Aesthetic Plastic Surgery最新文献

Introduction: Hand rejuvenation addresses aging-related changes such as subcutaneous fat loss, skin degradation, and photodamage. Autologous fat transfer (AFT) has emerged as a promising treatment, offering durable volume augmentation and regenerative effects. This study aims to systematically review the evidence on the techniques, outcomes, and complications of AFT for hand rejuvenation.

Methods: A systematic review was conducted following the PRISMA guidelines, searching databases such as MEDLINE, SCOPUS, DOAJ, and PUBMED from inception to April 2024. Inclusion criteria were studies reporting on hand rejuvenation using fat grafting, including randomized clinical trials, observational studies, case reports, and case series. Data extraction and risk of bias assessment were performed independently by multiple reviewers blindly.

Results: Eleven studies published between 2001 and 2019 were included, comprising 303 patients with a strong female predominance. Study designs varied, with three randomized clinical trials, seven case series, and one prospective study. High satisfaction rates were consistently reported, with complications being generally infrequent and minor. Various fat grafting techniques were employed, with manual aspiration being the predominant fat harvesting method. Follow-up periods ranged from 5 to 38 months, facilitating thorough evaluation of treatment outcomes.

Conclusion: AFT for hand rejuvenation is effective and safe, offering high patient satisfaction and minimal complications. Long-term fat retention and regenerative effects of adipose-derived stem cells contribute to success. However, fat graft resorption may require multiple treatments. Future research should standardize assessment tools, volumetrically measure graft resorption, and conduct high-quality trials to optimize protocols.

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.

Introduction: Silicone Lymphadenopathy (SL) is a complication of breast implants that involves migration of silicone to nearby soft tissue/lymph nodes. Data on its clinical features and management is scarce. We aimed to identify the clinical presentation and management of SL.

Methods: A single-institution retrospective cohort study was conducted from our institutional imaging system where search terms "Silicone lymphadenopathy", "silicone adenitis" and "silicone adenopathy" were used to identify patients with SL (January 2016-September 2023). Patient demographics, clinical features, imaging findings, pathological investigation, and treatment were obtained from the medical records.

Results: Of 52 patients with SL, breast augmentation accounted for 90.4% of the implant placements. All patients had silicone implants placed at some time. A significant portion of patients (69.3%) were asymptomatic, while 7.7% had non-tender lymphadenopathy, 19.2% experienced painful lymphadenopathy, and 1.9% presented with mixed symptoms. Implant rupture was observed in 88.7% of cases; 13.0% intracapsular, 26.1% extracapsular, 15.2% both, and unknown in 45.7%. Axillary nodes were the most commonly involved (86.5%), and ultrasonography was most commonly used to detect SL (80.7%). Biopsy was performed in 17.3% of cases, confirming benign pathology in all cases. No patients required surgical excision of lymph nodes for management of SL.

Conclusion: Most patients with SL are asymptomatic and are managed with observation. Biopsy and surgical intervention should be reserved for those patients with abnormal imaging or persistent symptoms. Evaluation of lymphadenopathy is essential to exclude malignancy in patients with a history of breast cancer.

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 .

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 .

Introduction: Surgeons prioritize scar appearance after surgery, making suture choice crucial. Traditionally, non-absorbable sutures were standard but require removal, causing patient discomfort and extra visits. Absorbable sutures, while offering convenience, might raise concerns about scar quality. This study aims to provide an overview of the plastic surgery literature and clinically based evidence of the efficacy and outcome of absorbable and non-absorbable sutures.

Methods: A systematic review of search databases in MEDLINE, EMBASE and the Cochrane Library was made to identify studies related to absorbable and non-absorbable sutures. The inclusion criteria for this study included RCTs comparing AS and NAS in plastic hand surgery, without any limitations of age or sex on recruited patients.

Results: A total of 532 hands were treated with a combined sample size of 517 patients undergoing plastic hand surgery. Two hundred seventy-three (51%) of patients had their wound closed with non-absorbable sutures, and 259 (49%) had absorbable sutures. Overall patient satisfaction among the studies that reported number of patients satisfied with the wound closure appearance was 64 (64%) in non-absorbable sutures cohort and 58 (59%) in absorbable sutures. Wound inflammation happened in 8 (3%) of wounds closed with non-absorbable sutures and in 9 (3.4%) of wounds closed with absorbable sutures.

Conclusion: In both patients cohorts, the overall patient satisfaction and complication rates were not significantly different. Non-absorbable sutures appeared to have slightly higher patient satisfaction rates. However, absorbable sutures may offer some benefits in terms of convenience with lower risk of wound dehiscence.

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: Gender-affirming surgery (GAS) for transgender females developed relatively late and limited in China due to some reasons. To introduce GAS surgical experiences for Chinese transgender females is necessary.

Aims: To report surgical choices and experience including clitoral/urethral reconstruction, vaginoplasty, and vulvoplasty, and their outcomes.

Methods: A single-center, retrospective case series was conducted among transgender females who underwent GAS between September 2018 and March 2023. Surgical outcomes were evaluated including short-term and long-term complications. Scar-Q Scale, Female Sexual Function Index (FSFI), Amsterdam Hyperactive Pelvic Floor Scale-Women (AHPFS-W), and Female Genital Self-Imaging Scale (FGSIS) were carried out for outcome evaluation.

Results: Thirteen transgender females underwent GAS. Among them, 7 patients underwent sigmoid colon vaginoplasty, 3 patients underwent zero-depth vaginoplasty (ZDV), and 3 patients underwent vaginoplasty using skin flap (penile or scrotum). Postoperative follow-up showed that for sigmoid colon neo-vagina, vaginal length can reach 10-15 cm, with a width of about 2 fingers. For skin flap neo-vagina, the long-term vaginal length can maintain at around 8-10 cm, with a width of about 2 fingers. AHPFS-W outcome shows that patients undergoing sigmoid colon vaginoplasty and ZDV have relatively better pelvic floor muscle function. Patients undergoing skin flap vaginoplasty scored higher on the FGSIS, indicating a higher level of self-acceptance toward reconstructed genitalia.

Discussion: Factors like anatomical characteristics, sexual customs and cultural backgrounds may alter the choice of GAS techniques for Chinese transgender females. The GAS surgical experience specialized to Chinese transgender females is necessary to share.

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: Bibliometric analyses of software applications in plastic surgery are relatively limited. This study aims to address this gap by summarizing current research trends and providing insights that may guide future developments in this field.

Methods: Data were retrieved from the Web of Science Core Collection. Visualized results, including publication characteristics, disciplines, journals, documents, countries/regions, institutions, authors, and research focuses, were analyzed and optimized using CiteSpace and the "Results Analysis" and "Citation Reports" functions in WoSCC.

Results: A total of 339 publications were identified through manual screening, indicating a general upward trend in annual publications and citations. Key research areas in this field include computer-aided design, modeling, virtual reality, augmented reality, artificial intelligence, social media software, telemedicine, and mobile health. However, challenges such as the high costs of advanced tools, the need for specialized training, and concerns regarding data security and patient privacy are significant barriers. Addressing these issues could be crucial for broader adoption. Despite these obstacles, the potential benefits offered by these technologies suggest their increasing relevance in plastic surgery.

Conclusion: Plastic surgery appears to be evolving toward a more standardized, digitalized, and intelligent future. Software has the potential to transform traditional workflows in both research and practice, contributing to improvements in efficiency and precision in the field.

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: Periorbital aging is a complex phenomenon that involves multiple layers of facial anatomy, including bone, fat, and globe. While previous studies have predominantly focused on age-related changes in facial fat compartments, this research aims to provide a comprehensive understanding of all periorbital components, including upper and lower orbital fat, orbital cavity volume, globe volume, and globe position, in the context of aging.

Methods: We conducted a retrospective study involving 118 patients (236 subjects) aged 18-99 years who underwent brain MRI using a 3 Tesla MR system. Baseline demographics and various parameters pertaining to periorbital aging were collected, and comprehensive measurements were obtained through meticulous radiological analysis.

Results: Our findings revealed distinct patterns of age-related changes in the periorbital region. Upper orbital fat remained stable with age, while lower orbital fat exhibited a substantial increase in both anterior and posterior compartments. Notably, orbital cavity volume expanded with bony resorption, while eye globe volume decreased, contributing to an enophthalmic appearance. We observed no vertical displacement of the globe with aging.

Conclusion: This study provides a comprehensive overview of the multifaceted anatomical changes that occur in the periorbital region with aging. The insights gained from this research offer important clinical implications for addressing the signs of periorbital aging, guiding surgical interventions, and ultimately enhancing patient 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: Artificial intelligence (AI) technologies use a three-part strategy for facial visual enhancement: (1) Facial Detection, (2) Facial Landmark Detection, and (3) Filter Application (Chen in Arch Fac Plast Surg 21:361-367, 2019). In the context of the surgical patient population, open-source AI algorithms are capable of modifying or simulating images to present potential results of plastic surgery procedures. Our primary aim was to understand whether AI filter use may influence individuals' perceptions and expectations of post-surgical outcomes.

Methods: We utilized Amazon's Mechanical Turk platform and collected information on prior experience using AI-driven visual enhancement. The cohort was divided into two groups: AI-exposed and non-AI-exposed. Questions gauged confidence in plastic surgery's ability to meet participant expectations. A second survey exposed users to either AI-enhanced or to unenhanced pre-operative photographs. Then, unedited post-operative photographs were shown and surgery's ability to enhance appearance was assessed. A multivariable linear analysis was constructed to measure associations between exposure to AI enhancement and survey outcomes.

Results: A total of 426 responses were analysed: 66.9% with AI exposure and 33.1% with no prior exposure. Participants with previous experience using AI-driven enhancers had a significantly higher average score for expectations after plastic surgery (P < 0.001). This finding was true across all outcomes, including surgery's ability to relieve discomfort with appearance/self-esteem (P < 0.001), to avoid post-operative complications (P < 0.001), to decrease post-operative scarring (P < 0.001), and to improve overall appearance (P < 0.001). The image comparison survey revealed that post-operative images were viewed as more successful at improving appearance when no pre-operative filter was applied (P = 0.151).

Conclusion: Exposure to AI photograph enhancement may significantly raise expectations for plastic surgery outcomes and may predispose to having lower satisfaction after surgery. The significance of this study lies in its potential to reveal the extent to which AI technologies can shape patient understanding of their plastic surgery outcomes. Plastic surgeons aware of the effect of AI enhancement may consider using these results to guide counselling.

Level of evidence iii: his 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 legalization and changing perception of marijuana have led to a significant increase in its use. Although studies exploring marijuana's physiological effects have grown, its effect on surgical outcomes remains unclear. This study investigates the influence of marijuana consumption on postoperative complications in patients undergoing abdominal body contouring surgeries such as abdominoplasties and panniculectomies.

Methods: A retrospective chart review was conducted on patients who underwent abdominal body contouring procedures at an urban academic institution from 2016 to 2021. Data collected included demographic characteristics, marijuana consumption (active use, former use (last use 6 weeks prior to surgery), or never user), preoperative comorbidities, tobacco usage, operative characteristics, and postoperative complication data within 90 days.

Results: A total of 815 patients were included, with 61 patients (7.5%) reporting active marijuana use, 31 patients (3.8%) reporting former marijuana use, and 723 (88.7%) reporting never using marijuana. The average age was 45.32 (SD 11.31), and the average BMI was 29.85 (SD 4.44). At the time of surgery, patients with any history of marijuana use had an increased risk of complications (OR=1.96; p = 0.006), and active marijuana users had a significantly higher risk of hematoma formation (OR = 3.02; p = 0.013).

Conclusions: Active marijuana use was significantly associated with an increased risk of postoperative hematoma formation following abdominal body contouring surgeries. These findings suggest the need for routine preoperative screening and tailored risk-reduction strategies for marijuana users.

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 .