Aesthetic Plastic Surgery最新文献

Objective: Injectable cosmetic procedures are increasingly popular among beauty seekers as rapid technology and material advancements making it easier to achieve desired results through minimal trauma. The technique of subperiosteal injection, which is not yet introduced to the field of medical esthetics, may achieve more satisfying results. This study confirms the possibility of subperiosteal injection of dermal filler, using the clavicle area as the validation region, and has been validated by ultrasound examinations. This novel injection technique combining sharp and cannula successfully achieves subperiosteal filling injections, aiming to shape clear contours by utilizing subperiosteal filling and addressing the displacement issues of conventionally injected dermal filler, thereby achieving long-term reliable results.

Methods: The new technique involves linear limited subperiosteal dissection using a cannula, followed by further expansion of the periosteum through injection pressure to complete the injection of dermal filler and retain it beneath the periosteum.

Results: The conclusion drawn from clinical observation and ultrasound validation confirms that the dermal filler is indeed injected at the subperiosteal level and provides very stable support. The results at the 6-month follow-up remain ideal.

Conclusion: This subperiosteal injection technique is easy to practice and conductive to promotion. In terms of results, it achieves long-term stable outcomes that traditional injection methods cannot achieve. Although the clavicle area was used as the validation region, this technique can also be applied to many conventional facial injection sites.

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 https://www.springer.com/00266 .

Background: Hyamax® Monophasic Volumizer Dermal Fillers is a newly designed hyaluronic acid soft tissue filler for chin augmentation.

Methods: A prospective, single-center, evaluator-blinded, randomized controlled study was designed to evaluate the effectiveness and safety of Hyamax® Volumizer in the correction of chin retrusion in the 18-55-year-old Chinese population for 12 months after treatment. Participants were randomized (3:1) to receive Hyamax® Volumizer injection (n = 21) or no treatment (n = 7). Assessments included live and blinded evaluations by photographs on a chin retrusion scale (Galderma Chin Retrusion Scale), aesthetic improvement (Global Aesthetic Improvement Scale) by the subjects and independent evaluators, and safety follow-up at 3, 6, 9, and 12 months.

Results: Hyamax® Volumizer was superior in improving chin retrusion at 6 months with a GCRS response rate of 57.14% versus 0% of the controls (P<0.0001) meeting the primary effectiveness objective. The GCRS and GAIS scores by subjects and evaluators achieved remarkable improvement at all follow-up points compared with the control group through 12 months. Common ISRs were injection-site pain (90.48%), tenderness (80.95%), redness (47.62%) and ecchymosis (19.05%). No serious treatment-related advert events were reported.

Conclusion: Hyamax® Volumizer significantly restored the facial volume and improved the chin projection with safety.

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: Breast asymmetry occurs when there is a discrepancy in the shape, volume, or positioning of the breasts. Various factors, including unequal development of breast buds, endocrine disorders, chest wall deformities, and surgical or posttraumatic sequelae, can contribute to this condition. Although breast asymmetry is common, clinically severe cases are rare and often require surgical correction because of potential postural, aesthetic, and psychological issues. Accurate assessment of the breast volume is crucial for planning and evaluating surgical interventions.

Methods: This prospective, non-randomized, interventional study was conducted between 2019 and 2024 at the Breast Reconstruction Section of the Federal University of São Paulo, Brazil. Forty patients with breast asymmetry were evaluated using the BREAST-V, which calculates the breast volume based on three linear measurements. Patients underwent various surgical procedures, including augmentation, reduction mammoplasty, and mastopexy, tailored to their specific type of asymmetry. Preoperative and postoperative breast volumes were compared to assess the effectiveness of surgical correction RESULTS: The study included 40 participants, with an average age of 25.2 years. The mean preoperative breast volumes were 469.6 g (right) and 448.8 g (left). The postoperative volumes decreased to 338.3 g (right) and 331.1 g (left), showing an average reduction in asymmetry of 72.9%. The minimal clinically important difference (MCID) for pre-treatment asymmetry was 65.4 g.

Conclusion: The BREAST-V tool has significant potential for the objective assessment of breast asymmetry. Reliable volumetric measurements can aid in surgical planning and postoperative evaluation, ultimately enhancing the clinical outcomes.

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: The formation of infraorbital dark circles involves various factors including hyperpigmentation, skin aging and laxity. This study is to investigate whether cell-free fat extract (CEFFE) inhibits melanin synthesis and improves the appearance of infraorbital dark circles.

Methods: Imaging systems analysed the melanin content in three groups of zebrafish embryos treated with 0 (CTRL), 100, and 200μg/mL of CEFFE. Eleven patients with infraorbital dark circles were enrolled and received intradermal injections of autologous CEFFE. Clinical trial assessments included subjective assessments (Global Aesthetic Improvement Scale and Likert satisfaction scale) and objective assessments (standard two-dimensional photographs, VISIA® photographs, and infraorbital skin colour measurement).

Results: In the experiment of zebrafish embryos, the melanin content of CEFFE treatment was significantly reduced. In clinical trial, 72.73% of patients considered CEFFE treatment for infraorbital dark circles to be effective, and more than half of the patients were satisfied with the treatment. In the evaluation of skin colour at the inner, middle, and outer edges of the infraorbital dark circles, there was a gradual improvement in infraorbital skin colour after each treatment and at the 3-month follow-up, with a statistically significant improvement in skin colour on the outer edge of the infraorbital dark circles (p < 0.05). Simultaneously, we observed a reduction in periocular wrinkles, with a significant difference at the 3-month follow-up (p < 0.05). The events observed included bruising, erythema, and oedema, which resolved spontaneously.

Conclusion: Our study demonstrated that CEFFE inhibits melanogenesis and is a safe and effective treatment for infraorbital dark circles.

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: Efficient pain control is essential in reconstructive surgeries, particularly in procedures involving the harvest of costal cartilage. This study examines and compares different pain relief treatments using a network meta-analysis (NMA) to determine the most effective techniques for managing pain.

Methods: We performed a systematic review and network meta-analysis (NMA) by scanning several databases such as PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI), Wanfang, and Weipu till March 18, 2024. The review analyzed randomized controlled trials and observational studies that evaluated the effectiveness of local anesthetics and multimodal analgesia techniques in treating postoperative pain following costal cartilage harvest. Primary outcomes were pain scores at 6-, 12-, 24-, and 48-h post-surgery, while secondary outcomes included the need for rescue analgesia and opioid-related adverse effects.

Results: Fourteen studies involving 935 participants were included. The analysis revealed that multimodal strategies, particularly 'Methylene Blue and Ropivacaine Intercostal Nerve Block (MB & Ropivacaine ICNB) combined with Patient-Controlled Analgesia (PCA),' were the most effective techniques to reduce pain scores across 6, 24, and 48-h time points. "Pre-operation SAPB & PSB + PCA" was most effective in reducing pain score at 12h and significantly decreased the need for rescue analgesia and opioid-related adverse effects. In contrast, traditional ICNB with single drug consistently showed the least efficacy.

Conclusion: The results of our study strongly support the use of multimodal analgesic techniques instead of typical single medication ICNB for managing postoperative pain after costal cartilage harvest. These strategies not only provide superior pain control but also contribute to reducing the dependency on opioids, aligning with current clinical priorities to enhance recovery and minimize opioid-related risks.

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 .

Background: Although thread lifting is a widely performed method, the degree of initial lifting and sustainability varies based on how the threads are inserted into the skin layers. This study aimed to perform thread lifting on 43 patients to achieve maximum lifting effects using thicker threads in the deeper layers of the subcutaneous fat layer and thinner threads in the shallower layers.

Methods: Immediately after the procedure, we measured the depth of the inserted threads using ultrasonography and evaluated the results based on patient satisfaction and the global aesthetic improvement scale (GAIS). At the end of the procedure, an upright position was employed to check for dimples or irregularities, and intraoral observation was also conducted.

Results: Patient satisfaction significantly increased immediately after the procedure compared to that before the procedure. High GAIS scores were maintained even after 6 months, indicating high satisfaction with the procedure.

Conclusions: Inserting threads into multiple layers was deemed more effective than inserting them into a single layer. Thread lifting on 43 patients was used to maximize lifting effects by utilizing thicker threads in deeper subcutaneous fat layers and thinner threads in shallower ones. Our procedure maintained high global aesthetic improvement scale (GAIS) scores even after 6 months, indicating patient satisfaction. Multiple layers were shown to be more effective than a single layer for thread insertion.

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 .

Introduction: The large mixture of races in Brazil gives the nose its distinctive composition, which makes rhinoplasty difficult for these patients. Every patient should have their anatomy thoroughly examined on an individual basis, as there is no unique strategy that works for all situations.

Methodology: This is a narrative overview of the last 10 years' worth of literature that describes the ethnic traits of each nose, with a particular emphasis on the Brazilian nose, and talks about the major surgical approaches that can be applied in these situations.

Results: The low dorsum, broad nasal bones, thick skin, and bulbous tip are the primary features of the Brazilian nose. Many times, lateral osteotomies, root grafting, isotretinoin treatment for skin thickness, and neodomus formation are required.

Conclusion: The Brazilian nose presents a surgical challenge that calls for the mastery of multiple procedures, not simply structured rhinoplasty. In certain cases, preservation rhinoplasty may even be used.

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 .