Aesthetic Plastic Surgery最新文献

Background: Non-surgical genioplasty is one of the best choices in cases of chin retrusion, and it represents a solution for the aesthetic amelioration of facial profile. Recent concerns arose about the risk of bone resorption and vascular occlusion. Different procedures and products may lead to different results. This study reports the experience of a single facial plastic surgeon (M.G.) using non-surgical techniques to fill the chin.

Methods: This retrospective study assesses 225 patients injected from January 2019 through March 2024 in private clinics in Milan (Italy), London (UK), and Dubai (UAE). Forty-five patients were injected with hyaluronic acid (Genefill DX 1x1 ml, BioScience GmbH, Dümmer, Germany), 90 underwent a lipofilling procedure, and 90 underwent a Dermgraft procedure, that is, a personalized lipofilling, modified by the main author. Half of the last 180 patients underwent shock waves before fat harvesting. Patients were followed up for 12 months, and facial angles and satisfaction data were analyzed. Three experts scored the results over time.

Results: After all the treatments, facial angles were corrected, but the maintenance of the results varied for the different treatments. Notably, at 3 months, the levels of satisfaction were higher for the HA filler treatment, while at 1 year, the levels of satisfaction were very high for the Dermgraft.

Conclusions: Liquid genioplasty is a safe technique to correct chin retrusion, with good results and high levels of patient satisfaction. The maintenance of the results varies according to the type of product injected.

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 .

Objective: Botulinum toxin type A (BTX-A) is a simple and effective method for treating drooping mouth corners. However, the effective dosage and injection sites remain controversial. The authors propose a triangular three-point injection technique and compare the effects of different dosages tailored to varying severity levels of drooping mouth corners.

Methods: Before the start of this prospective self-controlled study, subjects with drooping mouth corners received two treatment methods. First, participants received a single-point injection of 3 U of BTX-A per side. Four months later, an individualized approach was adopted, with 3-15 U of BTX-A injected at three sites per side based on severity. Data were collected at baseline and at 4- and 12-week follow-ups.

Results: Fifty-one subjects were enrolled. At 4 weeks after injection, both methods significantly improved drooping mouth corners, with the indicators returning to baseline levels by 12 weeks (P < 0.05). Based on clinical manifestations, subjects were categorized into mild, moderate, severe, and most severe cases, receiving 3 U, 6/9 U, 9/12 U, and 12/15 U per side, respectively. The results showed that 3 U/side for mild cases, 6 U/side for moderate cases, and 12 U/side for severe cases were the safest and most effective dosages, while most severe cases still did not achieve satisfactory results even at 15 U/side. Overall, at 4 weeks post-treatment, the reduction in the vertical distance from the mouth corner to the pupillary line and the angle of drooping were significantly greater with the triangular three-point injection technique compared to the single-point injection (P ≤ 0.05). No adverse events were observed in any subjects.

Conclusion: It is necessary to increase the injection dosage according to the severity of drooping mouth corners. The new triangular three-point injection technique is safe and demonstrates favorable clinical outcomes.

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 .

Background: Upper blepharoplasty is the most common cosmetic procedure in East Asia. A natural Asian double eyelid features specific crease characteristics. AI advancements, such as UNet and PointRend, enhance medical image segmentation, aiding in post-blepharoplasty evaluation. This study applies deep neural networks to analyze facial images, providing morphological parameters to assist surgeons in assessing outcomes and planning revisions.

Methods: This study included 102 eyes from 51 patients seeking for revisional blepharoplasty and 100 eyes from 50 volunteers with inborn double eyelid. Standardized images and videos were collected. The deep learning-based image analysis automatically evaluated four eyelid morphological parameters, including pre-tarsal show, corneal visibility ratio, dynamic value, and crease depth. Analysis was done on the agreement between the automated measures and the manual measurements. The parameters of the patients' and volunteers' eyelids were compared. FACE-Q surveys were used to measure patient-reported esthetic outcomes.

Results: The intraclass correlation coefficients between manual measures and automated measurements of pre-tarsal show, corneal visibility ratio, and dynamic value were 0.973, 0.975, and 0.965. At the long-term follow-up, the pre-tarsal show and crease depth decreased significantly, whereas the corneal visibility ratio and dynamic value increased significantly. FACE-Q scores demonstrated a high level of patient satisfaction for facial appearance (87.6) and were negatively correlated with pre-tarsal show (r = - 0.814, p = 0.000).

Conclusions: The deep neural network technique automatically measured the eyelid morphology with excellent precision and reproducibility, enabling an objective evaluation of the surgical outcomes for blepharoplasty.

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 .

Background: Vascular embolism is a common complication associated with the use of injectable fillers. Agarose gel, a novel filler, may have a lower risk of embolism. However, there are few studies investigated the embolism rate of agarose gel and other fillers. This study aims to compare the risk of rabbit retinal artery embolism caused by hyaluronic acid or agarose gel in vivo, as well as their dissolution characteristics in vitro.

Methods: The study used a rabbit model of retinal artery embolism. Agarose gel or hyaluronic acid was injected into the carotid artery at doses of 0.1, 0.2, and 0.3 mL (each group n = 6). A vascular clamp was used to redirect the material toward the internal carotid artery and retinal artery. The ocular fundus was observed before and after injection to assess embolism. In the dissolution experiment, both materials were dissolved in either saline or hyaluronidase, and their dissolution rate was recorded and quantified.

Results: We found that the embolism rate was significantly higher in the hyaluronic acid group especially in the HA_high group (83.3%) with no embolism observed for agarose gel. As the injection dose increased, the embolism rate in the HA groups increased. Agarose gel can be dissolved in saline and dissolved much faster (about 180s) compared to hyaluronic acid (about 456s) when treated with hyaluronidase (p < 0.001).

Conclusion: In rabbit retinal artery embolism model, agarose gel was a safe injectable filler with a low risk of vascular embolism in vivo and fast dissolution rate in vitro.

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 .

We read with great interest the recent "Lymphatic-Sparing Approaches and Liposuction Integration in Upper Body Lift Surgery" by Bruno (Aesth Plast Surg 2025, 10.1007/s00266-025-05369-8). This Letter to the Editor concerns the article "Lateral Tension Upper Body Lift: Zip-Shark Technique as a Surgical Procedure in Body Contouring after Massive Weight Loss" by Sharkov et al. (Aesthetic Plast Surg. 2025. 10.1007/s00266-025-05233-9) and Sharkov et al. (Body contouring surgery-the role of non-invasive, minimal invasive and surgical technologies, Springer, Heidelberg, 2023), and we commend the author for their detailed description on additional possibilities to further improve the results and reduce the possible side effects of our work.

Introduction: The two main features that are important in defining the attractiveness of the nose include the projection and rotation of the tip of the nose. Among many techniques, Strat and SEG are much more efficient. The purpose of this study is to compare these two methods in preserving and maintaining of the tip of the nose.

Research method: This study was conducted in two groups. Before, immediately after the operation and at intervals of six months and one year, distances and angles were measured with digital photo viewer software. Additionally, their satisfaction with the results of the operation was recorded on the basis of the prepared ROE questionnaire. Finally, the data were recorded in an Excel file and analyzed with statistical analysis software.

Findings: There was no significant difference in rotation before surgery between the two groups, but there was a significant difference in average rotation immediately after surgery. In addition, there was no significant difference between the averages at six months and 12 months after surgery. On the other hand, the preoperative projection did not significantly differ between the two groups. In addition, the mean projection immediately after surgery and six months later did not significantly differ between the two groups, but a significant difference was observed 12 months later.

Conclusion: Therefore, the SEG method has greater durability than columellar strut does in the long term and can maintain the shape of the nose for a longer period.

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 .