Aesthetic Plastic Surgery最新文献

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 .

Background: Venous thromboembolism (VTE) remains a critical concern in plastic and reconstructive surgery (PRS) due to prolonged operative duration, perioperative immobility, and procedure-specific risks. While low-molecular-weight heparin (LMWH) has been the prophylactic standard, use of direct oral anticoagulants (DOACs) and aspirin (ASA) has been gaining traction. This study summarizes prophylactic practices in PRS.

Methods: A systematic search of three databases was conducted. Studies evaluating ASA, DOACs, or LMWH prophylaxis in PRS with VTE, bleeding, or 30-day reoperation rates were included. Mixed anticoagulant regimens were excluded. Data on dosage, duration, and complication rates were extracted. A random-effect meta-analysis of proportions was conducted.

Results: Of 884 studies screened, 7 met inclusion criteria, totaling 3,475 patients: ASA (n=402), DOACs (n=2056), and LMWH (n=802). Common regimens included ASA 325mg daily for 5 days and DOAC 10mg daily for 10 days; LMWH dosing varied. VTE rates were low across groups: 1.15% ASA, 0.3% DOACs, and 0.44% LMWH. Hematoma rates were similar for ASA (4.6%) and LMWH (4.5%), while DOACs had a higher rate (8.7%), largely influenced by an outlier. Reoperation rate was highest for ASA (16.9%), followed by DOACs (10.5%) and LMWH (8.0%).

Conclusion: Despite comparable VTE rates across agents, variability in bleeding and reoperation highlights the need for procedure-specific, individualized prophylaxis. ASA and LMWH may offer more predictable safety profiles, while DOACs remain promising but warrant further investigation 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: Rhinoplasty is a complex operation that warrants careful consideration of both functional and aesthetic principles. Despite its prevalence within plastic surgery and otolaryngology-head and neck surgery fields-its exposure and education are highly variable among training programs. The purpose of this study is to identify the various supplemental methods utilized outside of the operating room for educating residents on the technical and clinical aspects of rhinoplasty and evaluate the outcomes associated with various educational approaches.

Methods: A scoping review was conducted using the PubMed/MEDLINE database using a combination of the following key terms: "rhinoplasty," "rhinoplasty education," and "resident training." Articles were included that 1) discussed methods of educating residents on the technical and clinical aspects of rhinoplasty and 2) reported outcomes to objectively assess such methods.

Results: Thirteen studies were included in the analysis. The majority of the studies discussed three-dimensional printed models and surgical simulators, followed by cadaver laboratories, detailed rhinoplasty educational programming, and video-assisted learning tools. In terms of assessed outcomes, surveys were utilized to assess residents' confidence before and after intervention, test their knowledge on various clinical aspects, and their perceived effectiveness of these tools.

Conclusion: This study highlights the various measures taken to provide education and instruction on rhinoplasty. Beyond intra-operating teaching and modeling, surgical simulators are highly effective and valuable for residents to practice technical maneuvers; however, future efforts leveraging artificial intelligence and software technologies can help further improve rhinoplasty education.

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 .