and oblique views), before and after treatment.

Results: Results demonstrated effacement of the NLF, improved nasal tip positioning during smiling, and generally more favorable facial expressions.

Conclusions: Combined treatment with HA in the deep pyriform space and abobotulinumtoxinA in the nasal muscles can improve angry expression and aging stigma in patients with deep empty pyriform space, both in the static and dynamic conditions of facial mimic.

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: This project aims to provide guidance for surgeons' online interactions by reviewing key legal decisions.

Methods: The Nexis Uni database was queried to search for state and federal case law and law journal articles. Search terms were "social media" AND (facial w/s plastic!) and internet AND advice AND "plastic surgery."

Results: The first query returned two cases and a law review article. The second returned 39 cases. The 17 most relevant results were included.

Conclusions: On surgeons' websites, increased interactivity or opportunities for the sale of products or services make out-of-state courts more likely to have personal jurisdiction over them. There are also many cases involving plastic surgeons filing defamation complaints against patients who reviewed them negatively online. Success in these cases has been limited. Surgeons are instead vulnerable to the "Streisand Effect," where legal action can bring attention to patient complaints. Unique cross-complaints may require the plaintiff to pay the defendant's legal fees if no defamation is proven. Surgeons who appear on "Top Doctor" lists, publish articles, or otherwise display their expertise may unknowingly make themselves "limited purpose public figures." This adds the burden of proving false patient claims were made "with actual malice" rather than through negligence.

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: Obesity is a growing global epidemic, with glucagon-like peptide-1 (GLP-1) receptor agonists emerging as effective pharmacological solutions for weight loss. However, these medications raise concerns in the context of aesthetic and reconstructive surgery due to their effects on wound healing, adipose tissue metabolism, and their potential impact on surgical outcomes.

Objective: To report two cases of delayed wound healing and fat necrosis in patients undergoing breast surgery while receiving GLP-1 receptor agonists for weight management.

Materials and methods: In our private clinical practice, two patients were observed. Both underwent breast surgeries (implant exchange with mastopexy and reduction mammoplasty) while using GLP-1 agonists (liraglutide). One patient continued therapy perioperatively, while the other discontinued seven days prior to surgery.

Results: Both patients experienced delayed wound healing. Wound dehiscence followed a characteristic progression involving fat necrosis and secondary healing. Despite standard surgical techniques and postoperative care, healing was prolonged in both cases.

Discussion: These findings highlight the potential impact of GLP-1-induced rapid weight loss on surgical outcomes. Current guidelines recommend therapy suspension to avoid anesthetic complications, but further studies are needed to evaluate the necessity of preoperative discontinuation in terms of surgical outcomes.

Conclusion: Our cases highlight the risk of delayed wound healing, fat necrosis, and tissue fragility in patients undergoing breast surgery while receiving GLP-1 receptor agonists. These complications have not been previously described in the literature, making this report particularly relevant as an alert for clinicians.

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: In most of the published plication techniques in face lift surgery, the vectors of plication are not entirely superiorly and vertically directed. The same applies with the deep plane, SMAS elevation techniques in the majority of which the vectors of traction are not superiorly vertically directed. The aging symptoms are mostly prominent at the anterior mobile face due to the gravity effect, and this is the area where attention should be focused to correct these symptoms following a face lift surgery.

Methods: We have evaluated the results of 58 patients who underwent the V plication face lift between January 2021 to January 2024 in terms of demographics, procedure, surgical technique, adjuvant treatments, final outcomes and complications.

Results: All 58 patients underwent primary face lift with the V plication for vertical superior traction and suspension of the facial tissues. The average age value was 64 years. Forty-six patients underwent concomitant upper and lower blepharoplasty, and 25 fat transfer of the upper periorbital region. There were one self-resolving neurapraxia of the right buccal branch of facial nerve and three minor self-absorbed localized blood collections.

Conclusion: The extensive V plication face lift of the anterior face together with the progressively less extensive plication of the lateral face due to the shape of plication addressed satisfactorily the prominent symptoms of gravity effect on the face with the action of the vertical superior suspension of the facial tissues and corrected the malar deflation by repositioning the downwards sliding malar fat pad.

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 .

The pursuit of aesthetically pleasing shoulder contours, particularly those characterised by a sharp, angular definition, has gained significant traction in Southeast Asia. Traditionally, neuromodulators have been used to achieve these results by inducing muscle atrophy, particularly in the trapezius muscles. However, this approach can carry potential risks, such as compromised muscle function and spinal instability. In response to these concerns, this article proposes a novel technique that combines the use of hyaluronic acid (HA) fillers with neuromodulators to achieve the desired shoulder contour. HA fillers, well established in facial aesthetics, offer the benefits of structural enhancement and long-term collagen stimulation. This combination technique aims to provide a more stable and natural-looking result by enhancing the underlying bone structure while selectively using neuromodulators to refine the shoulder profile. A clinical case study of a 32-year-old woman is presented, wherein 15cc of HA filler was injected into each shoulder to achieve a pronounced 90-degree contour, complemented by targeted neuromodulator injections in the deltoid muscles. The patient expressed high satisfaction with the outcome, noting the alignment with her aesthetic goals. This innovative approach has the potential to redefine shoulder contouring practices, offering patients a safer and more effective alternative to neuromodulators alone. Further research and clinical validation are necessary to fully establish the efficacy and safety of this technique.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 .

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 .