Aesthetic Plastic Surgery最新文献

Background: Capsular contracture (CC) remains one of the most common complications following breast implant surgery, yet its underlying mechanisms are not fully clarified. The mechanosensitive ion channel Piezo1 has been implicated in fibrotic processes across various organs; however, its role in breast implant-associated fibrosis remains unknown.

Objective: This study aimed to investigate the expression and functional significance of Piezo1 in the pathogenesis of breast implant-associated capsular contracture.

Methods: Using a murine silicone-implanted model, we analyzed expression of Piezo1 during capsule formation. Human capsular tissues (normal and contracted) were examined for Piezo1 expression. A lipoteichoic acid (LTA)-induced contracture model was employed to assess the therapeutic effect of GsMTx4, a specific Piezo1 inhibitor. Evaluations included histology, immunofluorescence, and Western blot analysis.

Results: Piezo1 expression was significantly upregulated during early capsule formation in mice, showing a correlating with collagen deposition and capsular thickening. Patients contracted capsules exhibited markedly higher Piezo1 levels compared to normal capsules. In the LTA-induced contracture model, pharmacological inhibition of Piezo1 with GsMTx4 substantially reduced collagen deposition, capsular thickness, and Piezo1 expression levels.

Conclusion: Our findings establish Piezo1 as a critical mediator in the pathogenesis of breast implant-associated capsular contracture. The channel's dynamic expression and the efficacy of its inhibition highlight its pivotal role in the fibrotic process. Piezo1 represents a novel target, offering a promising therapeutic strategy for preventing this challenging complication.

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 .

Cleft lip nasal deformity poses significant surgical challenges due to its multidimensional anatomical distortions and dynamic biomechanical interactions. Conventional approaches relying on two-dimensional imaging and empirical judgment fail to address the three-dimensional tissue mechanics governing nasal symmetry and airway function. This review demonstrates how finite element analysis (FEA) transforms cleft nasal reconstruction by integrating biomechanical precision with clinical translation. Patient-specific modeling based on CT/MRI data enables FEA to quantify stress-strain distributions during physiological loading, surgical manipulation, and long-term growth. Critical applications span multiple anatomical subunits including osseous, cartilaginous, muscular, and airway components. Closed-loop systems combining preoperative simulations with postoperative validation establish FEA as a transformative tool for precision reconstruction. We propose standardized "clinical data-FEA modeling-surgical validation" protocols to advance population-based biomechanical models toward personalized surgical navigation.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: Scarring, a form of tissue fibrosis, is an unavoidable outcome of wound healing and can lead to cosmetic, functional, and psychological burdens. While both surgical and non-surgical treatments are available, non-invasive topical therapies are generally more acceptable to patients and easier to maintain over the long-term. Despite the availability of various anti-scar products targeting inflammation, hydration, and mechanical tension, there is a lack of comparative data on their individual and combined efficacy. Therefore, evidence-based guidance is needed to optimize scar prevention strategies.

Methods: Full-thickness linear wounds were established on the dorsal skin of C57BL/6 mice. After re-epithelialization, mice were randomly assigned to receive one of eleven single treatments or one of four combination regimens over a 14-day period. Scar width measurements, histological assessments, and immunohistochemical analyses targeting TGF-β1, α-SMA, and collagen type I and type III were conducted on postoperative day 28.

Results: All single therapies reduced scar width compared to the control, with Centella asiatica-chitosan and tension reducer groups showing the most notable outcomes. Combination therapies, particularly triple-combination strategies (ointment + silicone-based product + mechanical interventions), achieved superior scar inhibition and more favorable molecular profiles, including reduced TGF-β1, α-SMA, collagen type I expression, and elevated collagen type III levels. These benefits appeared to reflect complementary and possibly synergistic mechanisms across pharmacologic, silicone-based, and mechanical pathways, rather than simple additivity.

Conclusion: Both single and combination interventions exhibited measurable anti-scar effects, but triple-combination strategies-especially those integrating biochemical and biomechanical modulation-produced the most significant improvements. These findings support the clinical adoption of mechanism-guided combination therapies for optimized scar prevention and treatment.

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 .