Aesthetic Plastic Surgery最新文献

Background: Polyacrylamide hydrogel (PAHG) is a new biomaterial that emerged in the last century and has been widely used in human filler procedures, such as injectable breast augmentation and facial contour improvement. However, as the implantation time of the material increases, various complications have been reported, which reflects that the safety of this material has not been adequately studied. Therefore, a more in-depth experimental analysis becomes particularly important.

Methods: We collected lesion tissues from six patients with PAHG facial injection. The lesion tissues were examined histologically and molecularly.

Results: Complications caused by PAHG facial injection included pain, subcutaneous nodules, swelling and gel displacement. Western blot revealed decreased expression of neural tissue markers, and increased expression of macrophage markers and oxidative stress-related factors. The results of this study provide new insights into the mechanism and development of PAHG facial injection complications.

Conclusion: This report explores the possible mechanism of PAHG complications after facial injection from a new perspective of oxidative stress and inflammation for the first time, which provides a reference for researchers and clinicians to further understand the characteristics of materials and strictly control surgical indications to reduce complications.

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 the infraorbital canal (IOC) and maxillary sinus (MS) have been well studied, understanding the effect of MS volume (MSV) on IOC morphology is critical in determining the safest surgical route for infraorbital depression and transmaxillary procedures.

Objectives: We aimed to describe the IOC types, measure the MSV and IOC angles (IOCA) in all three planes, and analyse the relationship between them using three-dimensional (3D) cone beam computed tomography (CBCT) images.

Methods: CBCT images of 280 patients were analysed to identify the IOC types and accessory IOC (IOCa), and to measure morphometric parameters. The relationship between them was examined using statistical analysis in relation to age, gender, and laterality.

Results: The most common IOC type was Type I (59.6%), followed by Type II (21.8%), Type III (13.6%), and Type IV (5%). According to MSV, three types of MS were described, with 38.2, 34.6, and 27.2% having normal, hypoplastic, and hyperplastic MS, respectively. Also, hyperplastic MS was associated with the highest likelihood of Type III IOC. Furthermore, logistic regression model revealed that the MSV and IOCA3 had a positive significant effect on the IOC protrusion, whereas being female, increasing age and IOCA1 had a negative significant effect on MS pneumatization. The probability of having hyperplastic MS, Types II and III IOC, IOCa also decreased with increasing age.

Conclusions: Using 3D technology, the results of this study provide a detailed classification of IOC and MS types, increasing the number of treatment options and reducing the risk of complications during surgery.

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 .

Introduction: Rhinoplasty surgery involves multiple specialties and often leads to respiratory and olfactory complaints. This study examines the impact of rhinoplasty on nasal function and patient satisfaction, aiming to enhance quality of life.

Objective: To assess the effect of rhinoplasty on nasal breathing and olfactory function.

Materials and methods: This longitudinal, single-center study included 62 patients undergoing rhinoplasty from April 2023 to April 2024. We evaluated nasal obstruction, olfactory function, and patient satisfaction using NOSE, ROE, and SAOQ scales at baseline, 6 months, and 1 year post-surgery.

Results: Rhinoplasty significantly improved nasal obstruction and satisfaction with nasal appearance. Notably, nasal obstruction decreased and patient satisfaction increased from baseline to 1 year post-surgery. Males reported greater satisfaction improvement compared to females, while smokers experienced more nasal obstruction at 1 year. Age and nasal trauma history had minimal effect on outcomes. Most patients reported relief from nasal congestion and improved olfactory function post-surgery.

Conclusion: Rhinoplasty enhances nasal function and appearance, with smoking impacting long-term results. Future research should explore diverse populations and the long-term effects of rhinoplasty.

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 .

In dorsal preservation rhinoplasty (DPR), approaching the septum with a subdorsal flap (or Cottle technique) classically requires two pillars. If either of these are compromised, despite release of all blocking points, the dorsal contour may not flatten adequately. The first is the caudal pillar, exemplified by the caudal fixation of the septal flap to a stable underlying structure. The subdorsal flap is sutured to the remnant caudal strut of septal cartilage, which remains attached to the maxillary spine, to secure the dorsum in its new extended and reduced position. However, in cases where the caudal septum must be replaced, tensioning the subdorsal flap on the anterior septal reconstruction (ASR) may introduce undesirable posterior and superior forces on the strut, and in turn lack the stability needed for adequate dorsal reduction. The second is the cephalic pillar, typically a stable PPE beneath the radix osteotomy. In some cases, the PPE may be unintentionally disrupted or the sub-radix PPE may be over-resected, resulting in loss of control at the radix. In this situation, the dorsum may not adequately flatten. The senior author (SPM) has successfully utilized a novel dorsal flattening suture (DFS) in situations where one of these pillars is compromised. The most common example would be the anterior septal reconstruction, a modified extracorporeal septoplasty technique.¹ Using the DFS, a single suture technique tightens and flattens the dorsum independently, freeing an ASR graft from the posterior forces of the subdorsal flap. The senior author has used the DFS successfully to correct deviated noses and caudal septal deviations with DPR.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: Infraorbital dark circles have become a troubling issue for many young people, giving a tired and aged appearance. A significant portion of these dark circles is caused by structural deformities in the lower eyelid area. Many treatment methods have been introduced for the treatment of structural dark circles (SDC). Among the treatment options, autologous fat grafting appears to be an effective approach for treating SDC in young individuals.

Methods: This study evaluated patients with SDC who underwent autologous fat grafting between December 2021 and August 2023. The proposed technique involved a deep-level ligament releasing injection using micro-fat, while the superficial layer was treated with stromal vascular fraction gel extracted from the micro-fat.

Results: A total of 88 patients enrolled in the study had an average age of 25.4 ± 3.1 years. Throughout the follow-up period (averaging 11.2 months), notable improvements in SDC and tear trough deformity were maintained without any major complications. Patient satisfaction, as self-assessed post-procedure questionnaires, revealed that 40.9% were very satisfied, 56.8% were satisfied, and 2.3% were neutral regarding the outcomes.

Conclusions: The autologous fat grafting technique we proposed is both effective and reliable, offering high patient satisfaction with minimal risk of complications. Long-term results have proved its effectiveness for young individuals with SDC.

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 .

OpenAI, telemedicine, and mHealth have great potential in aesthetic plastic surgery, but their full potential has yet to be realized. Trends and research in this field have not been comprehensively evaluated using bibliometric tools. Therefore, this study aims to address these gaps by conducting a bibliometric analysis of the integration of mHealth, telemedicine, and OpenAI in aesthetic plastic surgery. Relevant publications were obtained through a comprehensive and validated search query. The SciVerse Scopus database was utilized, with the study spanning from January 1, 2015, to December 31, 2024. This study examined 776 publications on the integration of OpenAI, telemedicine, and mobile health (mHealth) in aesthetic plastic surgery. Of these, 547 (70.49%) were original research articles, 123 (15.85%) were review papers, and 56 (7.22%) were letters. Over the years, the number of Scopus-indexed publications grew steadily until 2018, after which there was a noticeable increase in publication volume (R² = 0.9344; P < 0.001). The USA was the largest contributor, with 305 publications (39.3%), followed by the UK with 78 (10.05%), China with 65 (8.38%), and Italy with 53 (6.83%). Additionally, the theme of "implications of intelligent chatbots in clinical practise for plastic and reconstructive surgery" has become increasingly prominent in recent years, especially after 2022, highlighting a growing interest and emphasis in this area. This study provides a quantifiable overview of knowledge in the field, offering valuable evidence and guidance for future research, clinical applications, and educational efforts.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: Microtia usually presents as a unilateral defect often associated with hearing impairment and significant psychosocial challenges. Reconstruction with autologous rib cartilage is currently the gold standard due to lower complication rates. However, outcomes remain variable.

Aims and objectives: This study aims to assess the outcomes of a modified two-stage surgery technique, focusing on complications, aesthetics, satisfaction, and quality of life.

Materials and methods: A retrospective review of 130 patients undergoing ear reconstruction from 2016 to 2022 was conducted. Data included defect etiology, classification, and complications. Quality of Life was assessed using an adaptation of the questionnaire proposed by UK Care Standards for the Management of Patients with Microtia and Atresia.

Results: Most patients had congenital microtia (78%), with type III being the most common (81%). The majority were male (73%), with a mean age of 21 years. Surgeon-assessed outcomes were good in 90% of cases. The most common complication was partial skin necrosis (13%). Among 73 respondents (answer rate of 56%), there was a significant improvement in quality of life post-reconstruction (p = 2.4e-12).

Conclusion: Modifications to Firmin's technique, such as smaller thoracic incisions, limited dissection, and specific flap designs, enhanced aesthetic results while reducing complications. In conclusion, our modified technique offers improved outcomes in microtia reconstruction, emphasizing the importance of technical refinements in achieving satisfactory results and enhancing patient well-being.

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: Breast augmentation remains a leading cosmetic surgical procedure. Over the past two decades, various benefits and complications of pocket selection techniques have been described for breast augmentations. However, there has been limited evolution in the dissection technique sequence initially described by Tebbetts in his seminal publication.

Objective: We studied in detail the vascular anatomy of the pectoralis major and breast. We related the findings of anatomical dissections with the conclusions obtained by imaging and developed a systematic dissection sequence for creating a bloodless submuscular pocket.

Methods: Breast dissection was performed on ten fresh-frozen cadaveric tissues to observe vascular distribution mapping of the dual-plane pocket associated with the subpectoral space, and we replicated it in 727 female patients aged 18-66 years undergoing primary breast augmentation with a dual-plane pocket implant placement using a specific dissection sequence. Surgical data, implant information, patient demographics, and complications were systematically collected.

Results: The mean patient age was 30 years. Round implants were used exclusively, with 80.05% textured and 19.95% smooth. Implant sizes ranged widely from 150 cc to 450 cc. We identified the presence of eight perforator vessels within the breast in the cadaver dissections and observed a large retropectoral avascular space. These findings are correlated with the images obtained with indocyanine green (ICG). Consequently, we described four retropectoral zones based on the mapping of the perforators. Importantly, this approach significantly reduced the incidence of possible postoperative hematomas, demonstrating its potential to improve surgical outcomes.

Conclusion: This practical dissection sequence of the four retropectoral zones aims to shorten our learning curve for precision, safe, and a bloodless retro-muscular pocket dissection.

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: Breast reduction surgery is currently the most critical treatment for macromastia. Preoperatively, patients are not only concerned about the surgical outcomes and potential complications but also about the amount of breast tissue that can be resected. Previous studies have proposed formulas to predict the amount of resected breast tissue; however, these studies often suffer from limited variables and small sample sizes, leading to less accurate predictions. Therefore, this study aims to develop a more accurate predictive model for breast tissue resection in breast reduction surgery by incorporating a greater number of variables, providing better clinical guidance.

Methods: Retrospective data from 360 patients (711 sides) who underwent vertical-scar reduction mammoplasty were collected. The data included preoperative patient information such as age, height, weight, BMI, and breast surface measurements, along with the accurately measured weight of breast tissue resected from each side during surgery. Statistical analysis was performed on the data, and multiple linear regression was used to determine the relationship between these variables and the weight of the resected breast tissue.

Results: The formula established is as follows: Breast tissue resection weight (g) = (15 × Sternal Notch-to-Nipple + 10 × Clavicle-to-Nipple + 23 × Nipple-to-Inframammary Fold + 10 × BMI + 6 × Inter-Nipple distance + 8 × Midline-to-Nipple)-1023.

Conclusions: This predictive model for breast tissue resection weight in vertical-scar reduction mammoplasty represents an empirical summary of clinical data. Implementing this model can aid surgeons in preoperatively estimating resection weight, ultimately improving surgical outcomes and increasing patient satisfaction.

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: Breast mastopexy poses unique challenges in achieving long-term results, particularly regarding the recurrence of ptosis. For this reason, different surgical techniques have been proposed, including those involving the use of additional devices at the lower pole to provide better support for the mammary gland. To address this issue, we conducted a prospective analysis aimed to evaluate the efficacy of incorporating the bioabsorbable scaffold GalaFLEX with mastopexy procedure in preventing recurrent ptosis during a 12-month follow-up period.

Methods: The study enrolled 60 patients undergoing primary mastopexy for correcting grade III breast ptosis. The cohort was divided into two groups (A and B). Group A underwent mastopexy with the addition of the bioabsorbable mesh sling to the lower pole of the breast, serving as an internal, subcutaneous supportive "bra". Group B received a standard mastopexy without the mesh support. Patients were followed up for 12 months to assess the outcomes.

Results: The nipple-to-inframammary fold distance was measured before the surgery and during the 1-month and 12-month follow-up checks between the study group (Group A) and the control group (Group B) as indicator of post-operative breast ptosis recurrence. From the 12th post-operative month onward, measurements in Group A showed a statistically significant difference (P < 0.05) compared to Group B, indicating a better maintenance of the long-term results in patients treated with GalaFLEX.

Conclusion: The incorporation of GalaFLEX matrix in mastopexy procedures provided an additional layer of support and demonstrated efficacy in delaying the reoccurrence of ptosis following surgery. This study confirmed the potential benefits of using a bioabsorbable mesh in mastopexy procedures to enhance long-term breast shape stability, offering to the plastic surgeons a valuable adjunct in the management of breast ptosis.

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 .